Opinion Review
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 21, 2020; 26(11): 1107-1112
Published online Mar 21, 2020. doi: 10.3748/wjg.v26.i11.1107
Current status of endoscopic sleeve gastroplasty: An opinion review
Jiunn-Wei Wang, Chih-Yen Chen
Jiunn-Wei Wang, Division of Gastroenterology, Department of Internal medicine, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan
Jiunn-Wei Wang, Department of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
Jiunn-Wei Wang, Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
Chih-Yen Chen, Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan
Chih-Yen Chen, Endoscopy Center for Diagnosis and Treatment, Taipei Veterans General Hospital, Taipei 11217, Taiwan
Chih-Yen Chen, Faculty of Medicine and Institute of Emergency and Critical Medicine, National Yang-Ming University School of Medicine, Taipei 11217, Taiwan
Chih-Yen Chen, Institutional Review Board, Taipei Veterans General Hospital, Taipei 11217, Taiwan
Chih-Yen Chen, Chinese Taipei Society for the Study of Obesity, Taipei 11031, Taiwan
Author contributions: Chen CY conceived and designed the study; Wang JW reviewed the literature and wrote the manuscript; Chen CY and Wang JW made critical revisions and approved the final version of the manuscript.
Conflict-of-interest statement: Jiunn-Wei Wang and Chih-Yen Chen have no potential conflicts of interest to declare.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Chih-Yen Chen, AGAF, MD, PhD, Professor, Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei 11217, Taiwan. chency@vghtpe.gov.tw
Received: November 12, 2019
Peer-review started: November 12, 2019
First decision: February 24, 2020
Revised: February 27, 2020
Accepted: March 9, 2020
Article in press: March 9, 2020
Published online: March 21, 2020
Processing time: 129 Days and 11.6 Hours
Abstract

Bariatric surgeries have been demonstrated to be safe and effective treatment options for morbid obesity patients, but operative risks and high health care costs limit their clinical application. Endoscopic bariatric therapies are emerging as valuable alternatives for patients with doubts about bariatric surgery or ineligible for it. Endoscopic sleeve gastroplasty (ESG), a relatively novel technique of endoscopic bariatric therapies, has gained standing in the past few years. The safety, feasibility, repeatability, and potential for reversibility of ESG have been proven by multicenter studies. Compared to other weight loss strategies, current evidence demonstrates that ESG offers satisfactory efficacy in weight loss. Even though it is inferior to laparoscopic sleeve gastrectomy, it has lower risks of adverse events than surgical interventions and intragastric balloon within one-year follow-up. Furthermore, ESG may be the ideal weight control strategy for patients who have poor adherence to behavioral interventions. Even so, trends in decreased weight loss effect over time, post-procedure weight regain, post-procedure gut hormone alteration, and possible effects of race and ethnicity on ESG still remain undetermined due to very limited reports and very short follow-ups. Further clinical trials are required to validate and answer these questions.

Keywords: Obesity; Endoscopic bariatric therapy; Endoscopic sleeve gastroplasty; Laparoscopic sleeve gastrectomy; Intragastric balloon; Behavioral weight loss intervention

Core tip: Endoscopic sleeve gastroplasty offers satisfactory efficacy in weight loss, even though it is inferior to laparoscopic sleeve gastrectomy and has lower risks of adverse events than surgical interventions and intragastric balloon within one-year follow-up. Furthermore, it may be the ideal weight control strategy for patients who have poor adherence to behavioral interventions.