Preliminary experience with eighteen months result of endoscopic sleeve gastroplasty from Asian: Learning curve of one bariatric surgeon

Abstract

Endoscopic sleeve gastroplasty (ESG) is emerging as an innovative approach to treating obesity. It provides a bridge between surgical and medical treatments for obesity. Nevertheless, the majority of reports on ESG originate from Western countries, and there is a lack of data from Asian nations. This study aims to share our pioneering experience with this novel technique in Asia. We enrolled obese patients with a BMI greater than 27 kg/m2 who were at least 20 years old. Endoscopic sleeve gastroplasty (ESG) was conducted following a comprehensive pre-operative assessment. Following the procedure, patients were scheduled for regular outpatient department (OPD) follow-up appointments at 7 days, 1 month, 2 months, 3 months, and then every 3 months up to 18 months post-operation. Body weight and any adverse events were documented during each follow-up visit. A total of 49 obese patients were enrolled in this study. Our findings demonstrate that ESG can be safely integrated into a conventional bariatric surgery center, with a learning curve observed after 10 cases in this study. In our series, the results showed that total body weight loss (TBWL) reached 7% at one month, 9% at three months, 14% at six months, 16% at 12 months, and 18.6% at 18 months. No adverse events or complications were reported in the study; however, five patients experienced procedure failures. Four of these patients underwent a repeat ESG, while one patient opted for surgical intervention. Endoscopic sleeve gastroplasty can be utilized in Asian countries, and the effectiveness of weight loss has proven to be satisfactory.