Endoscopy 2020; 52(S 01): S53
DOI: 10.1055/s-0040-1704162
ESGE Days 2020 oral presentations
Thursday, April 23, 2020 16:30 – 18:00 Stent, seal, stitch. Advanced upper GI Ecocem Room therapeutics
© Georg Thieme Verlag KG Stuttgart · New York

RE-DO ENDOSCOPIC SLEEVE GASTROPLASTY: TECHNICAL ASPECTS AND SHORT-TERM OUTCOMES

V Bove
1   Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Centre for Endoscopic Research Therapeutics and Training (CERTT), Endoscopia Digestiva Chirurgica, Rome, Italy
,
I Boskoski
1   Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Centre for Endoscopic Research Therapeutics and Training (CERTT), Endoscopia Digestiva Chirurgica, Rome, Italy
,
V Pontecorvi
1   Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Centre for Endoscopic Research Therapeutics and Training (CERTT), Endoscopia Digestiva Chirurgica, Rome, Italy
,
C Gallo
1   Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Centre for Endoscopic Research Therapeutics and Training (CERTT), Endoscopia Digestiva Chirurgica, Rome, Italy
,
B Orlandini
1   Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Centre for Endoscopic Research Therapeutics and Training (CERTT), Endoscopia Digestiva Chirurgica, Rome, Italy
,
R Landi
1   Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Centre for Endoscopic Research Therapeutics and Training (CERTT), Endoscopia Digestiva Chirurgica, Rome, Italy
,
P Familiari
1   Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Centre for Endoscopic Research Therapeutics and Training (CERTT), Endoscopia Digestiva Chirurgica, Rome, Italy
,
A Tringali
1   Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Centre for Endoscopic Research Therapeutics and Training (CERTT), Endoscopia Digestiva Chirurgica, Rome, Italy
,
V Perri
1   Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Centre for Endoscopic Research Therapeutics and Training (CERTT), Endoscopia Digestiva Chirurgica, Rome, Italy
,
G Costamagna
1   Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Centre for Endoscopic Research Therapeutics and Training (CERTT), Endoscopia Digestiva Chirurgica, Rome, Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

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Aims Endoscopic Sleeve Gastroplasty (ESG) is a restrictive endoscopic bariatric procedure providing excellent results in the recent years (16% TBWL at 6 months, 1.1% complications). As every endoscopic procedure, ESG is repeatable. In this short case series, we analyze the technical aspects and short-term outcomes of the re-do ESG.

Methods A retrospective analysis was done on a prospective database collecting data of all patients selected for bariatric endoscopy (ESG) by a multidisciplinary team between March-2017 and May-2019. Patients that underwent a re-do ESG because of progressive satiety loss, weight regain or insufficient weight loss due to high baseline BMI were included. %EWL, %TBWL and Bariatric Analysis and Reporting Outcome System (BAROS) questionnaire were evaluated during follow-up.

Results 120 ESG procedures were performed with mean %EWL 44.4 (+/- 19.5), mean %TBWL 18.3 (+/- 6.7) and mean BAROS 4.5 (+/- 1.7) at 12 months. Four patients underwent re-do ESG. Three of them had re-do ESG after 12 months from the 1st ESG, whereas one of them after 7 months. During the 2nd procedure, old threads were removed with a seizure and new stitches were positioned following a triangular pattern (maximum three bites per suture line) and avoiding overlapping the previous stitches. No adverse events were reported intraoperatively. Six months follow-up was available for 3 patients: mean %EWL and %TBWL were 44.2% (30.5%-59.1%) and 20.4% (16.7%-24.5%) respectively; BAROS questionnaire mean score was 6.3 (range 6-7). One patient had only 1 month follow-up: mean %EWL and %TBWL were 33.3 and 12.2 respectively; BAROS questionnaire reported score was 6. All included patients reported excellent satiety feeling after re-do ESG.

Conclusions The re-do ESG short term outcomes are completely satisfying in terms of safety and efficacy. Performing re-do ESG should be considered as a second step of the endoscopic treatment strategy and not as a failure of the previous procedure.