September 24, 2019
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ASGE releases training curriculum for bariatric endoscopy

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The Association for Bariatric Endoscopy, a division of ASGE, released two documents Monday that outline the society’s recommendations and guidance on training and privileging for physicians who perform endoscopic bariatric treatments for weight loss.

“These procedures represent an attractive and effective option for patients who are within a certain percentage of excess body weight, or for those who may not be good candidates for surgery. They also work well as a bridge for patients who are not succeeding with lifestyle changes or medication, but who may not feel ready for a more invasive surgical treatment,” Christopher Thompson, MD, of the division of gastroenterology and hepatology at the University of Colorado School of Medicine and immediate past chair of ABE said in a press release, “It’s important that we share these best practices for training physicians to ensure the highest quality for these procedures.”

The first document is a position statement, which lays out what the ABE believes are the fundamental principles for effective training that are needed to provide the best care and to ensure its best practices are followed as bariatric endoscopy is integrated into practice. The statement is broken down into three principles:

  • Understanding of the management of patients with obesity: Physicians should have a broad, but in-depth, understanding of how to manage patients with obesity. In addition to knowledge about current endoscopic techniques, physicians should be familiar with other therapies such as lifestyle interventions, behavior modification, pharmacotherapy and bariatric surgery
  • Mastery of GI endoscopic skills: Performing bariatric endoscopy should require residency for fellowship training in GI endoscopy, as well as documentation of skills and competency.
  • Procedure- and device-specific knowledge: Because endoscopic bariatric treatments vary, privileges should be granted on a procedure-specific basis. Physicians should also have a comprehensive knowledge of the indications, contraindications, risks, benefits and outcomes for bariatric endoscopy.

The ABE is also working with other societies to develop programs to educate and certify physicians for these skills.

Core Curriculum

The second document is a core curriculum designed to highlight all the central concepts that every general gastroenterologist needs to know when managing patients with obesity.

“Only a small proportion of gastroenterologists currently treat obesity,” Rahul Pannala, MB, BS, MPH, of the division of gastroenterology, hepatology and endoscopy at Brigham and Women’s Hospital, said in the release. “However, given the burden of disease, there is an urgent need for greater involvement of physicians from multiple specialties, including gastroenterology, to be actively involved in the care of patients with obesity.”

The overview includes:

  • Lifestyle intervention;
  • Pharmacologic, endoscopic and surgical treatments for obesity;
  • Endoscopic evaluation and management of GI comorbidities in patients with obesity;
  • Endoscopic evaluation of post-bariatric surgical anatomy; and
  • Management of selected adverse events in patients who have had bariatric surgery. – by Alex Young

Disclosures: Pannala reports receiving research support from Apollo Endosurgery. Thompson reports no relevant financial disclosures. Please see the full study for all other authors’ relevant financial disclosures.