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01-08-2021 | Laparotomy | Original Contributions

Endoscopic Sleeve Gastroplasty (ESG) for High-Risk Patients, High Body Mass Index (> 50 kg/m²) Patients, and Contraindication to Abdominal Surgery

Authors: Renjie Li, Wilfried Veltzke-Schlieker, Andreas Adler, Maximilian Specht, Wael Eskander, Mahmoud Ismail, Harun Badakhshi, Manoel Passos Galvao, Ricardo Zorron

Published in: Obesity Surgery | Issue 8/2021

Abstract

Background

For high-risk classified patients, patients with superobesity and in cases of contraindication to abdominal surgery, traditional bariatric surgery might lead to potential morbidity and mortality. Endoscopic sleeve gastroplasty (ESG) is a novel and effective bariatric therapy for morbidly obese patients. Our research group initially evaluated the safety, feasibility, and efficacy of ESG for high-risk, high body mass index (BMI) patients, and patients contraindicated to abdominal surgeries.

Methods

Eligible patients characterized as high-risk for bariatric surgery due to high-BMI, severe comorbidities, or impenetrable abdomen were prospectively documented. ESG was performed by using Overstich® (Apollo Endosurgery, Austin, TX, USA). Primary outcomes included technical success, post-procedure adverse events and mortality, and the change of weight and BMI.

Results

ESG was successfully performed for all patients (N = 24, mean age was 55.6 (± 9.2) years old, 75% male). Baseline weight and BMI were 157.9 (± 49.1) kg and 49.9 (± 14.4) kg/m². According to Edmonton Obesity Staging System (EOSS), 8 (33.3%), 14 (58.3%), and 2 (8.3%) patients were respectively classified as EOSS 2, 3, and 4. Mean operation time was 114.7 (± 26.0) min, without intraoperative complication. Weight loss, BMI reduction, %total weight loss (%TWL), and %excess weight loss (%EWL) were 17.5 (± 14.6) kg, 5.6 (± 4.6) kg/m², 12.2% (± 8.9%), and 29.1% (± 17.9%) at post-ESG 12-month, respectively. One (4.2%) moderate post-procedure adverse event (gastric mucosal bleeding) was observed.

Conclusions

ESG can be used as a safe, feasible, and effective option for the therapy of patients with superobesity, high-risk patients, and patients contraindicated to abdominal surgery.

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Title: Endoscopic Sleeve Gastroplasty (ESG) for High-Risk Patients, High Body Mass Index (> 50 kg/m2) Patients, and Contraindication to Abdominal Surgery
Authors: Renjie Li
Wilfried Veltzke-Schlieker
Andreas Adler
Maximilian Specht
Wael Eskander
Mahmoud Ismail
Harun Badakhshi
Manoel Passos Galvao
Ricardo Zorron
Publication date: 01-08-2021
Publisher: Springer US
Keywords: Laparotomy
Obesity
Obesity
Laparotomy
Abdominal Surgery
Bariatric Surgery
Bariatric Surgery
Incisional Hernia
Published in: Obesity Surgery / Issue 8/2021
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI: https://doi.org/10.1007/s11695-021-05446-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Endoscopic Sleeve Gastroplasty (ESG) for High-Risk Patients, High Body Mass Index (> 50 kg/m²) Patients, and Contraindication to Abdominal Surgery

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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