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Review
Endoscopic Sleeve Gastroplasty - A New Tool to Manage Obesity
Deepanshu Jain, Bharat Singh Bhandari, Ankit Arora, Shashideep Singhal
Clin Endosc 2017;50(6):552-561.   Published online June 13, 2017
DOI: https://doi.org/10.5946/ce.2017.032
AbstractAbstract PDFPubReaderePub
Obesity is a growing pandemic across the world. Dietary restrictions and behavior modifications alone have a limited benefit. Bariatric surgery, despite being the current gold standard, has limited acceptance by patients due to cost and associated morbidity. In our review, we have discussed nine original studies describing endoscopic sleeve gastroplasty (ESG). A total of 172 subjects successfully underwent ESG. Of 65 subjects with follow up data, 95.4% (62/65) had intact gastric sleeve confirmed via esophagogastroduodenoscopy or oral contrast study at the end of study specific follow up interval (the longest being 6 months). Individual studies reported a technical success rate for intact gastric sleeve from as low as 50% to as high as 100%. A statistically significant (p<0.05) weight loss was reported in seven of the eight studies with available data. None of the patients experienced any intra-procedure complications, and approximately 2.3% (4/172) of patients experienced major post-procedure complications; however, no mortality was reported. Majority of the studies reported relatively high incidence of minor post-procedure complications, which improved with symptomatic treatment alone. Good patient tolerance with comparable clinical efficacy in achieving and sustaining desired weight loss makes ESG an attractive option to consider among other bariatric therapies.

Citations

Citations to this article as recorded by  
  • Endoscopic sleeve gastroplasty – Current status and future perspectives
    Stephen Ka‐Kei Ng, Anthony Yuen‐Bun Teoh
    Digestive Endoscopy.2025;[Epub]     CrossRef
  • Overview on the endoscopic treatment for obesity: A review
    Maheeba Abdulla, Nafeesa Mohammed, Jehad AlQamish
    World Journal of Gastroenterology.2023; 29(40): 5526.     CrossRef
  • Weight Loss Effect of GLP-1 RAs With Endoscopic Bariatric Therapy and Bariatric Surgeries
    Ahmad Imam, Hussam Alim, Mohammad Binhussein, Abdulrahman Kabli, Husam Alhasnani, Abdullah Allehyani, Ammar Aljohani, Ahmad Mohorjy, Abdullah Tawakul, Mohammed Samannodi, Wael Taha
    Journal of the Endocrine Society.2023;[Epub]     CrossRef
  • Extrapancreatic Advanced Endoscopic Interventions
    Haresh Vijay Naringrekar, Haroon Shahid, Cyril Varghese, Alex Schlachterman, Sandeep P. Deshmukh, Christopher G. Roth
    RadioGraphics.2022; 42(2): 379.     CrossRef
  • Anesthesia for Advanced Endoscopic Procedures
    Basavana Goudra, Monica Saumoy
    Clinical Endoscopy.2022; 55(1): 1.     CrossRef
  • Bariatric surgery, gastrointestinal hormones, and the microbiome: An Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) 2022
    Bharti Shetye, Franchell Richard Hamilton, Harold Edward Bays
    Obesity Pillars.2022; 2: 100015.     CrossRef
  • Safety and efficacy of endoscopic sleeve gastroplasty for obesity management in new bariatric endoscopy programs: a multicenter international study
    Avik Sarkar, Augustine Tawadros, Iman Andalib, Haroon M. Shahid, Amy Tyberg, Resheed Alkhiari, Monica Gaidhane, Prashant Kedia, Elizabeth S. John, Bryce Bushe, Guadalupe Ma Martinez, Felipe Zamarripa, Mine C. Carames, Juan C. Carames, Fernando Casarodrigu
    Therapeutic Advances in Gastrointestinal Endoscopy.2022;[Epub]     CrossRef
  • Safety of Endoscopic Sleeve Gastroplasty with a Single-Channel Endoscope
    Thierry Manos, Vianna Costil, Luc Karsenty, Phillipe Costil, Patrick Noel, Sergio Carandina, Marius Nedelcu
    Obesity Surgery.2022; 32(9): 3074.     CrossRef
  • Efficacy and Mechanisms of Gastric Volume-Restriction Bariatric Devices
    Yanmin Wang, Ghassan S. Kassab
    Frontiers in Physiology.2021;[Epub]     CrossRef
  • The Use of the OverStitch for Bariatric Weight Loss in Europe
    Ravishankar Asokkumar, Mohan Pappu Babu, Inmaculada Bautista, Gontrand Lopez-Nava
    Gastrointestinal Endoscopy Clinics of North America.2020; 30(1): 129.     CrossRef
  • Endoscopic sleeve gastroplasty versus high-intensity diet and lifestyle therapy: a case-matched study
    Lawrence J. Cheskin, Christine Hill, Atif Adam, Lea Fayad, Margo Dunlap, Dilhana Badurdeen, Kristen Koller, Linda Bunyard, Robin Frutchey, Haitham Al-Grain, Scott Kahan, Abdellah Hedjoudje, Mouen A. Khashab, Anthony N. Kalloo, Vivek Kumbhari
    Gastrointestinal Endoscopy.2020; 91(2): 342.     CrossRef
  • Does endoscopic sleeve gastroplasty stand the test of time? Objective assessment of endoscopic ESG appearance and its relation to weight loss in a large group of consecutive patients
    Margherita Pizzicannella, Alfonso Lapergola, Claudio Fiorillo, Andrea Spota, Pietro Mascagni, Michel Vix, Didier Mutter, Guido Costamagna, Jacques Marescaux, Lee Swanström, Silvana Perretta
    Surgical Endoscopy.2020; 34(8): 3696.     CrossRef
  • Gallbladder perforation due to endoscopic sleeve gastroplasty: A case report and review of literature
    João de Siqueira Neto, Diogo Turiani Hourneaux de Moura, Igor Braga Ribeiro, Sérgio Alexandre Barrichello, Kelly E Harthorn, Christopher C Thompson
    World Journal of Gastrointestinal Endoscopy.2020; 12(3): 111.     CrossRef
  • Endoscopic gastric suturing for weight loss: Techniques and outcomes
    Daniel B. Maselli, Ramzi Hani Mulki, Reem Matar, Andrew C. Storm, Barham K. Abu Dayyeh
    Techniques and Innovations in Gastrointestinal Endoscopy.2020; 22(3): 136.     CrossRef
  • Perspectives toward minimizing the adverse events of endoscopic sleeve gastroplasty
    Diogo Turiani Hourneaux de Moura, Dilhana S. Badurdeen, Igor Braga Ribeiro, Eduardo Filipe Marques da Silva Dantas Leite, Christopher C. Thompson, Vivek Kumbhari
    Gastrointestinal Endoscopy.2020; 92(5): 1115.     CrossRef
  • Short-term outcomes of endoscopic sleeve gastroplasty in 1000 consecutive patients
    Aayed Alqahtani, Abdullah Al-Darwish, Ahmed Elsayed Mahmoud, Yara A. Alqahtani, Mohamed Elahmedi
    Gastrointestinal Endoscopy.2019; 89(6): 1132.     CrossRef
  • Endoscopic gastroplasty to treat medically uncontrolled obesity needs more quality data: A systematic review
    Ricardo V. Cohen, Marcus Vinícius Oliveira da Costa, Laura Charry, Elizabeth Heins
    Surgery for Obesity and Related Diseases.2019; 15(7): 1219.     CrossRef
  • Endoscopic sleeve gastroplasty: From whence we came and where we are going
    Diogo Turiani Hourneaux de Moura, Eduardo Guimarães Hourneaux de Moura, Christopher C Thompson
    World Journal of Gastrointestinal Endoscopy.2019; 11(5): 322.     CrossRef
  • Endoscopic Gastroplasty Letter: ASGE/ABE
    Steven A. Edmundowicz, Christopher C. Thompson
    Surgery for Obesity and Related Diseases.2019; 15(11): 2004.     CrossRef
  • Endoscopic sleeve gastroplasty in the management of overweight and obesity: an international multicenter study
    Sérgio Barrichello, Diogo Turiani Hourneaux de Moura, Eduardo Guimaraes Hourneaux de Moura, Pichamol Jirapinyo, Anna Carolina Hoff, Ricardo José Fittipaldi-Fernandez, Giorgio Baretta, João Henrique Felício Lima, Eduardo N. Usuy, Leonardo Salles de Almeida
    Gastrointestinal Endoscopy.2019; 90(5): 770.     CrossRef
  • UEG Week 2019 Poster Presentations

    United European Gastroenterology Journal.2019; 7(S8): 189.     CrossRef
  • Laparoscopic sleeve gastrectomy following multiple failed endoscopic sleeve gastroplasties
    Sam Alhayo, Michael Devadas
    Journal of Surgical Case Reports.2019;[Epub]     CrossRef
  • The Effectiveness of Endoscopic Gastroplasty for Obesity Treatment According to FDA Thresholds: Systematic Review and Meta-Analysis Based on Randomized Controlled Trials
    Antonio Coutinho Madruga-Neto, Wanderley Marques Bernardo, Diogo Turiani Hourneaux de Moura, Vitor Ottoboni Brunaldi, Rafael Krieger Martins, Iatagan Rocha Josino, Eduardo Turiani Hourneaux de Moura, Thiago Ferreira de Souza, Marco Aurélio Santo, Eduardo
    Obesity Surgery.2018; 28(9): 2932.     CrossRef
  • Absence of Complications after Endoscopic Mucosal Biopsy
    Brian Johnson, Marc D. Basson
    Digestive Diseases.2018; 36(4): 328.     CrossRef
  • 9,798 View
  • 384 Download
  • 27 Web of Science
  • 24 Crossref
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Original Article
Obesity and Cecal Intubation Time
Deepanshu Jain, Abhinav Goyal, Jorge Uribe
Clin Endosc 2016;49(2):187-190.   Published online February 12, 2016
DOI: https://doi.org/10.5946/ce.2015.079
AbstractAbstract PDFPubReaderePub
Background
/Aims: Obesity is a much-debated factor with conflicting evidence regarding its association with cecum intubation rates during colonoscopy. We aimed to identify the association between cecal intubation (CI) time and obesity by eliminating confounding factors.
Methods
A retrospective chart review of subjects undergoing outpatient colonoscopy was conducted. The population was categorized by sex and obesity (body mass index [BMI, kg/m2 ]: I, <24.9; II, 25 to 29.9; III, ≥30). CI time was used as a marker for a difficult colonoscopy. Mean CI times (MCT) were compared for statistical significance using analysis of variance tests.
Results
A total of 926 subjects were included. Overall MCT was 15.7±7.9 minutes, and it was 15.9±7.9 and 15.5±7.9 minutes for men and women, respectively. MCT among women for BMI category I, II, and III was 14.4±6.5, 15.5±8.3, and 16.2±8.1 minutes (p=0.55), whereas for men, it was 16.3±8.9, 15.9±8.0, and 15.6±7.2 minutes (p=0.95), respectively.
Conclusions
BMI had a positive association with CI time for women, but had a negative association with CI for men.

Citations

Citations to this article as recorded by  
  • Investigation of the relationship between colonoscopy insertion difficulty factors and endoscope shape using an endoscopic position detection unit
    Takashi Kawai, Yusuke Kawai, Yoshika Akimito, Mariko Hamada, Eri Iwata, Ryota Niikura, Naoyoshi Nagata, Mitsushige Sugimoto, Kyosuke Yanagisawa, Masakatsu Fukuzawa, Takao Itoi
    Journal of Clinical Biochemistry and Nutrition.2024; 74(3): 245.     CrossRef
  • A randomized prospective study comparing single‐balloon‐assisted colonoscopy and cap‐assisted colonoscopy in patients with previous incomplete conventional colonoscopy
    Tsz Fai Cheng, Ka Shing Cheng
    Journal of Gastroenterology and Hepatology.2023; 38(2): 225.     CrossRef
  • Factors affecting cecal intubation time during colonoscopy
    Ke Wang, Wen-Tao Xu, Wen-Jing Kou, Xing-Shun Qi
    World Chinese Journal of Digestology.2023; 31(3): 105.     CrossRef
  • Dexmedetomidine–Oxycodone combination for conscious sedation during colonoscopy in obese patients: A randomized controlled trial
    Xinran Wang, Manman Zhang, Han Sun, Rui Zhang, Yangzi Zhu, Zhen Zhang, Rongxia Shi
    Heliyon.2023; 9(5): e16370.     CrossRef
  • Efficacy and tolerability of colonoscopies in overweight and obese patients: Results from a national database on gastrointestinal endoscopic outcomes
    Monica Passi, Farial Rahman, Christopher Koh, Sheila Kumar
    Endoscopy International Open.2022; 10(04): E311.     CrossRef
  • Impact of obesity in colorectal endoscopic submucosal dissection: single-center retrospective cohort study
    Jun Tachikawa, Hideyuki Chiba, Naoya Okada, Jun Arimoto, Keiichi Ashikari, Hiroki Kuwabara, Michiko Nakaoka, Takuma Higurashi, Toru Goto, Atsushi Nakajima
    BMC Gastroenterology.2021;[Epub]     CrossRef
  • Cecal intubation time in screening colonoscopy
    Hyun Young Kim
    Medicine.2021; 100(19): e25927.     CrossRef
  • Factors affecting bowel preparation adequacy and procedural time
    Mohammadali Zad, Cuong N Do, Aaron Heffernan, Lucy Johnston, Mohammed Al‐Ansari
    JGH Open.2020; 4(2): 206.     CrossRef
  • Fecal immunochemical test in colorectal cancer screening: Colonoscopy findings by different cut‐off levels
    Hanna Ribbing Wilén, Johannes Blom, Jonas Höijer, Rolf Hultcrantz
    Journal of Gastroenterology and Hepatology.2019; 34(1): 103.     CrossRef
  • Evaluation of the combined effect of factors influencing bowel preparation and adenoma detection rates in patients undergoing colonoscopy
    Hassan Tariq, Muhammad Umar Kamal, Binita Sapkota, Fady ElShikh, Usman Ali Pirzada, Nanda Pullela, Sara Azam, Aiyi Zhang, Ahmed Baiomi, Hafsa Abbas, Jasbir Makker, Bhavna Balar, Ariyo Ihimoyan, Myrta Daniel, Anil Dev
    BMJ Open Gastroenterology.2019; 6(1): e000254.     CrossRef
  • Factors for cecal intubation time during colonoscopy in women: Impact of surgical history
    JiHyung Nam, JungHyeon Lee, JaeHak Kim, HyounWoo Kang, DongKee Jang, YunJeong Lim, Moon-Soo Koh, HyunSoo Park, Eun-Cheol Park, JunKyu Lee, JinHo Lee
    Saudi Journal of Gastroenterology.2019; 25(6): 377.     CrossRef
  • Risk factors associated with longer cecal intubation time: a systematic review and meta-analysis
    Veeravich Jaruvongvanich, Tomoki Sempokuya, Passisd Laoveeravat, Patompong Ungprasert
    International Journal of Colorectal Disease.2018; 33(4): 359.     CrossRef
  • Papel del digestólogo en el manejo del paciente obeso
    Antonio López-Serrano, Inmaculada Ortiz Polo, Javier Sanz de la Vega, Eduardo Moreno-Osset
    Gastroenterología y Hepatología.2017; 40(6): 409.     CrossRef
  • Role of the gastroenterologist in the management of the obese patient
    Antonio López-Serrano, Inmaculada Ortiz Polo, Javier Sanz de la Vega, Eduardo Moreno-Osset
    Gastroenterología y Hepatología (English Edition).2017; 40(6): 409.     CrossRef
  • Predictors for difficult cecal insertion in colonoscopy: The impact of obesity indices
    Soo Yun Moon, Byung Chang Kim, Dae Kyung Sohn, Kyung Su Han, Bun Kim, Chang Won Hong, Bum Joon Park, Kum Hei Ryu, Ji Hyung Nam
    World Journal of Gastroenterology.2017; 23(13): 2346.     CrossRef
  • Cecal intubation time between cap-assisted water exchange and water exchange colonoscopy: a randomized-controlled trial
    Chih-Wei Tseng, Malcolm Koo, Yu-Hsi Hsieh
    European Journal of Gastroenterology & Hepatology.2017; 29(11): 1296.     CrossRef
  • Can Body Mass Index Predict the Difficulty of Colonoscopy?
    Eui Joo Kim, Yoon Jae Kim
    Clinical Endoscopy.2016; 49(2): 106.     CrossRef
  • Predicting Colonoscopy Time: A Quality Improvement Initiative
    Deepanshu Jain, Abhinav Goyal, Stacey Zavala
    Clinical Endoscopy.2016; 49(6): 555.     CrossRef
  • 9,817 View
  • 97 Download
  • 20 Web of Science
  • 18 Crossref
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Case Report
Superior Mesenteric Artery Syndrome Diagnosed with Linear Endoscopic Ultrasound (with Video) in a Patient with Normal Body Mass Index
Jee Wan Wee, Tae Hee Lee, Joon Seong Lee, Wan Jung Kim
Clin Endosc 2013;46(4):410-413.   Published online July 31, 2013
DOI: https://doi.org/10.5946/ce.2013.46.4.410
AbstractAbstract PDFPubReaderePub

Superior mesenteric artery (SMA) syndrome is an uncommon disease that results from SMA compression of the third portion of the duodenum. Patients with SMA syndrome present with upper gastrointestinal symptoms, such as nausea, vomiting, and abdominal pain. The diagnosis is usually made from an upper barium study or computed tomography. Typically, SMA syndrome is caused by a decreased aortomesenteric angle of 6° to 25°. An underweight body mass index (BMI) is a risk factor for development of SMA syndrome. There are few reports of the role of linear endoscopic ultrasound (EUS) in the diagnosis of SMA syndrome. We report a case of SMA syndrome, with normal BMI, that was diagnosed with the aid of linear EUS. Although SMA syndrome is not typically within the scope of practice of endosonographers, it is useful to get familiar with the findings.

Citations

Citations to this article as recorded by  
  • Evaluating aortomesenteric parameters in a tertiary center of Nepal for superior mesenteric artery syndrome diagnosis and risk factors: cross-sectional study
    Diwas Sapkota, Bikash Bikram Adhikari, Aimandu Shrestha, Shailendra Katwal
    Annals of Medicine & Surgery.2024; 86(5): 2612.     CrossRef
  • The superior mesenteric artery angle in diagnosis of nutcracker syndrome: a systematic review and meta-analysis
    Yong Qin, Lu Tian, Xia Chen, Qiu Li
    Abdominal Radiology.2024; 50(2): 851.     CrossRef
  • New frontiers for therapeutic endoscopic ultrasound in children
    Valerio Balassone, Simona Faraci, Chiara Imondi, Paola De Angelis, Tamara Caldaro, Luigi Dall'Oglio
    International Journal of Gastrointestinal Intervention.2023; 12(1): 1.     CrossRef
  • Endoscopic ultrasound diagnosis of superior mesenteric artery syndrome
    Chiara CASTELLANA, Leonardo H. EUSEBI, Carla SERRA, Rocco M. ZAGARI, Mario LIMA
    Gazzetta Medica Italiana Archivio per le Scienze Mediche.2023;[Epub]     CrossRef
  • Superior mesenteric artery syndrome after severe head trauma
    Jurgita Gailiene, Ausra Lukosiute-Urboniene, Arturas Kilda, Vidmantas Barauskas
    Journal of Pediatric Surgery Case Reports.2019; 48: 101255.     CrossRef
  • Co-occurring superior mesenteric artery syndrome and nutcracker syndrome requiring Roux-en-Y duodenojejunostomy and left renal vein transposition: a case report and review of the literature
    Rebeca Heidbreder
    Journal of Medical Case Reports.2018;[Epub]     CrossRef
  • Superior mesenteric artery (Wilkie’s) syndrome: a rare cause of upper gastrointestinal system obstruction
    Abdullah Oguz, Omer Uslukaya, Burak Veli Ülger, Ahmet Turkoglu, Mehmet Veysi Bahadır, Zubeyir Bozdag, Abdullah Böyük, Cemil Göya
    Acta Chirurgica Belgica.2016; 116(2): 81.     CrossRef
  • 9,221 View
  • 103 Download
  • 7 Crossref
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