**Abstract**

Obesity is the underlying constant for the development of the most common modern diseases such as insulin resistance, high blood pressure, lipid metabolism disorders, non-alcoholic steatohepatitis (fatty liver), joint problems and various malignancies. The role of endoscopic diagnostic and therapy in obese patients is highlighted in this chapter. In this chapter all devices and methods used in flexible endoscopy for diagnostic and treatment in obese patients are introduced. Role of endoscopy is presented in three parts: in preoperative setting, in post-operative complication management and instead of surgery as endoscopic bariatric therapy. If possible presentation of the effectiveness is compiled with study data. Finally, the interaction between endoscopy and surgery in the treatment of obesity is complex, essential and promising. Endoscopy is indispensable in preoperative preparation, as a primary therapeutic approach, and also in the detection and treatment of acute complications and long-term complications of obesity surgery.

**Keywords:** endoscopic bariatric therapy, endoscopic complication management

## **1. Introduction**

The annual number of obesity surgery and metabolic interventions increased worldwide significantly and the continued pressure to provide ambulatory surgery, endoluminal, and transgastric therapy has the potential to effect major changes in the way obesity is treated. Covering the "market demand" simply by further increasing the number of operations seems illusory if the prevalence of obesity is still rising. Endoluminal surgery is defined as surgery performed entirely within the lumen of the gastrointestinal tract using flexible endoscopy.

The interaction between endoscopy and surgery in the treatment of obesity is complex, essential and promising. Endoscopy is indispensable in preoperative preparation, as a primary therapeutic approach, and also in the detection and treatment of acute complications and long-term complications of obesity surgery.

The currently established and developing endoscopic procedures for bariatric therapy will be presented in this chapter. Division into pre-operative endoscopy,

endoscopic bariatric therapy (EBT) and post-surgical endoscopy for early and late complications was made.
