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According to the World Health Organization (WHO), over 500 million adults are obese. Obesity contributes to a range of harmful comorbidities and its economic burden approximates 150 billion dollars per year. Bariatric surgery remains a gold-standard treatment of morbid obesity and is effective at reducing weight, along with obesity-related conditions. Despite the prevalence of obesity and the proven efficacy of surgery, few who qualify ultimately receive this intervention, and surgery has associated risks. Endoscopic bariatric therapy is an alternative offering a less invasive, possibly cost-effective approach for patients who otherwise would not qualify for, or who are hesitant about or do not have access to, surgical bariatric therapy. An estimated 78% of Veterans are overweight or obese, however Veterans Affairs (VA) medical centers perform only 500 bariatric surgeries annually. If endoscopic bariatric interventions are to be increasingly utilized, it is important for the VA to understand the evidence of how they compare to surgical and pharmacologic therapies. In this review, we assess the impact of endoscopic bariatric therapies on weight loss, morbidity, mortality, and resolution of comorbid conditions compared to surgery and lifestyle modification.

Gastrectomy. --- Lifestyles.

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Gastrectomy --- Alanine --- Blood Glucose --- metabolism --- metabolism

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Gastrectomy --- Stomach Neoplasms --- Malabsorption Syndromes --- adverse effects --- surgery --- etiology

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Duodenal Ulcer --- Gastrectomy --- Postoperative Complications --- surgery --- adverse effects --- mortality

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Sleeve gastrectomy (SG) is the most common bariatric procedure, accounting for more than 55% of all such surgeries performed worldwide. Obesity has become a major global problem that continues to spread in both developed and developing countries. While prevention of obesity is the best approach for the future, the current challenge is managing those who are already obese or morbidly obese, who constitute close to two thirds of the population in many countries, such as the US. Today, bariatric surgery is the only evidence-based treatment for morbid obesity with a low complication rate and acceptable results in the long-term for both weight loss and resolution of comorbidities. This book details all the approaches used in sleeve gastrectomy (SG), offering readers the tools needed to perform the perfect SG. Each chapter focuses on the clinical problems and the indications for the sleeve, and describes the technique step-by-step (including videos), the staplers, the different sizes of bougies, reinforcement of the sutures after the sleeve and the metabolic effects of surgery. The book also presents nontraditional SG techniques, such as the endoscopic approach, stapled sleeve and robotic technologies, discussing how to immediately identify complications and their treatment using endoscopy, laparoscopy and percutaneous image guided surgery. Further, it includes a chapter on revision surgery and revision procedures, not only from sleeve to other procedures, but also from other procedures to SG. The last section offers an overview of what the authors imagine the future holds for this bariatric procedure. The Perfect Sleeve Gastrectomy - A Clinical Guide to Evaluation, Treatment, and Techniques is an ideal reference resource for general surgeons, bariatric surgeons, endoscopists and gastroenterologists as well as researchers with an interest in obesity and its management. It also appeals to residents and fellows, dietitians, diabetes specialist, psychotherapists and hospital administrators and quality officers.

Surgery. --- Gastroenterology . --- Gastroenterology. --- Internal medicine --- Digestive organs --- Surgery, Primitive --- Medicine --- Diseases --- Gastrectomy. --- Gastric resection --- Stomach --- Surgery