Digestive endoscopy is a medical discipline that allows us to explore the digestive tract. At the same time it is possible to perform therapeutic treatments through endoscopes. The main applications of digestive endoscopy are the prevention of colon cancer and the treatment of precancerous lesions.
Application of digestive endoscopy in obesity
Bariatric endoscopy is the subspecialty dedicated to the treatment of obesity. In recent years more and more therapeutic options are appearing in this sector, due to the tendency to look for minimally invasive procedures. Currently there are devices with restrictive action, others with malabsorptive action and finally some with mixed action.
Treatments against obesity: intragastric balloon, POSE method or bypass.
Among the treatments for obesity are the intragastric balloon or the POSE method, among other techniques.
The intragastric balloon is the standard in bariatric endoscopy. It is the oldest treatment, with more than 20 years on the market. The balloon has a mass effect, occupying space inside the stomach and, therefore, it does not have as much capacity to be filled with food. It is a silicone prosthesis (the most commonly used), although there are also those made of other materials. The balloon is usually filled with physiological saline solution, although there are models that are filled with air and liquid at the same time. The intragastric balloon is a pure restrictive method. Intragastric balloons last between six months and one year.
The POSE method is an intervention that produces a reduction in the elasticity of the stomach. This helps patients to have an early feeling of satiety. The main difference between the POSE method and the intragastric balloon is that this treatment is done in a single session, with general anesthesia, avoiding patients a second phase or reoperation to remove it (as in the case of the balloon). Once it is done, it is definitive.
Another existing method is the external bypass. This is the newest technique available. It basically consists of a modification of a device that has been used for years: gastrostomy tubes (PEG). Unlike the PEG, the external bypass allows partial elimination of gastric contents, so that patients, after eating, will be able to eliminate up to 30% of their caloric intake.
Who can undergo obesity treatments?
The ideal patient who can undergo these treatments are patients with grade I or grade II obesity. Morbidly or super-morbidly obese patients who actively refuse surgery are also eligible for treatment.
Bariatric endoscopy makes it possible to treat many patients who previously had no option. More than 95% of patients with obesity receive no treatment at all. These techniques give patients more possibilities to treat themselves.
Benefits and results of digestive endoscopy techniques
The results will depend on the patient and the technique used, being around 40% of excess weight loss in the first year.
There is also a clear improvement in obesity-related comorbidities, with improvements in hypertension, glycemia, dyslipidemia, musculoskeletal pain, etc. These improvements are observed from a loss of 5% of the total weight.
It also benefits them in case they are going to undergo a subsequent surgery, since it improves the degree of success of these. It is necessary to emphasize that bariatric endoscopy has the function of complementing bariatric surgery and not competing with it.