Obesity Surgery

, Volume 30, Issue 2, pp 736–752 | Cite as

The Role of Minimally Invasive and Endoscopic Technologies in Morbid Obesity Treatment: Review and Critical Appraisal of the Current Clinical Practice

  • Francesco Maria Carrano
  • Miroslav P. Peev
  • John K. Saunders
  • Marcovalerio Melis
  • Valeria Tognoni
  • Nicola Di LorenzoEmail author


Bariatric surgery is the most effective treatment for morbid obesity. Availability of different procedures with low complication rates, performed through a minimally invasive approach, have caused profound positive effect on patient’s quality of life and has led to their worldwide, rapid expansion of the field. The laparoscopic revolution has introduced the concept of lowering more and more the treatments’ invasiveness, leading to a change in the researchers’ mentality. They are now constantly looking for reducing patients’ discomfort through new methodologies and devices: aim of this review is to provide an in-depth analysis of the most promising, innovative procedures offering an alternative approach to “classic” laparoscopic procedures. They are described from their original development phases to the most recent experimental and clinical evidence. This review will discuss as well their future perspectives, and includes endoluminal techniques and/or procedures based on alternative concepts, all representing an appealing alternative to surgical approach. We conducted a MEDLINE for articles, clinical trials, and a patent search relating to the minimally invasive management of obesity, excluding intragastric balloons, SILS, and NOTES, and we selected 77 articles. Results are reported for each procedure/device, and discussed both in these paragraphs and in the final, general discussion. The concept of minimally invasive procedures continues to change and evolve over time with novel technologies emerging every year.


Bariatric surgery Bariatric endoscopy Endoluminal Endosleeve Pacing Obesity Minimally invasive surgery Aspiration therapy Gastric plication Transpyloric shuttle Duodenal mucosal resurfacing Magnetic anastomosis 


Compliance with Ethical Standards

Ethical Approval Statement

This article does not contain any studies with human participants or animals performed by any of the authors.

Conflict of Interest

The authors declare that they have no conflict of interest.


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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Endocrine and Metabolic SurgeryUniversity of InsubriaVareseItaly
  2. 2.Department of General SurgeryNYU Langone HealthNew YorkUSA
  3. 3.Department of Surgical SciencesUniversity of Rome “Tor Vergata”RomeItaly

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