Role of Gastroscopy in Bariatric Surgery
Hesham Mohammed Wagdy Ezzel Din;
Abstract
Obesity is a global pandemic with an escalating prevalence, affecting both sexes and all age groups.It is associated with many harmful co-morbidities as diabetes mellitus, respiratory disturbances, systemic vascular disease, dyslipidaemias, and psychic disturbances and also an increased incidence of all cause mortality. The health care cost for the obese population threatens to overwhelm the available resources
Traditional conservative measures to treat obesity like life style modification, diet regulation, and drugs have been largely disappointing, as they achieve a weight loss of only 5-10% with a high recidivism rate. Bariatric surgery is the only means that achieves remarkable long-term weight loss and marked improvement or even remission of co-morbidities.
Upper GI endoscopy (gastroscopy) has been proved to be an integral part of the surgical management program of obesity. Preoperative gastroscopy is essential to detect upper GI pathologies that may alter or postpone surgery, such as hiatal hernia, reflux disease, and peptic ulcer disease, and also to take samples for H.pylori testing. Recent guidelines strongly recommend routine preoperative screening endoscopy before bariatric surgery.
Gastroscopy has a growing therapeutic role in obesity management. Endoscopic (endolumenal) bariatric therapy includes intra-gastric balloon insertion and removal, as a temporary measure to achieve weight loss especially before major surgery whether bariatric or non-bariatric. It also includes insertion of bypass liners, and gastric restrictive procedures that alters the stomach anatomy by restrictive plications inside the stomach (Primary Obesity Surgery Endolumenal or POSE). In fact, the enormous recent advances in endolumenal technology which are going on and never stop, have allowed the POSE procedure to be performed by multiple techniques, including suturing, stapling and anchoring diaphragm. Results of the POSE procedure regarding primary and secondary efficacy end-points are comparable to that of bariatric surgical procedures, added the safety and benefits of a minimally invasive intervention.
Traditional conservative measures to treat obesity like life style modification, diet regulation, and drugs have been largely disappointing, as they achieve a weight loss of only 5-10% with a high recidivism rate. Bariatric surgery is the only means that achieves remarkable long-term weight loss and marked improvement or even remission of co-morbidities.
Upper GI endoscopy (gastroscopy) has been proved to be an integral part of the surgical management program of obesity. Preoperative gastroscopy is essential to detect upper GI pathologies that may alter or postpone surgery, such as hiatal hernia, reflux disease, and peptic ulcer disease, and also to take samples for H.pylori testing. Recent guidelines strongly recommend routine preoperative screening endoscopy before bariatric surgery.
Gastroscopy has a growing therapeutic role in obesity management. Endoscopic (endolumenal) bariatric therapy includes intra-gastric balloon insertion and removal, as a temporary measure to achieve weight loss especially before major surgery whether bariatric or non-bariatric. It also includes insertion of bypass liners, and gastric restrictive procedures that alters the stomach anatomy by restrictive plications inside the stomach (Primary Obesity Surgery Endolumenal or POSE). In fact, the enormous recent advances in endolumenal technology which are going on and never stop, have allowed the POSE procedure to be performed by multiple techniques, including suturing, stapling and anchoring diaphragm. Results of the POSE procedure regarding primary and secondary efficacy end-points are comparable to that of bariatric surgical procedures, added the safety and benefits of a minimally invasive intervention.
Other data
| Title | Role of Gastroscopy in Bariatric Surgery | Other Titles | دور التنظير الداخلى للمعدة فى جراحة السمنة | Authors | Hesham Mohammed Wagdy Ezzel Din | Issue Date | 2015 |
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