Endoscopic sleeve gastroplasty: early results of a minimally invasive procedure in patients with obesity

Surg Endosc. 2023 Apr;37(4):3215-3223. doi: 10.1007/s00464-023-09982-z. Epub 2023 Mar 15.

Abstract

Objectives: We aimed to analyze the efficacy and safety of endoscopic sleeve gastroplasty at 3 months as well as to determine factors influencing post-procedural weight loss.

Methods: Seventy-three patients with obesity classes I, II and III (BMI 31.1-46.6 kg/m2) underwent ESG between September 2021 and April 2022 at a tertiary care hospital using Overstitch (Apollo Endosurgery, Austin, TX). ESG's efficacy and safety was evaluated at 1 and 3 months post-procedure with regard to excess weight loss (EWL) and total weight loss (TWL). Categorical variables were expressed as percentages and compared with chi-square test while continuous variables were expressed as mean ± standard deviation and compared with paired t test and analysis of variance (ANOVA) as applicable. Pearson's correlation was used to determine association between factors at baseline and weight loss.

Results: Mean age was 49.2 ± 9.7 years with 61 (83.6%) patients being female. Mean initial weight was 105.7 ± 15.7 kg, and mean BMI was 38.6 ± 3.5 kg/m2. Median hospitalization was 2.0 ± 1.8 days with 62 (84.9%) patients discharged after 24 h. One patient had accidental suturing of the stomach to the abdominal wall and diaphragm which was managed laparoscopically. Mean %EWL was 25.4 ± 7.1 and 36.3 ± 11.4, and %TBWL was 11.2 ± 2.6 and 15.8 ± 4.2 at 1 and 3 months, respectively. Significant excess weight loss at 3 months was only observed in patients with BMI < 40 kg/m2 (p = 0.001).

Conclusions: ESG is safe and effective to manage obesity. Significant weight loss at 3 months was only observed in patients with obesity class I and class II.

Keywords: Bariatrics; Endoscopy; Gastroplasty; Obesity; Weight loss.

MeSH terms

  • Adult
  • Endoscopy / methods
  • Female
  • Gastroplasty* / methods
  • Humans
  • Male
  • Middle Aged
  • Obesity / complications
  • Obesity / surgery
  • Obesity, Morbid* / surgery
  • Treatment Outcome
  • Weight Loss