Endoscopic bariatrics: Current status and emerging technologies

Abstract

Endoscopic bariatrics has emerged as a minimally invasive alternative to traditional bariatric procedures. Over the last decade, significant progress in endoscopic techniques and technologies has improved the safety, efficacy, and accessibility of these procedures. Current methods, such as intragastric balloons, endoscopic sleeve gastroplasty, and endoscopic-assisted gastrojejunostomy, have promoted weight loss, improving the metabolic health of obese individuals, with emerging evidence suggesting that their combination with pharmacological agents could further maximize their benefit. Emerging technologies, such as robotic-assisted endoscopic devices, advanced imaging systems, and biodegradable implants, could enhance procedural precision, minimize complications, and provide more personalized treatment options. In contrast, novel approaches such as microbiome modulation and tissue regeneration could have an adjunct role in improving patient outcomes. This review provides a brief overview of the current status of endoscopic bariatrics, highlighting the most common procedures and emerging technologies. It also discusses the challenges and future directions for the field, emphasizing the importance of multidisciplinary collaboration, patient selection, and research priorities to establish the long-term benefit and effectiveness of the available endoscopic bariatric interventions.

Keywords: Bariatrics; Endoscopy; Gastroplasty; Microbiome; Obesity; Weight loss.

Figure 1

Clinical decision algorithm for endoscopic bariatric interventions. BMI: Body mass index; EBT: Endoscopic bariatric therapy.

Figure 2

Structured treatment hierarchy in obesity care. SADI: Single anastomosis duodenal-ileal bypass; DJ: Duodenal-jejunal.