title: Surgical Endoscopy Versus Endoscopic Surgery for Obesity.
abstract: BACKGROUND
  Obesity treatment options are of great interest worldwide with major developments in the past 20 years. From general surgery to natural orifice transluminal endoscopic surgery intervention nowadays, obesity surgical therapies have surely developed and are now offering a variety of possibilities.
  Although surgery is the only proven approach for weight loss, a joint decision between the physician and patient is required before proceeding to such a procedure. With a lot of options available, the treatment should be individualized because the benefits of surgical intervention must be weighed against the surgical risks.
  
  
  METHODS
  Medline search to locate full-text articles and abstracts with obvious conclusions by using the keywords: obesity, surgical endoscopy, gastric bypass, bariatric surgery, and endoscopic surgery, alone and in various combinations. Additional relevant publications were also searched using the reference lists of the identified articles as a starting point.
  
  
  RESULTS
  Laparoscopic Roux-en-Y gastric bypass still is the most effective, less invasive, bariatric surgical intervention, although there are various complications encountered, such as postoperative hemorrhage (1.9%-4.4%), internal hernias, anastomotic strictures (2.9%-23%), marginal ulcerations (1%-16%), fistulas (1.5%-6%), weight gain, and nutritional deficiencies. However, the absence of parietal incisions, less pain, decreased risk of infection, and short hospital stay make room for endoscopic surgery as a possible valid option for obesity for both the doctors' and the patients' perspective.
  
  
  CONCLUSIONS
  The current tendency is to promote surgical treatment of obesity to a status of less invasive scars therefore promoting minimally invasive surgical techniques.
authors.affiliation: 1Research Center of Gastroenterology and Hepatology of Craiova, University of Medicine and Pharmacy of Craiova, Craiova, Romania; 2Department of Surgery, University of Medicine and Pharmacy of Craiova, Craiova, Romania; and 3Department of Endoscopy, Gastrointestinal Unit, Copenhagen University Herlev Hospital, Copenhagen, Denmark.
authors.forename: Bogdan Silviu
authors.initials: BS
authors.lastname: Ungureanu
authors.forename: Ştefan
authors.initials: Ş
authors.lastname: Pătraşcu
authors.forename: Valeriu
authors.initials: V
authors.lastname: Şurlin
authors.forename: Adrian
authors.initials: A
authors.lastname: Săftoiu
mesh_terms: D000328:Adult; D004724:Endoscopy / Q000009:adverse effects / Q000379:methods*; D015390:Gastric Bypass / Q000009:adverse effects / Q000379:methods* / Q000639:trends; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay / Q000706:statistics & numerical data; D008875:Middle Aged; D009765:Obesity / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D057285:Precision Medicine / Q000009:adverse effects / Q000379:methods / Q000639:trends; D018570:Risk Assessment