Main prophylactic measures in bariatric endoscopy. Spanish Expert Recommendations Guideline

Area of Science:

• Gastroenterology
• Endocrinology
• Medical Devices

Background:

• Bariatric endoscopy (BE) includes diverse techniques for managing obesity and metabolic diseases.
• Existing BE methods range from intragastric balloons to malabsorptive devices and surgical revisions.
• Scientific evidence on BE effectiveness and safety is evolving but often insufficient for strong recommendations.

Purpose of the Study:

• To establish a consensus on common prophylactic measures for bariatric endoscopy (BE).
• To address the extrapolation of bariatric surgery (BS) prophylaxis measures to BE.
• To provide guidance for daily practice and mitigate medical-legal conflicts in BE.

Main Methods:

• Development of a consensus document following a 5-phase methodological design.
• Involved national experts from relevant Spanish societies (GETTEMO, SEED, SEPD, SECO).
• Utilized PICO framework for clinical questions and evidence assessment (GRADE, Oxford EBM classification).
• Recommendations based on expert opinion (Level 5 evidence) with Grade C or D recommendations.

Main Results:

• Limited scientific evidence necessitates expert consensus on BE prophylactic measures.
• Current practice often involves extrapolating measures from bariatric surgery.
• The consensus aims to standardize and optimize preventive strategies in BE.

Conclusions:

• Standardized prophylactic measures are crucial for bariatric endoscopy (BE) due to evidence gaps.
• This consensus provides practical guidelines for physicians performing BE.
• Implementing these measures can enhance patient safety and reduce potential conflicts.