How Do They Compare?
Endoscopic sleeve gastroplasty (ESG) is a novel endobariatric procedure. Initial studies demonstrated an association of ESG
with weight loss and improvement of obesity-related comorbidities. Our aim was to compare ESG to
laparoscopic sleeve gastrectomy (LSG) and laparoscopic adjustable gastric banding (LAGB).
We included 278 obese (BMI > 30) patients who underwent ESG (n = 91), LSG (n = 120), or LAGB (n = 67) at our tertiary care
academic center. Primary outcome was percent total body weight loss (%TBWL) at 3, 6, 9, and 12 months. Secondary outcome
measures included adverse events (AE), length of stay (LOS), and readmission rate.
At 12-month follow-up, LSG achieved the greatest %TBWL compared to LAGB and ESG (29.28 vs 13.30 vs 17.57%,
respectively; p < 0.001). However, ESG had a significantly lower rate of morbidity when compared to LSG or LAGB (p = 0.01).
The LOS was significantly less for ESG compared to LSG or LAGB (0.34 ± 0.73 vs 3.09 ± 1.47 vs 1.66 ± 3.07 days,
respectively; p < 0.01). Readmission rates were not significantly different between the groups (p = 0.72).
Although LSG is the most effective option for weight loss, ESG is a safe and feasible endobariatric option associated with low
morbidity and short LOS in select patients