New endoscopic procedures for diabetes mellitus type 2 and obesity treatment

Background: Obesity continues to be a growing epidemic worldwide. Obese patients have severe comorbidities that make risky and technically demanding the execution of bariatric surgery from both surgical and anesthetic point of view; therefore, the focus of bariatric surgeons is increasingly moving towards minimally invasive, endoscopic techniques. Methods: The present review presents and discusses recent endoscopic techniques employed in obesity treatment, their features and results. Results: Endoscopic treatment can be primary or revisional; we can mainly divide the endoscopic devices into five categories: space-occupying devices, restrictive procedures, bypass liner, aspiration therapy and endoscopic revision of gastric bypass for dilated gastric pouch. Conclusions: Endoscopic treatments for obesity are promising techniques for selected patients but each procedure should be tailored on the patient in a multimodal approach.