Advertisement

Is endoscopic sleeve gastroplasty ready for prime time?

Published:November 01, 2022DOI:https://doi.org/10.1016/j.gie.2022.09.003
      The growing prevalence of obesity and its increasing burden on society, in both economic and health-related terms, behoove us to find additional treatments. Obesity therapies and devices need to be appealing to patients and their doctors for their efficacy and low rate of adverse events but also must be approved by the U.S. Food and Drug Administration (FDA) and insurance providers. A 2013 study of the University HealthSystem Consortium database showed that bariatric operations are by far the most common elective surgical procedures performed at academic medical centers.
      • Nguyen N.T.
      • Nguyen B.
      • Shih A.
      • et al.
      Use of laparoscopy in general surgical operations at academic centers.
      Despite this, surgery remains grossly underused in the management of obesity, with <1% of the eligible population undergoing bariatric surgery.
      • Altieri M.S.
      • Irish W.
      • Pories W.J.
      • et al.
      Examining the rates of obesity and bariatric surgery in the United States.
      The reasons for this are numerous and include physician skepticism that obesity is even a disease, lack of primary care provider (PCP) awareness of candidacy guidelines, PCP concern about having to manage post–bariatric surgery care, lack of PCP comfort in discussing obesity treatments, health policy/insurance/financial issues, patient concerns about potential adverse events, lack of patient recognition of even having obesity, and many others.
      • Funk L.M.
      • Jolles S.A.
      • Voils C.I.
      Obesity as a disease: has the AMA resolution had an impact on how physicians view obesity?.
      • Balduf L.M.
      • Farrell T.M.
      Attitudes, beliefs, and referral patterns of PCPs to bariatric surgeons.
      • Afonso B.B.
      • Rosenthal R.
      • Li K.M.
      • et al.
      Perceived barriers to bariatric surgery among morbidly obese patients.

      Abbreviations:

      EBT (endoscopic bariatric therapy), ESG (endoscopic sleeve gastroplasty), FDA (US Food and Drug Administration), MBSAQIP (Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program), PCP (primary care provider), SG (surgical sleeve gastrectomy)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Gastrointestinal Endoscopy
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Nguyen N.T.
        • Nguyen B.
        • Shih A.
        • et al.
        Use of laparoscopy in general surgical operations at academic centers.
        Surg Obes Relat Dis. 2013; 9: 15-20
        • Altieri M.S.
        • Irish W.
        • Pories W.J.
        • et al.
        Examining the rates of obesity and bariatric surgery in the United States.
        Obes Surg. 2021; 31: 4754-4760
        • Funk L.M.
        • Jolles S.A.
        • Voils C.I.
        Obesity as a disease: has the AMA resolution had an impact on how physicians view obesity?.
        Surg Obes Relat Dis. 2016; 12: 1431-1435
        • Balduf L.M.
        • Farrell T.M.
        Attitudes, beliefs, and referral patterns of PCPs to bariatric surgeons.
        J Surg Res. 2008; 144: 49-58
        • Afonso B.B.
        • Rosenthal R.
        • Li K.M.
        • et al.
        Perceived barriers to bariatric surgery among morbidly obese patients.
        Surg Obes Relat Dis. 2010; 6: 16-21
        • Abu Dayyeh B.K.
        • Rajan E.
        • Gostout C.J.
        Endoscopic sleeve gastroplasty: a potential endoscopic alternative to surgical sleeve gastrectomy for treatment of obesity.
        Gastrointest Endosc. 2013; 78: 530-535
      1. Gudur AR, Geng C, Kshatri S, et al. Comparison of endoscopic sleeve gastroplasty versus surgical sleeve gastrectomy: a metabolic and bariatric surgery accreditation and quality improvement program database analysis. Gastrointest Endosc. Epub 2022 Jul 20.

        • Saumoy M.
        • Schneider Y.
        • Zhou X.K.
        • et al.
        A single-operator learning curse analysis for the endoscopic sleeve gastroplasty.
        Gastrointest Endosc. 2018; 87: 442-447
        • Abu Dayyeh B.K.
        • Bazerbachi F.
        • Vargas E.J.
        • et al.
        Endoscopic sleeve gastroplasty for treatment of class 1 and 2 obesity (MERIT): a prospective, multicentre, randomized trial.
        Lancet. 2022; 400: 441-451