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World J Hepatol. Sep 27, 2022; 14(9): 1704-1717
Published online Sep 27, 2022. doi: 10.4254/wjh.v14.i9.1704
Non-alcoholic fatty liver disease: Is surgery the best current option and can novel endoscopy play a role in the future?
Mandour Omer Mandour, Mohammed El-Hassan, Rawan M Elkomi, Jude A Oben
Mandour Omer Mandour, Mohammed El-Hassan, Rawan M Elkomi, Jude A Oben, Department of Gastroenterology and Hepatology, Guys & St Thomas Hospital, London, SE1 7EH, United Kingdom
Jude A Oben, King’s College London, School of Life Course Sciences, Faculty of Life Sciences and Medicine, London SE1 7EH, United Kingdom
Author contributions: All authors contributed to writing, have read and approved of the final manuscript.
Conflict-of-interest statement: Jude Oben served as a consultant for Apollo Endosurgery. The remaining authors have no potential competing interests.
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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mandour Omer Mandour, MBBS, MRCP, DTM RCSI, Department of Gastroenterology and Hepatology, Guys & St Thomas Hospital, Westminster Bridge Road, London, SE1 7EH, United Kingdom. omer.mandour@nhs.net
Received: March 9, 2022
Peer-review started: March 9, 2022
First decision: June 22, 2022
Revised: July 4, 2022
Accepted: August 1, 2022
Article in press: August 1, 2022
Published online: September 27, 2022
Core Tip

Core Tip: The overstitch endoscopic suturing system (Overstitch; Apollo Endosurgery, Austin, Tex) which was first reported in 2013, allows sleeve gastropexy to be performed by placing full-thickness sutures through the gastric wall from the pre-pyloric antrum to the gastro-oesophageal junction. Performed using flexible endoscopy, it has the advantage of being less invasive with no permanent visible scar and evidence suggestive of fewer complications compared to laparoscopic sleeve gastrectomy. There is now mounting evidence not only showing benefits in terms of weight loss but also improvements in other metabolic markers including Hemoglobin A1c, blood pressure and alanine aminotransferase, making endoscopic sleeve gastroplasty potentially a viable treatment option for non-alcoholic fatty liver disease in the future.