Obesity is a chronic, relapsing, degenerative, multifactorial disease that is associated
with many co-morbidities. The global increasing burden of obesity has led to calls
for an urgent need for additional treatment options. Given the rapid expansion of
bariatric endoscopy and bariatric surgery across Europe, the European Society of Gastrointestinal
Endoscopy (ESGE) has recognized the need to formalize and enhance training in bariatric
endoscopy and the endoscopic treatment of bariatric surgical adverse events. This
manuscript represents the outcome of a formal Delphi process resulting in an official
Position Statement of the ESGE and provides a framework to develop and maintain skills
in bariatric endoscopy and the endoscopic treatment of bariatric surgical adverse
events. This curriculum is set out in terms of the prerequisites prior to training,
minimum number of procedures, the steps for training and quality of training, and
how competence should be defined and evidenced before independent practice. 1: ESGE
recommends that every endoscopist should have achieved competence in upper gastrointestinal
endoscopy before commencing training in bariatric endoscopy and the endoscopic treatment
of bariatric surgical adverse events. 2: Trainees in bariatric endoscopy and the endoscopic
treatment of the complications of bariatric surgery should have basic knowledge of
the definition, classification, and social impact of obesity, its pathophysiology,
and its related co-morbidities. The recognition and management of gastrointestinal
diseases that are more common in patients with obesity, along with participation in
multidisciplinary teams where obese patients are evaluated, are mandatory. 3 : ESGE
recommends that competency in bariatric endoscopy and the endoscopic treatment of
the complications of bariatric surgery can be learned by attending validated training
courses on simulators initially, structured training courses, and then hands-on training
in tertiary referral centers.
