Current Endoscopic/Laparoscopic Bariatric Procedures

  • Elisabeth M. H. Mathus-Vliegen
  • Jérôme Dargent


The obesity epidemic requires an active involvement of the gastroenterologist for three reasons. The first reason is that many of the comorbidities associated with obesity involve the gastrointestinal tract and the gastroenterologist will meet these patients at the outpatient department. He/she should know that weight losses may ameliorate symptoms and, with substantial weight loss, promote cure of obesity-associated diseases. Secondly, a small proportion of severely obese patients will need bariatric surgery and may suffer from surgical complications that may be solved by minimally invasive endoscopic techniques. And finally, the majority will not be eligible for bariatric surgery and will need some other form of treatment. The first approach should consist of an energy-restricted diet, physical exercise and behaviour modification, followed by pharmacotherapy. For patients who do not respond to medical therapy but are not or not yet surgical candidates, an endoscopic treatment might look attractive. So, endoscopic bariatric therapy has a role to play either as an alternative or as an adjunct to medical treatment. The different endoscopic modalities may vary in mechanisms of action: in the stomach by gastric distension and space occupation, delayed gastric emptying, gastric restriction and decreased distensibility, impaired gastric accommodation, stimulation of antroduodenal receptors or vagal blockade, and in the small intestine by duodenal exclusion, diversion of the nutrient flow to lower intestinal regions and malabsorption. Minimally invasive procedures that need the assistance of laparoscopy will be discussed by the surgeon to conclude this chapter.


Overweight Obesity Endoscopic bariatric therapy Intragastric balloon Pharmacotherapy Anti-obesity drug Orlistat Orbera balloon ReShape Duo balloon Swallowable balloon Obalon balloon Endoscopic aspiration therapy AspireAssist Botulinum injection Gastric suturing Gastric plication POSE OverStitch Endoscopic sleeve gastroplasty Gastric stapling Duodenojejunal bypass liner Duodenojejunal bypass sleeve EndoBarrier Duodenal mucosal resurfacing Incisionless magnetic anastomotic system Gastric pacing Ability system Tantalus system Vagal blockade 



Adjustable balloon system


American College of Cardiology


Articulating circular endoscopic


Adverse event


American Heart Association


Angiopoietin-like protein


American Society for Gastrointestinal Endoscopy


American Society for Metabolic and Bariatric Surgery


Adjustable totally implanted intragastric prosthesis


Binge-eating disorder


BioEnterics Intragastric Balloon


Body mass index


Botulinum toxin A


Completers’ analysis




Confidence interval


Closed-loop gastric electrical stimulation


C-reactive protein


Dual-energy X-ray absorptiometry


Duodenojejunal bypass liner


Duodenojejunal bypass sleeve


Duodenal mucosal resurfacing


Excess BMI loss


Endoscopic bariatric and metabolic therapy


Endoscopic bariatric therapy


Eating disorders not otherwise specified


European Medicines Agency


Endoscopic sleeve gastroplasty


Endoluminal vertical gastroplasty


Excess weight loss


Food and Drugs Administration


Fibroblast growth factor


Garren-Edwards gastric bubble




Gastric inhibitory peptide or glucose-dependent insulinotropic polypeptide


Gastroduodenojejunal bypass sleeve


Glucagon-like peptide-1

H. pylori

Helicobacter pylori


Glycated haemoglobin


High density lipoprotein


Human immunodeficiency virus


High triglycerides


Intensive care unit




Intragastric balloon




Incisionless magnetic anastomotic systems


Incisionless operating platform




International unit


Laparoscopic adjustable (silicone) gastric banding


Low-density lipoprotein


Long segment


Monoamine oxidase


Monocyte chemoattractant protein-1


Modified intention-to-treat




Non-alcoholic fatty liver disease


National Institute for Health and Clinical Excellence


National Institute of Health


Normal Triglycerides


Obstructive sleep apnoea syndrome


Percutaneous endoscopic gastrostomy


Preservation and Incorporation of Valuable endoscopic Innovations


Primary obesity surgery endolumenal


Pancreatic polypeptide




Proton pump inhibitor


Peptide YY


Randomised controlled trial


Roux-en-Y gastric bypass


Semistationary antral balloon


Serious adverse event


Society of American Gastrointestinal and Endoscopic Surgeons


Sleeve gastrectomy


Silimed gastric balloon


Standard medical care


Short segment


Type 2 diabetes mellitus


Transmural antero-posterior endoscopic suture


Total body weight loss


Transoral endoscopic restrictive implant system


Transforming growth factor-1


Transoral gastric volume reduction


Tumour necrosis factor-α


Transoral gastroplasty


The Obesity Society


Transpyloric shuttle


Vagal blocking


World Health Organization



The author acknowledges J. Dargent for his help with the laparoscopic minimally invasive techniques.


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Elisabeth M. H. Mathus-Vliegen
    • 1
  • Jérôme Dargent
    • 2
  1. 1.Amsterdam UMC (University Medical Centres)AmsterdamThe Netherlands
  2. 2.Polyclinique Lyon NordLyonFrance

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