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Create a Free AccountProcedures - Bariatrics
Gastroplasty with endoscopic myotomy for the treatment of obesity
Endoscopic bariatric and metabolic therapies work by a variety of different mechanisms. A common target is the delay of gastric emptying (Fig. 1). Intragastric balloons and endoscopic sleeve gastroplasty (ESG) have both been shown to prolong gastric emptying. The original primary obesity surgery endoluminal procedure involved the placement of plications in the gastric fundus to limit accommodation, and other devices have directly targeted gastric emptying by disrupting the antral pump function of the stomach (Fig.Division of a long-term symptomatic tissue bridge for reversal of endoscopic sleeve gastroplasty
Endoscopic sleeve gastroplasty (ESG) induces weight loss through delayed gastric emptying through gastric remodeling.1 In the long term, this commonly manifests as tissue bridges seen on follow-up endoscopy.2,3 ESG’s clinical efficacy, long durability for weight loss,4 and minimal rate of severe adverse events5 have led to widespread adoption. Although “redo” ESG appears safe and effective,6 reversibility is not well described and is limited to the acute setting. There is a risk that cutting sutures acutely may result in microperforations that put a patient at risk for leak, perigastric fluid collection, abscess, and bleeding.Endoscopic sleeve gastroplasty is feasible after failed modified primary obesity surgery endoluminal procedure
Endoscopic sleeve gastroplasty (ESG) or gastric plication is a recent, minimally invasive treatment in bariatric endoscopy. The basic mechanisms of action are gastric volume reduction and alteration of gastric peristalsis.1 Currently, 3 devices are used in daily clinical practice: Apollo Overstitch (Apollo Endosurgery, Austin, Tex, USA), Endomina (Endo Tools Therapeutics, SA-ETT, Gosselies, Belgium), and an incisionless operating platform (USGI Medical, San Clemente, Calif, USA). They are used to perform the modified primary obesity surgery endoluminal (POSE-2) procedure.Endoscopic sleeve gastroplasty: the “cable” technique
Endoscopic sleeve gastroplasty (ESG) is a minimally invasive procedure for the treatment of obesity whereby transmural sutures are placed to reduce gastric volume. An endoscopic suturing system (OverStitch, Apollo Endosurgery, Austin, Tex, USA) is used to create a running suture pattern that imbricates the greater curvature of the stomach, resulting in a reduction in functional volume by approximately 70%, in addition to 30% foreshortening.1-3Laparoscopic hernia repair and fundoplication with endoscopic sleeve gastroplasty for complex hernia and GERD management in morbid obesity
Symptomatic hiatal hernia (HH) and gastroesophageal reflux disease (GERD) pose a unique medical and surgical challenge in the context of morbid obesity. On one hand, morbid obesity is a strong risk factor for GERD and HH1,2 as a result of increased intra-abdominal pressure and ineffective lower esophageal sphincter.3 On the other hand, management of HH and GERD in morbid obesity is challenging because of the high risk of hernia recurrence after conventional surgical repair.4 Therefore, an optimal solution for HH and GERD in morbid obesity is one that would provide durable hernia repair and weight loss.Same-session endoscopic sleeve gastroplasty and transoral incisionless fundoplication: a possible solution to a growing problem
Obesity and GERD have not only been rising in prevalence but also are among the most common conditions seen by gastroenterologists today.1 Here, we present a 63-year-old woman with class II obesity (body mass index, 36 kg/m2; weight, 236 lb), proton pump inhibitor (PPI)-responsive GERD, and Crohn’s ileocolitis, who was referred for further management of her obesity and GERD. Despite intensive lifestyle changes, she was unable to lose significant weight. In addition, she required double-dose PPI for her reflux symptoms.Endoscopic sleeve gastroplasty by use of a novel suturing pattern, which allays concerns for revisional bariatric surgery
Endoscopic sleeve gastroplasty (ESG) is a safe and effective minimally invasive procedure that has been gaining traction to treat patients with obesity.1-3 Because obesity is a chronic disease, revisional bariatric surgery may be beneficial if adverse events, inadequate weight loss, or weight regain have occurred.4Endoscopic sleeve gastroplasty in peritoneal dialysis
Endoscopic sleeve gastroplasty (ESG) is a minimally invasive, safe, and effective weight-loss technique first described in 2013.1 The principle is to reduce the gastric capacity by creating a restrictive sleeve through an endoluminal suturing system. This is done by the placement of full-thickness sutures along the corpus of the stomach. Although bariatric surgery is recommended for obesity management, the benefits of ESG include less morbidity and mortality, shorter hospital stays, and quicker recovery times.Management of postendoscopic sleeve gastroplasty abscess
Endoscopic sleeve gastroplasty (ESG) is a minimally invasive, endoscopic bariatric therapy that results in significant and durable weight loss. The procedure is generally safe, with major adverse events occurring in less than 2% to 3% of cases.The descending gastric fundus in endoscopic sleeve gastroplasty: implications for procedural technique and adverse events
Endoscopic sleeve gastroplasty (ESG) is performed in patients with obesity to reduce gastric volume and delay gastric emptying, resulting in weight loss. ESG is performed with the use of full-thickness suture placement aided by a tissue helix device to pull the gastric wall into the suturing arm of an over-the-scope suturing attachment. ESG begins with distal suture placement and proceeds proximally to just below the fundus. Transfundic sutures are a known risk factor for adverse procedural events, including perigastric abscess formation1; therefore, avoidance of suture placement in the fundus is critical.
