Brazilian Consensus on Endoscopic Sleeve Gastroplasty

Neto, Manoel Galvão; Silva, Lyz Bezerra; Quadros, Luiz Gustavo de; Grecco, Eduardo; Filho, Admar Concon; Amorim, Artagnan Menezes Barbosa de; Galvao, Manoela; Santos, Newton Teixeira dos; Lima, João Henrique Felício de; Souza, Thiago Ferreira de; Morais, Helmut Wagner Poti de; Vieira, Felipe Matz; Moon, Rena; Teixeira, André; Alexandre, Adriano Tomas Vasconcelos; Almeida, Leonardo S.; Arnoni, Jose Rubes; Bueno, Fermanda Nascimento; Cantanhebe, Keila Regina Matos; Carvalho, Rafael Pasqualini de; Cenatti, Alexandre; Durelli, Bruna; Ferreira, Elaine Moreira; Filho, Luiz Henrique de Sousa; Filho, Idiberto José Zotarelli; Hoff, Anna Carolina; Jacome, Mauro Rodrigues Coelho; Jawad, Muhammad; Marchetti, Igor; Matta, Luis Augusto; Medeiros, Túlio S.; Mestieri, Luiz Henrique Mazzonetto; Moraes, Marcius Vinicius de; Neto, João de Siqueira; Neto, Alvaro Oliveira; Neto, Joffre Rezende; Pandolfi, Harley; Pupo, André S.; Ramos, Flavio M.; Ramos, Almino Cardoso; Rodrigues, Leonardo Teixeira; Sander, Guilherme Becker; Silva, Rodrigo Dallegrave Correa da; Sousa, José Américo Gomides de; Spagnol, Maurício; Usuy, Eduardo N.; Veloso, Julio Cesar de Soares; Vieira, Hans Roman Wulf; Zeve, Jorge Luiz de Mattos

doi:10.1007/s11695-020-04915-4

Cited by 29 publications

(26 citation statements)

References 13 publications

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“…On the following sutures, the same pattern was applied on the gastric body distal to proximal up to the proximal gastric fundus. The surgical procedure was performed according Galvao Neto et al’s description [ 8 ] and clinical management according to the Brazilian Consensus on ESG [ 9 ].…”

Section: Methodsmentioning

confidence: 99%

Learning Process Effectiveness During the COVID-19 Pandemic: Teleproctoring Advanced Endoscopic Skills by Training Endoscopists in Endoscopic Sleeve Gastroplasty Procedure

Neto¹,

Jerez²,

Brunaldi

et al. 2021

OBES SURG

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Background and Aims The COVID‐19 pandemic has led health institutions to cancel many of the activities including training in different fields. Most practices and training programs have been encouraged to use teleproctoring as an alternative method to enhance physician’s ability and assure training. We aimed to evaluate remote training program for endoscopy sleeve gastroplasty (ESG). Methods Ten consecutive patients underwent an endoscopic sleeve gastroplasty procedure guided by a proctor expert using an online platform. A stepwise approach was created to assure skill acquisition. Results All cases were safely performed with no serious adverse events under teleproctoring. The average surgical and suturing times significantly decreased during the training model. From the first 5 cases to the last 5 ones, the endoscopic procedure time decreased from 120 to 93.4 min while suturing time from 92.8 to 68.4 min. The effect size was large in both cases, and the changes were meaningful according to the fitted learning curves. Conclusions The proposed teleproctoring program was effective to deliver advanced endoscopic skills such as endosuturing for ESG, despite the restrictions imposed by the COVID-19 pandemic. Graphical abstract

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Section: Methodsmentioning

confidence: 99%

Learning Process Effectiveness During the COVID-19 Pandemic: Teleproctoring Advanced Endoscopic Skills by Training Endoscopists in Endoscopic Sleeve Gastroplasty Procedure

Neto¹,

Jerez²,

Brunaldi

et al. 2021

OBES SURG

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“…Most complications can be managed conservatively and rarely require surgical intervention. According to the device manufacturer, it is estimated that at least 12 000–15 000 procedures have been performed worldwide, and to date, there has been a single complication resulting in death due to deep vein thrombosis with pulmonary embolism 45 . An RCT of endoscopic sleeve gastroplasty (the MERIT Trial; ClinicalTrials.gov identifier NCT03406975) has recently concluded and the results are anticipated in December 2021.…”

Section: Endoscopic Sleeve Gastroplastymentioning

confidence: 99%

Endoscopic bariatric therapies for obesity: a review

Staudenmann

Sui

Saxena

et al. 2021

Medical Journal of Australia

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Summary ▪ Obesity is reaching pandemic proportions globally, with overweight or obesity affecting at least two‐thirds of Australian adults. ▪ Bariatric surgery is an effective weight loss strategy but is constrained by high resource requirements and low patient acceptance. ▪ Multiple endoscopic bariatric therapies have matured, with well established and favourable safety and efficacy profiles in multiple randomised controlled trials (RCTs), and are best used within a multidisciplinary setting as an adjuvant to lifestyle intervention. ▪ Three types of intragastric balloon are currently in use in Australia offering average total weight loss ranging from 10% to 18%, with others available internationally. ▪ Endoscopic sleeve gastroplasty produces average total weight loss of 15–20% with low rates of severe complications, with RCT data anticipated in December 2021. ▪Bariatric and metabolic endoscopy is rapidly evolving, with many novel, promising therapies currently under investigation.

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“…This consensus group agreed on several consensus statements such as indication, contraindication, procedure techniques, and post-procedure follow-up. 83 A meta-analysis examining 22 cohort studies on ESG showed that the procedures were effective at short-term weight loss with few adverse risk events. 84 However, a recent meta-analysis showed that ESG improved weight loss compared with laparoscopic techniques with fewer side effects.…”

Section: Society Guidelinesmentioning

confidence: 99%

Endobariatric procedures for obesity: clinical indications and available options

Goyal

Kopel

Perisetti

et al. 2021

Clin Med Insights Gastroenterol

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Obesity remains a growing public health epidemic that has increased healthcare costs and related comorbidities. Current treatment guidelines encourage a multidisciplinary approach starting from patient selection, interventions, and long-term follow-up to maintain weight loss. However, these conservative interventions are largely ineffective at reducing body weight due to low adherence to the treatment regimen. Recently, endoscopic bariatric therapies have become an attractive alternative to traditional invasive bariatric surgeries due to their improved efficacy, safety, and cost-effectiveness. Endoscopic bariatric therapies include intragastric balloon placement, endoscopic sleeve gastroplasty, gastric bypass revision, and aspiration therapy. These procedures fall into two separate categories depending on the primary mechanism involved: restrictive or malabsorptive. Restrictive methods, such as the Orbera® and ReShape™ intragastric balloons, increase satiation and delay gastric emptying while decreasing the amount of food that can be ingested. In contrast, malabsorptive devices, such as the EndoBarrier®, interfere with the small intestine’s ability to absorb food while restoring normal gastrointestinal hormone levels regulating satiation. Together, these techniques provide useful alternatives for patients in whom pharmacological or lifestyle modifications have proven ineffective. Despite these advantages, the long-term effects of these procedures on metabolic changes remain to be studied. Furthermore, the management of complications from these procedures continues to evolve. In this review, we aim to elaborate on the clinical indications and efficacy of the endobariatric procedures, together with various types of available endoscopic bariatric therapy procedures.

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Brazilian Consensus on Endoscopic Sleeve Gastroplasty

Cited by 29 publications

References 13 publications

Learning Process Effectiveness During the COVID-19 Pandemic: Teleproctoring Advanced Endoscopic Skills by Training Endoscopists in Endoscopic Sleeve Gastroplasty Procedure

Learning Process Effectiveness During the COVID-19 Pandemic: Teleproctoring Advanced Endoscopic Skills by Training Endoscopists in Endoscopic Sleeve Gastroplasty Procedure

Endoscopic bariatric therapies for obesity: a review

Endobariatric procedures for obesity: clinical indications and available options

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