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Abstract

According to emerging role of endoscopic procedures in the treatment of obesity and rapid changes in endoscopic technologies and techniques, the current state of endoscopic management of obesity will be presented. Endoluminal interventions performed entirely through the GI tract by using flexible endoscopy offer the potential for an ambulatory weight loss procedure that may be safer and more cost-effective compared with current surgical approaches. Endoscopic techniques attempt to mimic the anatomic features of bariatric surgery. Accordingly, there are two main endoscopic weight loss modalities - restrictive and malabsorptive. Restrictive procedures act to decrease gastric volume by space-occupying prosthesis and/or by suturing or stapling devices, while malabsorptive procedures tend to create malabsorption by preventing food contact with the duodenum and proximal jejunum. The former include intragastric balloon treatment, endoluminal vertical gastroplasty, transoral gastroplasty and transoral endoscopic restrictive implant system, while the latter include duodenojejunal bypass sleeve. Gastroduodenojejunal bypass sleeve is a combination of both procedures. Except for intragastric balloon, all mentioned procedures are rather new, tested on a small number of human subjects, with a high rate of success, but with limited knowledge on safety and long-term efficacy. The role of gastric electrical stimulation and intragastric injections of botulinum toxin in obesity treatment is also considered as is the role of minimally invasive bariatric endoscopic interventions.

Biography

Davor Štimac is a Professor in the university of rijeka. He is Director of Clinical Hospital Center Rijeka from 2016. Head of the Clinic for Internal Medicine of the Clinical Hospital Center Rijeka from the year 2014. Deputy Head of the Department of Internal Medicine of the Faculty of Medicine of the University of Rijeka from the year 2001. He is member in the following societies, Croatian Medical Association- member of the Executive Board, Croatian Gastroenterological Society - Member of the Steering Committee, Croatian Pancreatic Club –President, Croatian Society for Thickness - the President, Croatian Society for Health Care Quality Improvement-Vice President, World Gastroenterology Organization (WGO)- a member of the Global Guidelines and Publication Board and a member of the Trainers' Trainers (TTT), United European Gastroenterology Federation (UEGF)- a member of the General Assembly, European Association of Gastroenterology, Endoscopy and Nutrition (EAGEN)- Member of the Board of Directors, European Board for Gastroenterology and Hepatology (EBGH)- Member of the Management Board, UEMS Section for Gastroenterology- HLZ representative. He had published about 121articles. Editor for 7 books and had 21 chapters in the books, 71 work in other indices.

E-mail: davor.stimac@ri.ht.hr