Endoscopic Sleeve Gastroplasty Versus Laparoscopic Sleeve Gastrectomy: A Comparison in Effectiveness and Safety Profile

Mar 30, 2025Asian journal of endoscopic surgery

Effectiveness and Safety of Endoscopic Sleeve Gastroplasty Compared to Laparoscopic Sleeve Gastrectomy

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Abstract

Endoscopic sleeve gastroplasty (ESG) resulted in a significantly shorter hospital stay of 9.14 hours compared to laparoscopic sleeve gastrectomy (LSG) at 27.77 hours.

Both ESG and LSG led to significant weight loss, but LSG resulted in greater total body weight loss at 6 and 12 months.
ESG was associated with fewer adverse events, occurring in 8.5% of patients, compared to 17.1% for LSG.
New-onset gastroesophageal reflux disease (GERD) occurred more frequently after LSG, with rates of 20% versus 4.3% for ESG.
Patients undergoing ESG had an average age of 38.07 years, while those undergoing LSG had an average age of 33.99 years.
ESG may be a suitable alternative for patients with a higher body mass index (BMI).

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BACKGROUND AND OBJECTIVES: Current treatment options for obesity typically involve a combination of lifestyle changes, medications, and bariatric surgeries. This study aimed to assess the safety profile of the endoscopic sleeve gastroplasty (ESG), which is a novel non-invasive approach, as compared to laparoscopic sleeve gastrectomy (LSG) and to correlate their weight loss effectiveness and complication risk in Lebanese patients.

SUBJECTS AND METHODS: This is a retrospective study, including 70 patients who underwent ESG at Fouad Khoury Hospital and 70 patients who underwent LSG at Trad Hospital, between September 2021 and March 2023. Data collection targeted the patients' medical records and included their demographic characteristics (age, sex, weight, height, BMI), comorbidities, and post-procedural information. Weight and BMI (pre-op, 6-months post-op, and 1-year post-op) were collected. Total body weight loss was calculated, and analysis was performed using SPSS version 25.

RESULTS: Patients who underwent ESG were distributed between 43 (61.4%) females and 27 (38.6%) males, with an average age of 38.07 ± 10.78 years. Patients who underwent LSG were distributed between 42 (60%) females and 28 (40%) males, with an average age of 33.99 ± 10.55 years. Both ESG and LSG resulted in significant weight loss, but LSG achieved greater total body weight loss at 6 and 12 months. ESG was associated with significantly shorter hospital stays (9.14 h vs. 27.77 h, p < 0.001) and fewer adverse events (8.5% vs. 17.1%, p = 0.111). New-onset GERD was more frequent after LSG (20% vs. 4.3%, p = 0.004).

CONCLUSION: ESG offers a less invasive approach with a potentially more favorable short-term safety profile and faster recovery, while LSG yields greater total body weight loss. ESG may be a suitable alternative for patients with a higher BMI. Further research is needed to assess long-term outcomes and cost-effectiveness.

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Endoscopic Sleeve Gastroplasty Versus Laparoscopic Sleeve Gastrectomy: A Comparison in Effectiveness and Safety Profile

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