Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jun;35(6):2523-2530.
doi: 10.1007/s00464-020-07666-6. Epub 2020 Jun 24.

Re-suturing after primary endoscopic sleeve gastroplasty (ESG) for obesity

Gontrand Lopez-Nava #  1 , Ravishankar Asokkumar #  2   3 , Anuradha Negi  2 , Enrique Normand  2 , Inmaculada Bautista  2
Affiliations

Re-suturing after primary endoscopic sleeve gastroplasty (ESG) for obesity

Gontrand Lopez-Nava et al. Surg Endosc. 2021 Jun.

Abstract

Introduction: Although primary endoscopic sleeve gastroplasty (P-ESG) is effective, some patients may require revision procedures to augment weight loss. We hypothesized that a non-surgical approach using redo ESG (R-ESG) might be a viable option in such patients. We aimed to assess the safety and efficacy of R-ESG following P-ESG to treat obesity.

Methods: We reviewed the outcome of patients who underwent R-ESG at our unit. We classified them as weight loss failure (WF)-< 10% total body weight (TBWL) at 6-months; weight regain (WR)-lost ≥ 10% TBWL and regained 50% of the maximum weight loss at or after 1-year; weight plateau (WP)-lost ≥ 10% TBWL but could not lose further over 3-months. We analyzed the feasibility, safety, and evaluated the efficacy of R-ESG in each group.

Results: Of the 482 patients who underwent P-ESG, 35 (7%) required R- ESG (WF-12, WR-12, WP-11). The mean age, weight, BMI (38.2 kg/m2), and the number of sutures used during P-ESG were similar between the groups. The nadir %TBWL was lowest in WF group compared to WR and WP (6.5% vs. 20% vs. 22.4%, p = 0.001). The mean BMI at R-ESG was 33.6 kg/m2. The time to R-ESG was longer in the WR group compared to WF and WP (22.3 vs. 13.4 vs. 13.7 months, p = 0.03). We placed a median of 3 (range 2-6) sutures. R-ESG was technically successful, and no serious complications occurred. All except two patients were discharged on the same day. The overall %TBWL achieved by R-ESG was significantly higher in WP (26%) as compared to WF (11.2%) and WR (12%), respectively (p = 0.001).

Conclusion: The need for R-ESG after P-ESG is low. R-ESG is safe and induced weight loss in all patients. The maximum benefit was observed in WP.

Keywords: Bariatric endoscopy; Endoscopic sleeve gastroplasty; Obesity; Re-suturing; Weight regain.

PubMed Disclaimer

References

    1. Caterson ID, Alfadda AA, Auerbach P et al (2019) Gaps to bridge: Misalignment between perception, reality and actions in obesity. Diabetes Obes Metab 21:1914–1924 - DOI
    1. Joseph MS, Konerman MA, Zhang M et al (2018) Long-term outcomes following completion of a structured nutrition and exercise lifestyle intervention program for patients with metabolic syndrome. Diabetes Metab Syndr Obes 11:753–759 - DOI
    1. Gregg EW, Chen H, Wagenknecht LE et al (2012) Association of an intensive lifestyle intervention with remission of type 2 diabetes. JAMA 308:2489–2496 - DOI
    1. Look AHEAD Research Group (2014) Eight-year weight losses with an intensive lifestyle intervention: the look AHEAD study. Obesity (Silver Spring) 22:5–13 - DOI
    1. Buchwald H, Oien DM (2011) Metabolic/bariatric surgery worldwide. Obes Surg 23:427–436 - DOI

LinkOut - more resources