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 Jan;31(1):70-78.
doi: 10.1007/s11695-020-04915-4. Epub 2020 Aug 20.

Brazilian Consensus on Endoscopic Sleeve Gastroplasty

Manoel Galvão Neto  1   2 , Lyz Bezerra Silva  3 , Luiz Gustavo de Quadros  2   4 , Eduardo Grecco  1   2 , Admar Concon Filho  2   5 , Artagnan Menezes Barbosa de Amorim  6 , Marcelo Falcao de Santana  7 , Newton Teixeira Dos Santos  8 , Joao Henrique Felicio de Lima  9 , Thiago Ferreira de Souza  1   2 , Helmut Wagner Poti de Morais  10 , Felipe Matz Vieira  11 , Rena Moon  12 , André F Teixeira  13 ; Brazilian Endoscopic Sleeve Gastroplasty Collaborative
Collaborators, Affiliations

Brazilian Consensus on Endoscopic Sleeve Gastroplasty

Manoel Galvão Neto et al. Obes Surg. 2021 Jan.

Abstract

Purpose: Bariatric endoscopy is a less invasive approach for obesity management, with better efficacy than pharmacological treatment and low morbidity. Endoscopic sleeve gastroplasty (ESG) is the remodeling of the stomach using a suturing device showing technical feasibility, safety, and sustained weight loss. With growing numbers of procedures worldwide, there is a need to standardize the procedure.

Materials and methods: A consensus meeting was held in São Caetano do Sul-SP, Brazil, in June 2019, bringing together 47 Brazilian endoscopists with experience in ESG from all regions of the country. Topics on indications and contraindications of the procedure, pre-procedure evaluation and multidisciplinary follow-up, technique and post-procedure follow-up, and training requirements were discussed. An electronic voting was carried, and a consensus was defined as ≥ 70% agreement.

Results: The panel's experience consisted of 1828 procedures, with a mean percentage total body weight loss (TBWL) of 18.2% in 1 year. Adverse events happened in 0.8% of the cases, the most common being hematemesis. The selected experts discussed and reached a consensus on several questions concerning patient selection, contraindications for the procedure, technical details such as patient preparation, procedure technique, and patient follow-up.

Conclusions: This consensus establishes practical guidelines for performance of ESG. The experience of 1828 procedures shows the expertise of the selected specialists participating in this consensus statement. The group's experience has a satisfactory weight loss with low adverse events rate. The main points discussed in this paper may serve as a guide for endoscopists performing ESG. Practical recommendations and technique standardization are described.

Keywords: Bariatric endoscopy; Consensus statement; Endoscopic sleeve gastroplasty; Endoscopy; Obesity.

PubMed Disclaimer

References

    1. Courcoulas AP, Christian NJ, Belle SH, et al. Weight change and health outcomes at 3 years after bariatric surgery among individuals with severe obesity. JAMA. 2013;310(22):2416–25. - PubMed - PMC
    1. Buchwald H, Oien DM. Metabolic/bariatric surgery worldwide 2011. Obes Surg. 2013;23(4):427–36. - DOI
    1. Force ABET, Committee AT, Abu Dayyeh BK, et al. Endoscopic bariatric therapies. Gastrointest Endosc. 2015;81(5):1073–86. - DOI
    1. Force ABET, Committee AT, Abu Dayyeh BK, et al. ASGE Bariatric Endoscopy Task Force systematic review and meta-analysis assessing the ASGE PIVI thresholds for adopting endoscopic bariatric therapies. Gastrointest Endosc. 2015;82(3):425–38. e5 - DOI
    1. Lopez-Nava G, Galvao MP, Bautista-Castano I, et al. Endoscopic sleeve gastroplasty: how I do it? Obes Surg. 2015;25(8):1534–8. - DOI

LinkOut - more resources