Endoscopic Sleeve Gastroplasty (ESG) Is a Reproducible and Effective Endoscopic Bariatric Therapy Suitable for Widespread Clinical Adoption

a Large, International Multicenter Study

Adrian Sartoretto, Zhixian Sui, Christine Hill, Margo Dunlap, Angielyn R. Rivera, Mouen Khashab, Anthony N Kalloo, Lea Fayad, Lawrence J Cheskin, George Marinos, Erik Wilson, Vivek Kumbhari

Research output: Contribution to journalArticle

Abstract

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 (∆BMI, in kg/m2), total body weight loss (TBWL, %), excess weight loss (EWL, in %), and immediate and delayed adverse events. 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.

Original languageEnglish (US)
Pages (from-to)1-10
Number of pages10
JournalObesity Surgery
DOIs
StateAccepted/In press - Feb 15 2018

Fingerprint

Gastroplasty
Bariatrics
Multicenter Studies
Weight Loss
Weights and Measures
Therapeutics
Body Weight
Body Mass Index
Outpatients
Safety
Equipment and Supplies

Keywords

  • Endoscopic bariatric therapy
  • Endoscopic sleeve gastroplasty
  • Endoscopic suturing
  • Obesity
  • Weight loss

ASJC Scopus subject areas

  • Surgery
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics

Cite this

Endoscopic Sleeve Gastroplasty (ESG) Is a Reproducible and Effective Endoscopic Bariatric Therapy Suitable for Widespread Clinical Adoption : a Large, International Multicenter Study. / Sartoretto, Adrian; Sui, Zhixian; Hill, Christine; Dunlap, Margo; Rivera, Angielyn R.; Khashab, Mouen; Kalloo, Anthony N; Fayad, Lea; Cheskin, Lawrence J; Marinos, George; Wilson, Erik; Kumbhari, Vivek.

In: Obesity Surgery, 15.02.2018, p. 1-10.

Research output: Contribution to journalArticle

Sartoretto, Adrian ; Sui, Zhixian ; Hill, Christine ; Dunlap, Margo ; Rivera, Angielyn R. ; Khashab, Mouen ; Kalloo, Anthony N ; Fayad, Lea ; Cheskin, Lawrence J ; Marinos, George ; Wilson, Erik ; Kumbhari, Vivek. / Endoscopic Sleeve Gastroplasty (ESG) Is a Reproducible and Effective Endoscopic Bariatric Therapy Suitable for Widespread Clinical Adoption : a Large, International Multicenter Study. In: Obesity Surgery. 2018 ; pp. 1-10.
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abstract = "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 (∆BMI, in kg/m2), total body weight loss (TBWL, {\%}), excess weight loss (EWL, in {\%}), and immediate and delayed adverse events. 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.",
keywords = "Endoscopic bariatric therapy, Endoscopic sleeve gastroplasty, Endoscopic suturing, Obesity, Weight loss",
author = "Adrian Sartoretto and Zhixian Sui and Christine Hill and Margo Dunlap and Rivera, {Angielyn R.} and Mouen Khashab and Kalloo, {Anthony N} and Lea Fayad and Cheskin, {Lawrence J} and George Marinos and Erik Wilson and Vivek Kumbhari",
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T1 - Endoscopic Sleeve Gastroplasty (ESG) Is a Reproducible and Effective Endoscopic Bariatric Therapy Suitable for Widespread Clinical Adoption

T2 - a Large, International Multicenter Study

AU - Sartoretto, Adrian

AU - Sui, Zhixian

AU - Hill, Christine

AU - Dunlap, Margo

AU - Rivera, Angielyn R.

AU - Khashab, Mouen

AU - Kalloo, Anthony N

AU - Fayad, Lea

AU - Cheskin, Lawrence J

AU - Marinos, George

AU - Wilson, Erik

AU - Kumbhari, Vivek

PY - 2018/2/15

Y1 - 2018/2/15

N2 - 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 (∆BMI, in kg/m2), total body weight loss (TBWL, %), excess weight loss (EWL, in %), and immediate and delayed adverse events. 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.

AB - 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 (∆BMI, in kg/m2), total body weight loss (TBWL, %), excess weight loss (EWL, in %), and immediate and delayed adverse events. 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.

KW - Endoscopic bariatric therapy

KW - Endoscopic sleeve gastroplasty

KW - Endoscopic suturing

KW - Obesity

KW - Weight loss

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