Although medical therapy is an effective intervention, weight loss surgery has been associated with the greatest reduction in obesity-related complications. With advances in technology and improved surgical techniques, the mortality following bariatric surgery is less than 1% at centers of excellence. Yet approximatively 5 to 10% will present with acute postoperative complications and 9-25% with late complications. The most common acute complications include anastomotics leaks, bowel obstruction, gastrointestinal or intra-abdominal hemorrhage. Complications such as anastomotic stricture, marginal ulcers, gastric ulcers, stomal ulcers, band erosion, staple-line dehiscence, and inadequate weight loss occur months to years following surgical weight loss interventions. Till recently traditional management of such complications has been surgical with reoperations and revisions on bariatric surgery associated with high complication and mortality rates. Endoscopic endoluminal approaches are currently gaining ground on treating bariatric surgery complications due to their less invasive nature. This is a new and unknown field by most endoscopists even if they are experts due to the fact the bariatric surgery complications presents differently from similar surgical complications in lean patients.

The primary role of endoscopic intervention in the care of bariatric surgery patients is in the management of acute and late bariatric surgical complications and non-operative revision of the surgical anatomy. In the future, indications for bariatric endoscopy will involve primary weight loss interventions as cutting edge technology is currently evolving. Surgeons and endoscopists caring for these patients should become familiar with post-bariatric surgical anatomy, potential complications, common presenting symptoms, anticipated luminal/extra-luminal findings, and endoscopic management of common bariatric complications.

The following lectures review and addresses these issues discussing discuss common presenting symptoms, luminal as well as extra-luminal findings and endoscopic management of common bariatric complications.