This book aims to deepen collaboration between gastroenterologists and surgeons by providing endoscopists and gastroenterologists with a clear understanding of the anatomic alterations likely to be observed after bariatric surgery and acquainting bariatric surgeons with the possibilities offered by endoscopic treatment of obesity itself and of the complications associated with bariatric surgery. The treatment approach in patients with obesity and morbid obesity is usually stepwise, starting with dietary measures, exercise, and behavioral therapy, followed by pharmaceutical therapies, endoscopic bariatric therapy, and, finally, bariatric surgery. Endoscopists and gastroenterologists are involved first because the gastrointestinal tract is affected by obesity-related co-morbidity and second because it provides access for a range of treatment modalities involving endoscopy. Bariatric surgeons may need the assistance of endoscopists and gastroenterologists in the preoperative work-up of patients, in the perioperative period, when acute complications may require an endoscopic intervention, or in the late follow-up period, when complications or insufficient weight loss may be present. This book will be of value for both groups of specialists, enabling them to optimize their cooperation to the benefit of patients.
Introduction: Definition of obesity. Obesity-associated morbidity and the discussion of diseases where surgeons and gastroenterologist will meet when treating these patients. Short summary of weight loss options and the role of the bariatric surgery herein. Effects of treatment and herewith achieved weight loss on comorbidities.- Bariatric surgery: Discussion of bariatric techniques with the most current operations more into detail. Endoscopic view of changed view after bariatric surgery. Effect of bariatric surgery through weight loss and metabolic changes on obesity-associated comorbidities.- Screening and preoperative work-up: Minimally required preoperative work-up. Sense and nonsense of preoperative weight loss. Role of the gastroenterologist in preoperative work-up.- Complications associated with bariatric surgery: complaints and endoscopic treatment: Laparoscopic Gastric banding. Laparoscopic sleeve gastrectomy. Gastric bypass.- Postoperatie guidance: Dietary requirements. Supplementation of minerals and vitamins. Long-term effects (bone mineralisation etc.).