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. 2025 Oct 6.
doi: 10.1007/s00464-025-12247-6. Online ahead of print.

Influence of the argon plasma coagulation protocol in endoscopic procedures on body composition in patients with recurrent weight gain after Roux-en-Y gastric bypass: a randomized clinical trial

Mariana Bordinhon de Moraes  1 , Amanda Gomes Pereira  2 , Karen Kaori Miyamoto  2 , Filipe Welson Leal Pereira  2 , Marcos Ferreira Minicucci  2 , Daniela Vulcano Salate Biagione  2 , Paula Schmidt Azevedo Gaiolla  2 , Cássio Vieira de Oliveira  2 , Luiz Gustavo de Quadros  3 , Sérgio Alberto Rupp de Paiva  2
Affiliations

Influence of the argon plasma coagulation protocol in endoscopic procedures on body composition in patients with recurrent weight gain after Roux-en-Y gastric bypass: a randomized clinical trial

Mariana Bordinhon de Moraes et al. Surg Endosc. .

Abstract

Introduction: The management of recurrent weight gain (RWG) following Roux-en-Y Gastric Bypass (RYGB) should be individualized, considering endoscopic procedure treatment. The most common is argon plasma coagulation (APC). The aim was to evaluate the influence of the APC procedure and/or liquid diet intake on weight loss, body composition, satiety, gastrointestinal symptoms (GIS), and energy intake in patients with RWG after RYGB.

Methods: A prospective, controlled, double-blind, randomized study was conducted to compare four groups: the APC procedure with a 7-day liquid diet, the APC procedure with a 20-day liquid diet, the sham procedure with a 7-day liquid diet, and the sham procedure with a 20-day liquid diet. Weight loss cases were analyzed using the χ2 test, while comparisons between procedures and diets were made using two-way ANOVA. Non-normally distributed variables were assessed using generalized linear models.

Results: Fifty-five patients were eligible to undergo the endoscopic procedure. The % total weight loss at the final time compared to baseline was 1.7% for patients in the sham procedure group and 5.1% for patients in the APC group.

Conclusion: The APC procedure led to weight loss and body fat reduction in RWG patients after RYGB, regardless of the liquid diet period. Furthermore, APC improved the sensation of satiety, increased GIS, and showed no difference in energy and macronutrients intake.

Keywords: Argon plasma; Liquid diet; Obesity; Weight recurrence.

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Conflict of interest statement

Declarations. Disclosures: Dr. Mariana Bordinhon de Moraes was financed in part by the Coordination for the Improvement of Higher Education Personnel—Brazil (CAPES)—Finance Code 001. Drs. Amanda Gomes Pereira, Karen Kaori Miyamoto, Filipe Welson Leal Pereira, Marcos Ferreira Minicucci, Daniela Vulcano Salate Biagione, Paula Schmidt Azevedo Gaiolla, Cássio Vieira de Oliveira, Luiz Gustavo de Quadros and Sérgio Alberto Rupp de Paiva have no conflicts of interest or financial ties to disclose.

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