Efficacy of Revisional Endoscopic Sleeve Gastroplasty After Laparoscopic Sleeve Gastrectomy

Jan 8, 2025Obesity surgery

Effectiveness of Repeat Endoscopic Sleeve Gastroplasty After Initial Sleeve Stomach Surgery

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Abstract

Total body weight loss post-revisional endoscopic sleeve gastroplasty (r-ESG) was 12.6% at 24 months.

Weight loss outcomes post-r-ESG increased progressively, with 8.6% at 12 months, 10.7% at 18 months, and 12.6% at 24 months.
No significant predictors were identified for achieving weight loss of 5% or more at 12 months.
Revisional endoscopic sleeve gastroplasty may serve as an effective and durable treatment for weight recurrence after laparoscopic sleeve gastrectomy.

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BACKGROUND: Recurrent weight gain after laparoscopic sleeve gastrectomy (LSG) is common. Revisional endoscopic sleeve gastroplasty (r-ESG) has been shown to be a promising endoscopic bariatric therapy (EBT) to treat weight recurrence after LSG. However, to date, weight loss outcomes beyond 1-year follow-up are unknown. Our study aims as follows: (1) examine 1 year, 18-month, and 24-month weight loss outcomes post-r-ESG and (2) determine if weight loss outcomes post-LSG predict clinical outcomes post-r-ESG.

METHODS: This was a retrospective cohort data of patients who completed r-ESG from December 2020 to November 2023. The primary outcome was percentage of total body weight loss (TBWL) at 1-year post-r-ESG. Secondary outcomes included TBWL at 18- and 24-month post-r-ESG. Multivariable logistic regression analysis was used to determine predictors of weight loss ≥ 5% at 12 months.

RESULTS: A total of 55 patients completed r-ESG. TBWL post-r-ESG at 12 months was 8.6% (n = 37), at 18 months was 10.7% (n = 31), and at 24 months was 12.6% (n = 18) (Table 2). There were no statistically significant variables associated with weight loss ≥ 5% at 12 months (Table 3).

CONCLUSIONS: Our study demonstrates that r-ESG is an effective and durable EBT for post-LSG weight recurrence. Further research is needed to determine optimal timing of r-ESG for weight recurrence as well as the adjunctive role of anti-obesity medications.

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Efficacy of Revisional Endoscopic Sleeve Gastroplasty After Laparoscopic Sleeve Gastrectomy

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