Gastroplasty with endoscopic myotomy as a revision procedure after weight regain after remote endoscopic sleeve gastroplasty

Q3 Medicine

VideoGIE Pub Date : 2025-04-06 DOI:10.1016/j.vgie.2025.03.038

Kartik Sampath MD , Kamal Hassan MD , Jeong Hoon Kim MD , Jade Wang MD , Vladislav Fomin MD, Anam Rizvi MD, Reem Z. Sharaiha MD

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引用次数: 0

Abstract

Background and Aims

Suture dehiscence and gastric sleeve dilation can cause post–endoscopic sleeve gastroplasty (ESG) weight regain. To our knowledge, gastroplasty with endoscopic myotomy (GEM) as a post-ESG revision technique has not been previously reported. We present a case of GEM successfully used after a primary ESG as a revision procedure.

Methods

A 52-year-old man had a weight of 111 kg in 2016 before ESG. Postprocedure, his weight reached 95 kg. However, he returned in 2023 with weight regain to 121 kg. GEM was decided after multidisciplinary discussion. Previous suture sites were appreciated. An antral myotomy was started with a bleb injected 8 cm proximal to the pylorus. The submucosal tunnel was entered by hybrid knife incision and dissected 2 cm before the pylorus. A partial full-thickness myotomy was performed with lysis of significant submucosal fibrosis. Gastroplasty was performed, and 8 suture bites were placed in a running modified “U” pattern to decrease gastric volume.

Results

There were no intraprocedure adverse events. At 3-month follow-up, the patient had lost 11 kg, and at 1-year follow-up, he had lost 20 kg.

Conclusions

To our knowledge, GEM as a post-ESG revision has not been previously reported. Our case suggests that a post-ESG revision GEM with a modified “U” suturing pattern is feasible.

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胃成形术与内窥镜肌切开术作为修正程序后体重恢复后的远程内窥镜袖胃成形术

背景和目的缝合线断裂和胃袖扩张可导致内镜下胃袖成形术（ESG）后体重恢复。据我们所知，胃成形术与内窥镜肌切开术（GEM）作为esg后翻修技术以前没有报道。我们提出了一个在初级ESG后成功使用创业板作为修订程序的案例。方法52岁男性，2016年ESG术前体重111 kg。术后，他的体重达到了95公斤。然而，他在2023年重返赛场，体重恢复到121公斤。GEM是在多学科讨论后决定的。既往的缝合位置值得赞赏。在幽门近端8厘米处注入一个气泡，开始进行胃窦肌切开术。采用混合刀切口进入粘膜下隧道，在幽门前2cm处切开。行部分全层肌切开术，明显的粘膜下纤维化溶解。行胃成形术，并将8个缝合口以改良的“U”形放置以减少胃容量。结果无术中不良事件发生。随访3个月，患者减重11公斤，随访1年，患者减重20公斤。据我们所知，GEM作为esg后的修订以前没有报道。我们的病例表明，esg修订后的GEM采用改良的“U”型缝合模式是可行的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

VideoGIE Medicine-Gastroenterology

CiteScore

1.50

自引率

0.00%

发文量

132

审稿时长

105 days

期刊介绍： VideoGIE, an official video journal of the American Society for Gastrointestinal Endoscopy, is an Open Access, online-only journal to serve patients with digestive diseases. VideoGIE publishes original, single-blinded peer-reviewed video case reports and case series of endoscopic procedures used in the study, diagnosis, and treatment of digestive diseases. Videos demonstrate use of endoscopic systems, devices, and techniques; report outcomes of endoscopic interventions; and educate physicians and patients about gastrointestinal endoscopy. VideoGIE serves the educational needs of endoscopists in training as well as advanced endoscopists, endoscopy staff and industry, and patients. VideoGIE brings video commentaries from experts, legends, committees, and leadership of the society. Careful adherence to submission guidelines will avoid unnecessary delays, as incomplete submissions may be returned to the authors before initiation of the peer review process.