Endoscopic sleeve gastroplasty: a potential endoscopic alternative to surgical sleeve gastrectomy for treatment of obesity

BackgroundObesity and its associated conditions, including type 2 diabetes and cardiovascular disease, have reached epidemic proportions. High-efficacy, high-risk surgical approaches are unlikely to meet the increasing burden of disease. Emerging endoscopic technologies have opened the door for endoscopic approaches to reproduce many of the benefits of GI weight loss surgery and thereby contribute to the effective treatment of obesity and its associated disorders.ObjectiveTo demonstrate the technical feasibility of transoral endoscopic gastric volume reduction with an endoscopic suturing device in a fashion similar to sleeve gastrectomy for the treatment of obesity.DesignSingle-center, pilot feasibility study.PatientsFour human subjects with obesity.InterventionsTransoral sleeve gastroplasty.Main Outcome MeasurementsTechnical feasibility.ResultsWe successfully used an endoscopic free-hand suturing system in 4 subjects, thus demonstrating the technical feasibility of a novel technique to mimic the anatomic manipulations created by surgical sleeve gastrectomy endoscopically.LimitationsPilot feasibility study with small number of subjects.ConclusionsEndoscopic sleeve gastroplasty for treatment of obesity is feasible.