Endoscopy 2020; 52(S 01): S49
DOI: 10.1055/s-0040-1704151
ESGE Days 2020 oral presentations
Thursday, April 23, 2020 14:30 – 16:00 Quality in gastroscopy: Raising the bar Wicklow Hall 1
© Georg Thieme Verlag KG Stuttgart · New York

ENDOSCOPIC SLEEVE GASTROPLASTY FOR OBESITY: FEATURES INVOLVING THE LEARNING CURVE

AJ del Pozo-Garcia
1   Hospital Universitario Virgen de la Paloma, DISESCOP Obesity Unit, Madrid, Spain
,
DR de la Cruz
1   Hospital Universitario Virgen de la Paloma, DISESCOP Obesity Unit, Madrid, Spain
,
T Valdés-Lacasa
1   Hospital Universitario Virgen de la Paloma, DISESCOP Obesity Unit, Madrid, Spain
,
R Polanco
2   Clínicas Diego de León, Obesity Unit, Madrid, Spain
,
S Nevado
2   Clínicas Diego de León, Obesity Unit, Madrid, Spain
,
FS Gómez
1   Hospital Universitario Virgen de la Paloma, DISESCOP Obesity Unit, Madrid, Spain
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

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Aims Endoscopic sleeve gastroplasty (ESG) has positioned as one of the most promising incisionless technique to induce gastric volume restriction, leading to weight loss, having showed good short-term results within a safe profile. Its main drawback is a slow and challenging learning curve which has not yet been standardised.

We have conducted a prospective registry regarding the evolution in technique, compiling intraprocedural incidents, operating time, and adverse events within the first 70 consecutive ESG procedures performed in obese patients by a single endoscopist (AJPG) with previous several formation sessions in a pig-model.

Methods Evaluation of the first 70 consecutive ESG performed by the same endoscopist (AJPG) in a single center, since June 2017 to November 2019. The outcome measures were: length of procedure (OT); number of sutures and plicatures used per procedure; intraprocedural incidents description; length of hospital stay; and adverse events rate. All patients signed the informed consent and were done under antibiotic prophylaxis, CO2 insufflation and general anesthesia in an inpatient basis. All procedures were done using the Apollo overstitch system attached to a double channel Olympus 165 gastroscope after ruling out contraindications.

Results 70 consecutive patients (males) with a mean age years and mean BMI underwent ESG. OT decreased significantly across consecutive patients meanwhile the number of stitches and sutures did not differ significantly. There was a decreasing trend in the number of intraprocedural incidents . Around 20 procedures were required to decrease the OT under 60 minutes, and around 50 surgeries to lower it below 50 minutes. There were two complications: two gastric bleedings solved by endoscopic treatments. Neither surgical rescue nor death were found.

Conclusions A progressive reduction in the length of procedure as augments the case load is expected during the learning curve of ESG as well as the number of incidents during the operating time.