Endoscopic sleeve gastroplasty (the Apollo method): a new approach to obesity management

Abstract

Background: Many obese patients cannot lose weight or reject conventional obesity management. Endoscopic sleeve gastroplasty (the Apollo method) is a pioneering coadjuvant, interventionist technique for the integral management of obesity.Objectives: The goals of this study were to report safety and efficacy results obtained at 6 months in patients undergoing endoscopic sleeve gastroplasty.Material and methods: A prospective study was performed in 55 patients (13 males, 42 females) who were subjected to the Apollo technique; mean age was 43.5 years (range 25-60) and mean BMI was 37.7 kg/m 2 (range 30-48). All received multidisciplinary follow-up for weight loss. Weight changes and presence of complications were assessed. Through the endoscope a triangular pattern suture is performed consisting of approximately 3-6 transmural (mucosa to serosa) stitches, using a cinch device to bring them nearer and form a plication.Results: A total of 6-8 plications are used to provide a tubular or sleeve-shaped restriction to the gastric cavity. No major complications developed and patients were discharged at 24 hours following the procedure. Endoscopic and radiographic follow-up at 6 months post-procedure showed a well preserved tubular form to the stomach. After 6 months patients had lost 18.9 kg and 55.3% of excess weight.Conclusions: Endoscopic sleeve gastroplasty, together with dietary and psycho-behavioral changes, is a safe, effective technique in the coadjuvant management of obese patients.

Multicenter study on the safety of bariatric endoscopy

“…In the first series reported, using the older model, three isolated complications were encountered (perigastric collection, lung embolism, pneumothorax), which were solved with medical treatment (30). No other complications have been reported in the other series reported so far (31)(32)(33)(34)(35), nor regarding the initial experience of 55 cases in our series.…”

Endoscopic sleeve gastroplasty: Case report, technique and literature review

“…Endoscopic sleeve gastroplasty (ESG) is a novel therapeutic endoscopic technique first reported by Abu Dayyeh et al in 2013, which reduces the size of gastric reservoir by using full‐thickness endoscopic suturing device . Recent studies have shown that this is a safe and technically feasible procedure resulting in significant weight loss . In this study, we reported the first case of ESG in Asia.…”

“…7 Recent studies have shown that this is a safe and technically feasible procedure resulting in significant weight loss. [8][9][10][11] In this study, we reported the first case of ESG in Asia.…”

“…The patient made an instant recovery and experienced a remarkable amount of weight loss and improvement in his metabolic profile and liver parameters, which was sustained at 1-year follow-up. Since the initial feasibility report of ESG in four patients, 7 long-term follow-up studies with larger sample sizes have been published [8][9][10][11] (see literature review in File S1). The largest series of 91 patients by Sharaiha et al reported significant total weight loss of 14.4% at 6 months, 17.6% at Figure 2.…”

Redo endoscopic sleeve gastroplasty: technical aspects and short-term outcomes

“…[3][4][5][6] The reported mean percentage of total body weight loss (%TBWL) is 17.2% at 12 months and 20.2% at 24 months, on average (Table 1). 2,3,[6][7][8][9][10][11][12][13] If weight resumption after surgery is considered a real failure of the technique, the need to perform a redo ESG in selected patients should not be considered as a failure of the previous procedure. ESG is repeatable per definition, likewise for every endoscopic procedure.…”