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Endoscopic Sleeve Gastroplasty (ESG) Is a Reproducible and Effective Endoscopic Bariatric Therapy Suitable for Widespread Clinical Adoption: a Large, International Multicenter Study.

Endoscopic Sleeve Gastroplasty (ESG) Is a Reproducible and Effective Endoscopic Bariatric Therapy Suitable for Widespread Clinical Adoption: a Large, International Multicenter Study.

Obes Surg. 2018 Jul;28(7):1812-1821. doi: 10.1007/s11695-018-3135-x.
OBJECTIVE:
Endoscopic sleeve gastroplasty (ESG), an incisionless endoscopic bariatric procedure, has shown impressive results in case
series. This study examines the reproducibility, efficacy, and safety in three centers across two countries, and identifies key
determinants for procedural success.


DESIGN:
Patients who underwent ESG between February 2016 and May 2017 at one of three centers (Australia and USA) were
retrospectively analyzed. All procedures were performed on an outpatient basis using the Apollo OverStitch device (Apollo
Endosurgery, Austin, TX). Primary outcomes included absolute weight loss (ΔWeight, kg), change in body mass index (ΔBMI,
in kg/m2), total body weight loss (TBWL, %), excess weight loss (EWL, in %), and immediate and delayed adverse events.
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RESULTS:
In total, 112 consecutive patients (male 31%, age 45.1 ± 11.7 years, baseline BMI 37.9 ± 6.7 kg/m2) underwent ESG. At 1, 3,
and 6 months, Δweight was 9.0 ± 4.6 kg (TBWL 8.4 ± 4.1%), 12.9 ± 6.4 kg (TBWL 11.9 ± 4.5%), and 16.4 ± 10.7 kg (TBWL
14.9 ± 6.1%), respectively. The proportion of patients who attained greater than 10% TBWL and 25% EWL was 62.2 and 78.0%
at 3 months post-ESG and 81.0 and 86.5% at 6 months post-ESG. Weight loss was similar between the three centers.
Multivariable analysis showed that male sex, greater baseline body weight, and lack of prior endoscopic bariatric therapy were
predictors of greater Δweight at 6 months. Three (2.7%) severe adverse events were observed.
CONCLUSIONS:
ESG is an effective, reproducible, and safe weight loss therapy that is suitable for widespread clinical adoption.