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Review
. 2022 Jul 14:13:946870.
doi: 10.3389/fendo.2022.946870. eCollection 2022.

Endoscopic Management of Weight Recurrence Following Bariatric Surgery

Donna Maria Abboud  1 , Rebecca Yao  1 , Babusai Rapaka  1 , Rabih Ghazi  1 , Omar M Ghanem  2 , Barham K Abu Dayyeh  1
Affiliations
Review

Endoscopic Management of Weight Recurrence Following Bariatric Surgery

Donna Maria Abboud et al. Front Endocrinol (Lausanne). .

Abstract

Metabolic and bariatric surgery is the most effective therapy for weight loss and improving obesity-related comorbidities, comprising the Roux-en-Y gastric bypass (RYGB), gastric banding, sleeve gastrectomy (SG), and biliopancreatic diversion with duodenal switch. While the effectiveness of weight loss surgery is well-rooted in existing literature, weight recurrence (WR) following bariatric surgery is a concern. Endoscopic bariatric therapy presents an anatomy-preserving and minimally invasive option for managing WR in select cases. In this review article, we will highlight the endoscopic management techniques for WR for the most commonly performed bariatric surgeries in the United States -RYGB and SG. For each endoscopic technique, we will review weight loss outcomes in the short and mid-terms and discuss safety and known adverse events. While there are multiple endoscopic options to help address anatomical issues, patients should be managed in a multidisciplinary approach to address anatomical, nutritional, psychological, and social factors contributing to WR.

Keywords: Roux-En-Y gastric bypass; endoscopic sleeve gastroplasty; metabolic and bariatric surgery; sleeve gastrectomy; transoral outlet reduction; weight recurrence.

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Conflict of interest statement

Author BA is a consultant for Endogenex, Endo-TAGSS, Metamodix, and BFKW; consultant and grant/research support from USGI, Cairn Diagnostics, Aspire Bariatrics, Boston Scientific; Speaker roles with Olympus, Johnson and Johnson; speaker and grant/research support from Medtronic, Endogastric solutions; and research support from Apollo Endosurgery, and Spatz Medica The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The different bariatric surgery modalities.
Figure 2
Figure 2
Available modalities for endoscopic management of weight regain after RYGB.
Figure 3
Figure 3
Endoscopic sleeve gastroplasty for endoscopic revision of sleeve gastrectomy.
See this image and copyright information in PMC

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