Endoscopic sutured gastroplasty: procedure evolution from first-in-man cases through current technique

Kumar, Nitin; Dayyeh, Barham K. Abu; Breviere, Gontrand López-Nava; Neto, Manoel Galvao; Sahdala, Nicole P.; Shaikh, Sohail N.; Hawes, Robert H.; Gostout, Christopher J.; Goenka, Mahesh K.; Orillac, J; Alvarado, Alonso; Jirapinyo, Pichamol; Zundel, Natán; Thompson, Christopher C.

doi:10.1007/s00464-017-5869-2

Cited by 92 publications

(58 citation statements)

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“…In their first 1000 cases, the mean percentage of total body weight loss at 12 months was 15.0% AE 7.7%, with an SAE rate of <0.01, consistent with previously reported multicenter data. [4][5][6][7] To synthesize the evidence available to date to support the safety and midterm efficacy of ESG, we have collected all unique cases reported as large multicenter series, with care to avoid duplicated follow-up study results, which when combined with these data total 1607 unique cases. Across these data, percentage of total body weight loss at 6, 12, and 18 or more months was 15.8, 17.1, and 17.3, respectively ( Fig.…”

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Endoscopic sleeve gastroplasty for obesity: defining the risk and reward after more than 1600 procedures

Storm

Dayyeh

2019

Gastrointestinal Endoscopy

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confidence: 99%

“…Serious adverse events across all major endoscopic sleeve gastroplasty reports totaling 1607 cases[3][4][5][6][7] …”

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Endoscopic sleeve gastroplasty for obesity: defining the risk and reward after more than 1600 procedures

Storm

Dayyeh

2019

Gastrointestinal Endoscopy

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“…Although we found rates of 43% and 22%, respectively, some articles show rates of up to 80% for each of these symptoms. 18,[22][23][24] Our average length of stay was higher than usual (2 days) but that was a per-protocol definition. As this was our first experience with ESG, we opted to be more cautious and to admit all patients until we had demonstrated its safety profile.…”

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confidence: 85%

Endoscopic sleeve gastroplasty is an effective and safe minimally invasive approach for treatment of obesity: First Indian experience

Bhandari

Jain

Mathur

et al. 2019

Digestive Endoscopy

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Background and Aim: Endoscopic sleeve gastroplasty (ESG) is gaining acceptance as a non-surgical option for the treatment of obesity. However, its role is still not consolidated for all populations and the ideal indications are yet to be determined. We aimed to study the efficacy and safety of ESG in Indian patients. Methods:We conducted a single-center retrospective study of obese patients who underwent consecutive ESG at our tertiary care center. Data on weight loss and adverse events at 1, 3, 6, and 12 months were collected and analyzed. Results: Fifty-three patients underwent ESG from March 2017 toOctober 2018. Eighty one percent of patients were female (43/53). Mean baseline age and body mass index were 40.54 AE 13.79 years and 34.78AE 5.20 kg/m 2 , respectively. Mean duration of procedure was 68.96 AE 11.19 min. Immediate postoperative complications included mainly epigastric pain (45.2%) and nausea (22.6%) but there was no serious adverse event. Average percentage of total weight loss (%TWL) was 8.26%, 11.96%, 14.25%, and 19.94% at 1, 3, 6, and 12 months, respectively. Eighty-eight percent of patients achieved >15% TWL at 12 months. Younger patients (<30 years old) and female patients had greater %TWL at 12 months (P = 0.01 and P = 0.021, respectively). Last 18 procedures were significantly faster than the first 35 cases (P = 0.01).Conclusions: Endoscopic sleeve gastroplasty is effective and safe at promoting weight loss in the Indian population. Young age and female gender are related to better outcomes.

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“…The overall mean %TBWL at 12 months of the 121 patients that were treated in our center is in accordance with other studies (Table 1). 2,3,[6][7][8][9][10][11][12][13] As in all endoscopic procedures, ESG is repeatable per definition and the need to perform a redo ESG should not be considered as a failure of the previous procedure, but in selected patients it can be contemplated as a second-step endoscopic treatment approach. Indications for redo ESG are the same as for the first procedure.…”

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

Boškoski

Pontecorvi

Gallo

et al. 2020

Therap Adv Gastroenterol

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Background: Endoscopic sleeve gastroplasty (ESG) is a restrictive endoscopic bariatric procedure providing promising results. In this short case series, we analyze the technical aspects and short-term outcomes of the redo ESG. Methods: A retrospective analysis was done on a prospective database of all patients that were selected by a multidisciplinary team that underwent ESG between March 2017 and May 2019. Patients that underwent a redo ESG because of a progressive loss of satiety, weight regain, or insufficient weight loss due to high baseline body mass index were included. Percentage of excess weight loss (%EWL), percentage of total body weight loss (%TBWL), and the Bariatric Analysis and Reporting Outcome System (BAROS) questionnaire were evaluated during follow-up. Results: A total of 120 ESG procedures were performed with mean %EWL of 44.4% (± 19.5), mean %TBWL of 18.3% (± 6.7), and mean BAROS of 4.5 (± 1.7) at 12 months. Of those, four patients that underwent a redo ESG were identified. A total of three of them had a redo ESG after 12 months from the first ESG, whereas one of them had a redo ESG after 7 months. During the second procedure, old threads were removed with scissors and new stitches were positioned following a triangular pattern and avoiding overlap with the previous stitches. No adverse events were reported during the redo ESG. Six month follow-up was available for three patients, mean %EWL and %TBWL were 44.2% and 20.4%, respectively; BAROS questionnaire mean score was 6.3. One patient had only 1 month follow-up with a mean %EWL and %TBWL of 33.3% and 12.2%, respectively; BAROS questionnaire reported score was 6. All included patients reported excellent satiety feeling after redo ESG. Conclusions: The redo ESG short-term outcomes are completely satisfying in terms of safety and efficacy. The need to perform a redo ESG should not be considered as a failure of the previous procedure, but it can be considered as a second step of the endoscopic treatment strategy.

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Endoscopic sutured gastroplasty: procedure evolution from first-in-man cases through current technique

Abstract: Following a methodical procedure development phase, ESG demonstrated safety and short-term efficacy in this trial. The procedure also achieved meaningful weight loss during the follow-up period.

Cited by 92 publications

References 10 publications

Endoscopic sleeve gastroplasty for obesity: defining the risk and reward after more than 1600 procedures

Endoscopic sleeve gastroplasty for obesity: defining the risk and reward after more than 1600 procedures

Endoscopic sleeve gastroplasty is an effective and safe minimally invasive approach for treatment of obesity: First Indian experience

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

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