Endoscopic Sleeve Gastroplasty: Technique Evolution

Abstract

According to the World Health Organization (WHO), in 2019, 2.3 billion people were overweight worldwide. In Brazil, overweight already affects 52.5% of adults, and this rate has been increasing every year. New weight loss alternatives have emerged, including endoscopic sleeve gastroplasty (ESG), an endoscopic procedure that reduces stomach volume through internal sutures, to demonstrate the safety, efficacy, and durability of ESG in patients undergoing a new endoscopic suturing technique, called Sander-Scarparo Technique, in obese patients. A retrospective study in two different health centers, with participants who underwent the Sander-Scarparo Technique in ESG, compares them to the traditional technique that was performed between July 2017 and December 2019. Participants were distributed into different groups, with follow-up time ranging from 12 to 48 months, depending on the interval between the procedure and data collection. All were at least 18 years old, had a minimum body mass index (BMI) of 30 kg/m2 (grade I obesity), and had no previous bariatric surgery. The variables that may influence the efficacy and durability of ESG were analyzed (suture patterns [U versus U + argon (with or without oversuture)]): “Sander-Scarparo Technique,” resuture, number of sutures, number of bites, weight loss (in kilograms), percentage of total body weight loss (%TBWL), percentage of excess weight loss (%EWL), argon plasma electrocautery, and complications and intercurrences, in a follow-up of up to 4 years after the procedure, at 12-month interval.