The role of the endoscopist in a multidisciplinary obesity center

Abstract

GI endoscopists now have an integral role in the multidisciplinary treatment of obese patients undergoing bariatric surgery, particularly in the prevention and treatment of postoperative complications. Although it is controversial, routine preoperative upper endoscopy should be considered in all bariatric patients, especially those undergoing Roux-en-Y gastric bypass (RYGB) surgery. Endoscopists need to work in close coordination with their bariatric surgery colleagues in all phases of care in order to maximize the yield and safety of endoscopy in this patient population. The purpose of this article is to review the role of the endoscopist in a multidisciplinary obesity center as it pertains to the preoperative, intraoperative, and postoperative management of bariatric surgery patients. As the performance of bariatric surgery continues to rise in response to the obesity epidemic, GI endoscopists are becoming increasingly involved in the preoperative and postoperative care of patients who had bariatric surgery. The American Society for Gastrointestinal Endoscopy (ASGE) Standards of Practice Committee recently published its guidelines on the role of endoscopy in this patient population. 1 The purpose of this article is to complement those guidelines and to highlight the role of the endoscopist in a multidisciplinary obesity center as it pertains to the preoperative, intraoperative, and postoperative management of patients for bariatric surgery. THE ROLE OF PREOPERATIVE ENDOSCOPY