The PULSE team is involved not only in the surgical treatment of gastrointestinal diseases but also, thanks to its minimally invasive approach, in endoscopic treatment.
The EndoscopieDigest team, led by Dr. Gianfranco Donatelli, is one of the leading references in France in the field of digestive and interventional endoscopy.
They have several years of experience specifically in managing complications related to obesity surgery.
Endoscopy plays an increasingly important role in the management of obesity—both for weight loss treatments and for the treatment of postoperative complications following bariatric surgery.
Endoscopic techniques have become a key component in the management of obesity—both for achieving weight lossand for treating post-surgical complications. They offer patients less invasive, effective solutions with faster recovery times.
Endoscopic treatments offer a non-surgical alternative for individuals with obesity—especially for those who are not eligible for bariatric surgery or who prefer a less invasive approach. The main options include:
Gastric balloon placement
- Principle: A gastric balloon is inserted into the stomach via endoscopy and then inflated with saline solution or air. This reduces the stomach’s capacity and induces an early feeling of fullness.
- Duration: The balloon is temporary, typically remaining in place for 6 to 12 months.
- Goal: To achieve significant weight loss—often used as a preliminary step before bariatric surgery, or for patients who wish to avoid surgery altogether.
Endoscopic gastric suturing (Endoscopic sleeve gastroplasty)
- Principle: This procedure involves placing sutures inside the stomach to reduce its size, creating an effect similar to a sleeve gastrectomy, but without removing any tissue.
- Goal: To reduce stomach volume and limit food intake, while being less invasive than traditional surgery.
Endoscopic revision after sleeve or bypass surgery
- Principle: This technique is used to reduce the size of the stomach after bariatric surgery (such as sleeve gastrectomy or gastric bypass) when a patient begins to regain weight. Sutures are placed endoscopically to tighten the dilated stomach.
- Goal: To restore reduced gastric capacity and support renewed weight loss.
Endoscopic techniques are also widely used to treat complications that may arise after obesity surgery, such as sleeve gastrectomy, gastric bypass, or gastric banding. The main procedures include:
Endoscopic dilation of strictures
- Principle: After bariatric surgery, certain areas of the digestive tract—such as the anastomosis (the connection between the stomach and intestine) or the lower part of the stomach—may become narrowed (strictures). Endoscopic dilation involves using balloon dilators to widen these areas and restore normal food passage.
- Goal: To relieve symptoms such as nausea, vomiting, and difficulty swallowing.
Treatment of fistulas
- Principle: Fistulas, or abnormal connections between the stomach and other parts of the body (such as the abdominal cavity), can occur after bariatric surgery. Endoscopy can be used to close these fistulas using clips or stents, avoiding the need for more invasive surgery.
- Goal: To close the fistula, prevent infections, and promote healing.
Stent placement for gastrointestinal leaks
- Principle: After a sleeve gastrectomy or gastric bypass, leaks can occur at the surgical suture sites. Endoscopic stents, which are flexible tube-like devices, are placed to cover the leak area, allowing it to heal without additional surgery.
- Goal: To support fast recovery, minimize infection risk, and promote healing.
Removal of displaced gastric bands
- Principle: If a gastric band shifts or causes complications such as erosion into the stomach wall, it can be removed endoscopically, avoiding the need for repeat surgery.
- Goal: To resolve the complication through a less invasive procedure than traditional surgery.
Endoscopic treatments offer several advantages compared to traditional surgical procedures:
- Reduced Risk: Endoscopy is less invasive and carries a lower risk of complications compared to open surgery.
- Faster Recovery: Patients can often go home the same day or after a short hospital stay, with a significantly quicker recovery time.
- Alternatives for Non-Surgical Candidates: These procedures can be offered to patients who have contraindications to traditional surgery.