Minimally invasive approaches to obesity: Evaluating the efficacy and safety of endoscopic gastroplasty.

Obesity is a major global health issue, contributing to numerous comorbidities such as type 2 diabetes mellitus, hypertension, and cardiovascular diseases. While bariatric surgery remains the gold standard for treating severe obesity, its invasive nature has led to the development of minimally invasive alternatives. Endoscopic sleeve gastroplasty (ESG) is a promising, minimally invasive procedure for weight loss, offering significant weight reduction without the need for surgical incisions. This editorial evaluates the efficacy and safety of ESG, highlighting its weight loss outcomes, safety profile, and comparison with other bariatric procedures, including intragastric balloon, laparoscopic sleeve gastrectomy, and robotic sleeve gastrectomy. ESG has shown substantial weight loss with a mean total weight loss ranging from 15.03% to 17.51% at 12 months and sustained weight reduction over 36 months. The safety profile is favorable, with low rates of serious adverse events and minimal complications compared to surgical alternatives. ESG is particularly suited for patients with mild to moderate obesity or those not eligible for surgical options. However, further long-term studies and standardized protocols are needed to refine patient selection and optimize treatment outcomes.