Endoscopic bariatric procedures: Assessment of postintervention safety and success

Morbid obesity has become one of the largest health care crises facing modern medicine. Medical intervention alone has proven inadequate in addressing this issue. Although bariatric surgery has been proven to be the most effective treatment for the medical comorbidities associated with morbid obesity, only a fraction of obese patients will undergo bariatric surgery owing to fear, financial restraint, and limited access to surgical expertise. There exists a void for which endoscopic therapies can provide substantial improvements in the care of the morbidly obese patient. Compared to traditional surgical therapies, endoscopic approaches may potentially speed recovery with decreased pain, incisional hernia development, and surgical site infections. Primary endoscopic bariatric procedures can be classified as space-occupying, restrictive, or bypass. These procedures, as well as foresight into endoscopic bridges to surgery and revisional approaches, are discussed herein.