Bariatric surgery has never been safer, but severely ill or morbidly obese patients who are considered high-risk may benefit from innovative therapies being performed and perfected today.
Read a recently published paper by Matthew Brengman, MD, FASMBS, Chief of Staff at Henrico, Parham, and Retreat Doctors' Hospitals, and Weight Loss Medical Director of Parham Doctors' Hospital, regarding new and exciting therapies to treat patients who are otherwise considered high-risk for life-saving bariatric surgery.
Bariatric surgery remains the gold standard for therapy of the morbidly obese patient. However, these procedures are not without risk.
Risk factors for adverse events and readmission after bariatric surgery are well studied. Included in these risk factors are preoperative weight, liver size, and medical comorbidities that can be improved with modest weight loss before bariatric surgery and other major abdominal procedures.
This article reviews intragastric space-occupying devices, endoluminal gastric volume reduction procedures, gastric content aspiration therapy, and endoluminal duodenal exclusion as possible choices to “bridge” the high-risk patient to bariatric surgery and as a possible alternative to bariatric surgery.
The current state of the literature is robust for the intragastric balloon, supporting both primary and preoperative indications. The limited literature support for gastric volume reduction, gastric content aspiration, and endoluminal barrier therapy is reviewed.