מפגש מומחים: השמנה - טיפולים בריאטריים פרופ' זמיר הלפרן

Life style modification Maintain a Healthy Weight Management Algorithm Surgery Medications Life style modification Avoid Gain weight Maintain a Healthy Weight OVERWEIGHT= Weight Loss

Bariatric Surgery

ENDOSCOPIC THERAPY OF OBESITY: A new paradigm in bariatric care Bariatric Surgery with No medication and no scar But also new opportunities

Spectrum of Treatment Modalities Cardiovascular disease Noninvasive – Diet/ medication Minimal invasive – Stents Invasive – Coronary bypass Obesity Noninvasive – Diet/ sport Minimal invasive – Endoscopic surgery Invasive – Bariatric surge

Potential Endoscopic Obesity Procedure Opportunities Providing weight loss or stabilization in early stage obese patients who do not yet qualify for traditional surgery Early intervention Reducing the obesity-related operative risk for various bariatric and non-bariatric surgeries Bridge to surgery Primarily addressing co morbid illness (e.g., diabetes) Metabolic Endoscopic option for the traditional surgical population, with outcomes and risk profiles similar to those of current surgeries Primary Repairing failed bariatric surgical procedure Revision

Metabolic Surgery

Post-surgical Weight Recurrence How to Achieve Weight Loss after the “Honey Moon” is Over Ineffective weight loss or complications following bariatric surgery may require a corrective re-intervention As surgical revisions carry high morbidity rates Post-surgical endoscopic interventions may prove to be a valuable alternative

F. Treatment Of Surgical Complications Dilation of anastomotic/ post gastroplasty stenoses Removal of partially migrated Rings and Lapbands Treatment of leakages Gastrointest.Endosc.2005;61:594

Summary Endoscopic obesity procedures may offer a solution by providing improved effectiveness compared with medications, with a lower risk profile than traditional surgery

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