Endoscopic Sleeve Gastrectomy Conversion to Roux-en-Y Gastric Bypass

Abstract Background Endoscopic sleeve gastroplasty (ESG) is an effective treatment option for obesity. However, data comparing its efficacy to bariatric surgery are scarce. We aimed to compare the effectiveness and safety of ESG with laparoscopic sleeve gastrectomy (LSG) and laparoscopic greater curve plication (LGCP) at 2 years. Methods We reviewed 353 patient records and identified 296 patients who underwent ESG (n = 199), LSG (n = 61), and LGCP (n = 36) at four centers in Spain between 2014 and 2016. We compared their total body weight loss (%TBWL) and safety over 2 years. A linear mixed model (LMM) was used to analyze repeated measures of weight loss outcomes at 6, 12, 18, and 24 months to compare the three procedures. Results Among the 296 patients, 210 (ESG 135, LSG 43, LGCP 32) completed 1 year of follow-up and 102 (ESG 46, LSG 34, LGCP 22) reached 2 years. Their mean (standard deviation [SD]) body mass index (BMI) was 39.6 (4.8) kg/m2. There were no differences in age, sex, or BMI between the groups. In LMM analysis, adjusting for age, sex, and initial BMI, we found ESG had a significantly lower TBWL, %TBWL, and BMI decline compared with LSG and LGCP at all time points (P = 0.001). The adjusted mean %TBWL at 2 years for ESG, LSG, and LGCP were 18.5 %, 28.3 %, and 26.9 %, respectively. However, ESG, when compared with LSG and LGCP, had a shorter inpatient stay (1 vs. 3 vs. 3 days; P < 0.001) and lower complication rate (0.5 % vs. 4.9 % vs. 8.3 %; P = 0.006). Conclusion All three procedures induced significant weight loss in obese patients. Although the weight loss was lower with ESG compared with other techniques, it displayed a better safety profile and shorter hospital stay.

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Initial experience with endoscopic sleeve gastroplasty in Poland

Polish Journal of Surgery ◽

10.5604/01.3001.0011.7488 ◽

2018 ◽

Vol 90 (2) ◽

pp. 16-22 ◽

Cited By ~ 1

Author(s):

Aleksander Sowier ◽

Przemysław Pyda ◽

Anna-Maria Borucka ◽

Sebastian Sowier ◽

Jacek Białecki ◽

...

Keyword(s):

Weight Loss ◽

Body Weight ◽

Sleeve Gastrectomy ◽

Laparoscopic Sleeve Gastrectomy ◽

Body Weight Loss ◽

Total Body Weight ◽

Sleeve Resection ◽

Less Invasive ◽

Endoscopic Sleeve Gastroplasty ◽

Sleeve Gastroplasty

Introduction: Obesity is becoming one of the major public health problems. Bariatric procedures are considered the most effective methods of treating this condition but they are costly and entail a high risk of complications. Thus, there is a need to look for better bariatric treatment solutions. One of the newest, highly promising bariatric methods is endoscopic sleeve gastroplasty (ESG), which is comparably effective to other bariatric procedures in terms of weight loss but at the same time it is much less invasive. Materials and methods: Eight obese patients underwent ESG. Under general anaesthesia, an endoscope was inserted into the stomach, where a row of 4-5 running stitches was placed (from the pyloric part towards the GE junction). Each of the stitches was cinched tight, which resulted in gastric lumen reduction comparable to that achieved with laparoscopic sleeve gastrectomy. Results: The procedures were performed without any severe peri-operative complications. The only adverse event was a minor haemorrhage in one of the patients, which did not require any surgical intervention. After the surgery, the patients reported a substantial weight loss. Mean %TBWL was 8.6%, 15.4% and 19.6% at 1, 2 and 3 months, respectively. Conclusions: Minimally invasive and highly effective in body weight reduction, endoscopic sleeve gastroplasty is a promising method of treating obesity. The procedure requires appropriate tools and equipment. The method guarantees gastric volume reduction comparable to that achieved with sleeve resection. The initial results confirm that the effectiveness of the surgery in terms of body weight loss is similar to that seen in other forms of bariatric treatment. Discussion: Compared to laparoscopic sleeve gastrectomy, endoscopic sleeve gastroplasty is substantially less invasive. Also, it requires shorter procedure time and shorter hospital stay. Data from other medical centres demonstrate somewhat lower dynamics of total body weight loss but these results need to be verified in a long-term follow-up.

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Initial experience with endoscopic sleeve gastroplasty in Poland

Polish Journal of Surgery ◽

10.5604/01.3001.0011.8183 ◽

2018 ◽

Vol 90 (4) ◽

pp. 6-11 ◽

Cited By ~ 3

Author(s):

Przemysław Pyda ◽

Aleksander Sowier ◽

Sebastian Sowier ◽

Anna-Maria Borucka ◽

Joanna Kapturzak ◽

...

Keyword(s):

Weight Loss ◽

Body Weight ◽

Sleeve Gastrectomy ◽

Laparoscopic Sleeve Gastrectomy ◽

Body Weight Loss ◽

Total Body Weight ◽

Sleeve Resection ◽

Less Invasive ◽

Endoscopic Sleeve Gastroplasty ◽

Sleeve Gastroplasty

Introduction: Obesity is becoming one of the major public health problems. Bariatric procedures are considered the most effective methods of treating this condition but they are costly and entail a high risk of complications. Thus, there is a need to look for better bariatric treatment solutions. One of the newest, highly promising bariatric methods is endoscopic sleeve gastroplasty (ESG), which is comparably effective to other bariatric procedures in terms of weight loss but at the same time it is much less invasive. Materials and methods: Eight obese patients underwent ESG. Under general anaesthesia, an endoscope was inserted into the stomach, where a row of 4-5 running stitches was placed (from the pyloric part towards the GE junction). Each of the stitches was cinched tight, which resulted in gastric lumen reduction comparable to that achieved with laparoscopic sleeve gastrectomy. Results: The procedures were performed without any severe peri-operative complications. The only adverse event was a minor haemorrhage in one of the patients, which did not require any surgical intervention. After the surgery, the patients reported a substantial weight loss. Mean %TBWL was 8.6%, 15.4% and 19.6% at 1, 2 and 3 months, respectively. Conclusions: Minimally invasive and highly effective in body weight reduction, endoscopic sleeve gastroplasty is a promising method of treating obesity. The procedure requires appropriate tools and equipment. The method guarantees gastric volume reduction comparable to that achieved with sleeve resection. The initial results confirm that the effectiveness of the surgery in terms of body weight loss is similar to that seen in other forms of bariatric treatment. Discussion: Compared to laparoscopic sleeve gastrectomy, endoscopic sleeve gastroplasty is substantially less invasive. Also, it requires shorter procedure time and shorter hospital stay. Data from other medical centres demonstrate somewhat lower dynamics of total body weight loss but these results need to be verified in a long-term follow-up.

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Endoscopic sleeve gastroplasty in the management of weight regain after sleeve gastrectomy

Endoscopy ◽

10.1055/a-1086-0627 ◽

2020 ◽

Vol 52 (03) ◽

pp. 202-210 ◽

Cited By ~ 3

Author(s):

Diogo Turiani Hourneaux de Moura ◽

Sérgio Barrichello Jr ◽

Eduardo Guimarães Hourneaux de Moura ◽

Thiago Ferreira de Souza ◽

Manoel dos Passos Galvão Neto ◽

...

Keyword(s):

Weight Loss ◽

Sleeve Gastrectomy ◽

Weight Regain ◽

Clinical Success ◽

Overweight And Obesity ◽

Obesity Class ◽

Endoscopic Sleeve Gastroplasty ◽

Percent Excess Weight Loss ◽

Long Term Follow Up ◽

Sleeve Gastroplasty

Abstract Background Sleeve gastrectomy is a well-standardized surgical treatment for obesity. However, rates of weight regain after sleeve gastrectomy in long-term follow-up are relatively high. This multicenter study is the first to evaluate the use of an endoscopic sleeve gastroplasty (ESG) technique for the management of this population. Methods This was a multicenter retrospective study, including patients with weight regain following sleeve gastrectomy who underwent ESG for weight loss. Primary outcomes included absolute weight loss, percent total weight loss (%TWL), change in body mass index (BMI), percent excess weight loss (%EWL) at 6 and 12 months, and safety profile. Clinical success was defined as achieving ≥ 25 % EWL at 1 year, ≤ 5 % serious adverse event (SAE) rate following society-recommended thresholds, and %TWL ≥ 10 %. Results 34 patients underwent ESG after sleeve gastrectomy. Technical success was 100 %. At 1 year, 82.4 % and 100 % of patients achieved ≥ 10 %TWL and ≥ 25 % EWL, respectively. Mean (SD) %TWL was 13.2 % (3.9) and 18.3 % (5.5), and %EWL was 51.9 % (19.1) and 69.9 % (29.9) at 6 months and 1 year, respectively. Mean (SD) %TWL was 14.2 % (12.5), 19.3 % (5.3), 17.5 % (5.2), and 20.4 % (3.3), and %EWL was 88.5 % (52.8), 84.4 % (22.4), 55.4 % (14.8), and 47.8 % (11.2) for BMI categories of overweight and obesity class I, II, and III, respectively, at 1 year. No predictors of success were identified in the multivariable regression analysis. No SAEs were reported. Conclusion ESG appears to be safe and effective in the management of weight regain following sleeve gastrectomy.

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ENDOSCOPIC SLEEVE GASTROPLASTY - MINIMALLY INVASIVE THERAPY FOR PRIMARY OBESITY TREATMENT

ABCD Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) ◽

10.1590/0102-6720201600s10023 ◽

2016 ◽

Vol 29 (suppl 1) ◽

pp. 95-97 ◽

Cited By ~ 18

Author(s):

Manoel dos Passos GALVÃO-NETO ◽

Eduardo GRECCO ◽

Thiago Ferreira de SOUZA ◽

Luiz Gustavo de QUADROS ◽

Lyz Bezerra SILVA ◽

...

Keyword(s):

Abdominal Pain ◽

Sleeve Gastrectomy ◽

Gastric Fundus ◽

Minimally Invasive Therapy ◽

Early Complications ◽

Endoscopic Sleeve Gastroplasty ◽

Mild Abdominal Pain ◽

Technical Details ◽

Sleeve Gastroplasty ◽

Greater Curvature

ABSTRACT Background: Less invasive and complex procedures have been developed to treat obesity. The successful use of Endoscopic Sleeve Gastroplasty using OverStitch(r) (Apollo Endosurgery, Austin, Texas, USA) has been reported in the literature. Aim: Present technical details of the procedure and its surgical/ endoscopic preliminary outcome. Method: The device was used to perform plications along the greater curvature of the stomach, creating a tubulization similar to a sleeve gastrectomy. Result: A male patient with a BMI of 35.17 kg/m2 underwent the procedure, with successful achievement of four plications, and preservation of gastric fundus. The procedure was successfully performed in 50 minutes, time without bleeding or other complications. The patient presented mild abdominal pain and good acceptance of liquid diet. Conclusions: The endoscopic gastroplasty procedure was safe, with acceptable technical viability, short in duration and without early complications.

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Efficacy and Safety of Endoscopic Sleeve Gastroplasty versus Laparoscopic Sleeve Gastrectomy in Obese Subjects with non-alcoholic steatohepatitis (NASH): Study protocol for a randomised controlled trial (TESLA-NASH study)

10.21203/rs.3.rs-618551/v1 ◽

2021 ◽

Author(s):

LUCIA LAVIN-ALCONERO ◽

TATIANA FERNANDEZ-LANAS ◽

PAULA IRUZUBIETA COZ ◽

MARIA TERESA ARIAS-LOSTE ◽

JUAN CARLOS RODRIGUEZ DUQUE ◽

...

Keyword(s):

Metabolic Syndrome ◽

Weight Loss ◽

Sleeve Gastrectomy ◽

Laparoscopic Sleeve Gastrectomy ◽

Standard Treatment ◽

Liver Histology ◽

Obese Patients ◽

Efficacy And Safety ◽

Endoscopic Sleeve Gastroplasty ◽

Sleeve Gastroplasty

Abstract Background : Non-alcoholic steatohepatitis (NASH) is a growing public health problem that affects more than 5% of the population. The standard treatment is weight loss with diet and exercise, which has been shown a histological and analytical improvement in patients capable to achieve a 5-10% reduction in their body weight. However, less than 25% of subjects achieve this goal. Bariatric surgery (BS) is the treatment of choice for its efficacy in obese patients. This intervention has resolved NASH in 85% of cases. However, bariatric endoscopy (BE) is presented as a therapeutic alternative with good results in terms of efficacy, long-term weight loss, and safety, decrease of adverse events. Methods : The TESLA-NASH study is a randomized, controlled, open-label, unicentric clinical trial with a medical device. The aim of this study is to evaluate and compare the efficacy and safety of endoscopic sleeve gastroplasty (ESG) versus laparoscopic sleeve gastrectomy (LSG) in liver histology improvement of patients with obesity +/- metabolic syndrome and NASH. A total of 30 patients will be randomized 1:1 to the experimental or control group. Discussion : Gastric bypass surgery and restrictive surgical treatments have been successful improving metabolic syndrome, insulin resistance and liver histology of obese patients. Currently, endoscopic techniques which are less invasive, are being developed, showing fewer complications and lower sanitary cost, and gastric restrictions with similar characteristics to the traditional surgical method. The tubulization or vertical gastroplasty with the OverStitch system (Apollo Endosurgery, Austin, TX, USA) is one of the most promising one. However, currently, any method is accepted as a standard treatment for NASH. Trial registration : Clinical trial.gov: NCT04060368. Registred on 19 August 2019, https://clinicaltrials.gov/ct2/show/NCT04060368 Protocol version: v 2.0, dated 15 nov 2019.

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Endoscopic Sleeve Gastroplasty, Laparoscopic Sleeve Gastrectomy, and Laparoscopic Band for Weight Loss: How Do They Compare?

Journal of Gastrointestinal Surgery ◽

10.1007/s11605-017-3615-7 ◽

2017 ◽

Vol 22 (2) ◽

pp. 267-273 ◽

Cited By ~ 41

Author(s):

Aleksey A. Novikov ◽

Cheguevara Afaneh ◽

Monica Saumoy ◽

Viviana Parra ◽

Alpana Shukla ◽

...

Keyword(s):

Weight Loss ◽

Sleeve Gastrectomy ◽

Laparoscopic Sleeve Gastrectomy ◽

Endoscopic Sleeve Gastroplasty ◽

Sleeve Gastroplasty

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A Rare Case of Gastric Volvulus Post Laparoscopic Gastric Greater Curvature Plication

The Surgery Journal ◽

10.1055/s-0040-1701224 ◽

2020 ◽

Vol 06 (01) ◽

pp. e24-e27

Author(s):

Antoine Kachi ◽

Khalil Chidiac ◽

Charif Khaled

Keyword(s):

Weight Loss ◽

Gastric Bypass ◽

Sleeve Gastrectomy ◽

Rare Case ◽

Gastric Volvulus ◽

Atypical Presentation ◽

Rare Entity ◽

Surgery Patient ◽

Greater Curvature ◽

Greater Curvature Plication

AbstractGastric volvulus is a rare entity. Its diagnosis remains tricky and challenging. In recent years, the incidence of gastric volvulus has shown a rise in postbariatric surgery patient. Several cases were reported of gastric remnant volvulus post-laparoscopic sleeve gastrectomy and laparoscopic gastric bypass. Laparoscopic gastric greater curvature plication is a new and experimental restrictive technique for weight loss. Several of its complications were reported in the literature but never was a case of volvulus postgastric plication reported, as far as we know. We present this rare case with an atypical presentation and go through similar cases in the literature.

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Outcomes of endoscopic sleeve gastroplasty; how does it compare to laparoscopic sleeve gastrectomy? A systematic review and meta-analysis

Endoscopy International Open ◽

10.1055/a-1120-8350 ◽

2020 ◽

Vol 08 (04) ◽

pp. E558-E565 ◽

Cited By ~ 1

Author(s):

Babu P. Mohan ◽

Ravishankar Asokkumar ◽

Shahab R. Khan ◽

Rajesh Kotagiri ◽

Gurusravanan Kutti Sridharan ◽

...

Keyword(s):

Weight Loss ◽

Sleeve Gastrectomy ◽

Laparoscopic Sleeve Gastrectomy ◽

Meta Analysis ◽

Time Frame ◽

Invasive Technique ◽

Similar Time ◽

Endoscopic Sleeve Gastroplasty ◽

Sleeve Gastroplasty ◽

Treatment Of Obesity

Abstract Background and study aims Endoscopic sleeve gastroplasty (ESG) is a novel moderately invasive technique in endo-bariatrics as compared to laparoscopic sleeve gastrectomy (LSG). Data is limited as to its efficacy and safety. Methods We searched multiple databases from inception through August 2019 to identify studies that reported on ESG in the treatment of obesity. Our goals were to calculate the pooled rates of total weight loss (%TWL), excess weight loss (%EWL), and body mass index (BMI) at 1 month, 6 months, and 12 months with ESG. We included studies that reported on LSG, in a similar time frame as ESG, and compared the 12-month outcomes. Results From eight studies on ESG (1815 patients), the pooled rates of %TWL at 1 month, 6 months, and 12 months were 8.7 (7.2–10.2), 15.3 (14.1–16.6) and 17.1 (15.1–19.1), respectively. The pooled rates of %EWL at 1 month, 6 months, and 12 months were 31.7 (29.3–34.1), 59.4 (57–61.8) and 63 (51.3–74.6), respectively. The pooled rates of BMI at 1 m, 6 m, and 12 m were 32.6 (31–34.3), 30.4 (29–31.8) and 30 (27.7–32.3, I2 = 97), respectively. At 12 months, the pooled %TWL, %EWL and BMI with LSG (7 studies, 2179 patients) were 30.5 (27.4–33.5), 69.3 (60.1–78.4) and 29.3 (27.1–31.4) respectively. On comparison analysis, %TWL with LSG was superior to ESG (P = 0.001). %EWL and BMI were comparable. All adverse events, bleeding and gastro-esophageal reflux disease were significantly lower with ESG when compared to LSG. Conclusion ESG demonstrates acceptable weight loss parameters and seems to have a better safety profile when compared to LSG.

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Conversion of sleeve Gastrectomy to Roux-en-Y Gastric bypass for weight loss failure

Journal of the Faculty of Medicine Baghdad ◽

10.32007/jfacmedbagdad.v60i1.31 ◽

2018 ◽

Vol 60 (1) ◽

pp. 5-8

Author(s):

Mohammed Q. Abdul Jabbar ◽

Ramiz S. Mukhtar ◽

Mustafa A. Abbas

Keyword(s):

Weight Loss ◽

Gastric Bypass ◽

Sleeve Gastrectomy ◽

Laparoscopic Sleeve Gastrectomy ◽

Laparoscopic Adjustable Gastric Band ◽

Adjustable Gastric Band ◽

Bariatric Operation ◽

Weight Loss Failure ◽

Insufficient Weight Loss ◽

Global Health Issue

Background: Obesity is a global health issue. Laparoscopic sleeve gastrectomy has progressively become the most popular procedure among the surgical community as a definitive bariatric operation. The increasing number of surgeries performed will be likely be followed by increasing reports of patients experiencing weight loss failure.Objectives: To determine the effectiveness of conversion from laparoscopic sleeve gastrectomy to Roux-en-Y gastric bypass in cases with weight loss failure.Patient &methods: The retrospective review of patients who had operated with laparoscopic sleeve gastrectomy from October 2009 to January 2016 at Saint Raphael hospital, 21 patients included in this study had insufficient weight loss after Sleeve Gastrectomy and converted to Roux-en-Y gastric bypass.Results: Fifteen patients (71.4%) had LSG as their single bariatric operation before conversion to roux en Y gastric bypass, 2 patients (9.5%) had Intragastric balloon and 4 (19.1%) patients had the laparoscopic adjustable gastric band before to their sleeve gastrectomy. Fourteen patients (66.6%) were female and 7 (33.4%) were males, At 6, 12, 18 months after bypass ,mean BMI was 37.2 (32.7-44.3),32.5(28.7-39.1) and 30.2 kg/m2 (24.3-37.9 kg/m2) respectively , reflecting a %EWL (percentage weight loss) at 18 month of 61.7%.Conclusion: insufficient weight loss after Sleeve Gastrectomy can be safely and effectively treated by conversion to Roux-en-Y gastric bypass to control weight loss failure or weight regain.Keywords: weight loss failure, weight regain, failed Sleeve Gastrectomy تحويل عملية قص المعدة الى عملية تحويل مسار المعدة للمرضى الذين فشلوا في فقدان الوزن د. محمد قاسم عبدالجبار د. رامز سامي مختار د. مصطفى عادل عباس الخلاصة: خلفية: البدانة لا تزال تمثل مصدر قلق كبير في جميع أنحاء العالم. وقد اكتسبت استئصال و تكميم المعدة بالمنظار شعبية كبيرة بين المجتمع الجراحي باعتباره إجراء جراحي مستقل. ومن المرجح أن يتبع العدد المتزايد في اجراء قَص وتكميم المعدة بوجود إعداد متزايدة من المرضى الذين يعانون من فشل في فقدان الوزن ، وتعرف بأن فقدان الوزن غير كافي أو اكتساب الوزن من جديد. الهدف من الدراسة: لتقييم فعالية تحويل قَص وتكميم المعدة الى عملية تحويل مسار المعدة في موضوع فشل فقدان الوزن المرضى والطرق: استعراض بأثر رجعي للمرضى الذين خضعوا لقص وتكميم المعدة بالمنظار من تشرين الاول ٢٠٠٩ حتى كانون الاول ٢٠١٦في مستشفى القديس رافائيل(الراهبات)، خضع ٢١ مريضا يعانون من فشل في فقدان الوزن بعد عملية قَص وتكميم المعدة الى عملية تحويل مسار المعدة بالناظور وتمت متابعة فقدان الوزن لدى المرضى لمدة ١٨ شهر أو اكثر. النتائج: خضع سبعة عشر مريضا (٨٠.٩٪) لعملية قَص وتكميم المعدة كإجراء وحيد ، وخضع ٤ (١٩.١٪) من المرضى لعملية قرص المعدة قبل اجراء قَص وتكميم المعدة. وكان ١٤ مريضا (٦٦.٦٪) من الإناث و ٧ (٣٣.٤٪) من الذكور، في الشهر السادس و والاثنا عشر والثامن عشر شهرا بعد بعد تحويل مسار المعدة، كان متوسط مؤشر كتلة الجسم ٣٧.٢ (٣٢.٧-٤٤.٣)، ٣٢.٥ (٢٨.٧-٣٩.١) و ٣٠.٢ كجم / م ٢ (٢٤.٣ -٣٧.٩ كغ / م ٢) على التوالي، مما يعكس (نسبة فقدان الوزن) في الشهر الثامن عشر ٦١.٧٪. الاستنتاج: عملية تحويل مسار المعدة بالناظور بعد فشل فقدان الوزن بعد عملية قَص وتكميم المعدة هو اجراء أمن وفعال. كلمات البحث: فشل في فقدان الوزن ،استعادة الوزن، فشل قَص وتكميم المعدة

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