Clinical Endoscopy

Focused Review Series: Updates on endoscopic bariatric and metabolic therapies

Experimental Gastric Non-Balloon Devices: Youn I Choi, Kyoung Oh Kim; Clin Endosc 2018;51(5):420-424. Published online September 27, 2018; DOI: https://doi.org/10.5946/ce.2018.150

Endoscopic bariatric therapies (EBTs) are promising alternatives to the conventional surgeries used to treat obesity and related metabolic conditions, targeting gastrointestinal anatomical and physiological processes. Many EBTs are at various stages of development and are aimed at promoting an early sense of satiety via anatomical and physiological mechanisms. In the present study, we focused on relevant clinical issues and future perspectives with regard to gastric non-balloon methods treating obesity.

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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

Abstract PDF PubReader ePub

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.

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