Redo Endoscopic Sleeve Gastroplasty: Repeating does not mean Failing

Aims Endoscopic Sleeve Gastroplasty (ESG) is an effective and repeatable bariatric procedure, thus some patients may need a redo ESG to increase weight loss. In this case series, we evaluate the technical aspects and short and medium-term outcomes of the redo ESG.

Methods A retrospective analysis was done on a prospective database reporting patients that underwent ESG between March 2017 and October 2020; patients who received a redo ESG because of progressive loss of satiety, weight regain, or insufficient weight loss were included. %EWL, %TBWL, %EBMIL, the Bariatric Analysis and Reporting Outcome System (BAROS) questionnaire and the Quality of Life (QoL) were assessed during follow-up.

Results Of 252 patients that underwent ESG, six required a redo ESG. Four redo ESG were performed within 12 months from the first ESG, whereas the remaining two were performed within 7 and 18 months. No periprocedural adverse events occurred. One patient had 1-month follow-up, two of them reached 6-months and other two reached 12-months. Mean %EWL was 51 %±16.5, 50 %±19 and 40.5 %±6.8 at 1, 6 and 12 months, respectively. Similarly, mean %TBWL and %EBMIL were 18.3 %±5.8 and 51 %±16.5 at 1 month, 18.6 %±7.4 and 50 %±19 at 6 months, 16.3 %±4.6 and 40.5 %±6.8 at 12 months. BAROS questionnaire mean score was 4.3±1.3, 4.4±1.2 and 3.7±1.3 during follow-up. The only patient who reached 18-months follow-up reported a %EWL of 44.6 %, a %TBWL and a %EBMIL of 18.3 % and 44.6 %, respectively, and a BAROS score of 2.5. All patients reported excellent satiety and significant QoL improvement after the procedure.

Redo ESG outcomes	1-month follow-up	6-months follow-up	12-months follow-up
%EWL	51 %±16.5	50 %±19	40.5 %±6.8
%TBWL	18.3 %±5.8	18.6 %±7.4	16.3 %±4.6
%EBMIL	51 %±16.5	50 %±19	40.5 %±6.8
BAROS questionnaire	4.3±1.3	4.4±1.2	3.7±1.3

Conclusions According to our limited experience, redo ESG short and medium-term outcomes are satisfying in terms of satiety, weight loss and QoL. Repeating the procedure should thus not be considered as a failure, but as a second step of the treatment.

Citation: Gallo C, Matteo MV, Boskoski I et al. OP44 REDO ENDOSCOPIC SLEEVE GASTROPLASTY: REPEATING DOES NOT MEAN FAILING. Endoscopy 2021; 53: S20.

Publication History

Article published online:
19 March 2021