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Efficacy and safety of endoscopic sleeve gastroplasty for obesity patients: a meta-analysis



Endoscopic sleeve gastroplasty (ESG) is a minimally invasive, effective, and safe technique for weight loss intervention. Since a relatively small number of cases were present in previous studies, this study aimed to elucidate the efficacy and safety of ESG.


Relevant publications were identified through searching PubMed, EMBASE, Cochrane, and Web of Science before March 1, 2019. The percentage of total body weight loss (%TBWL), percentage of excess weight loss (%EWL), and the adverse event rate in each follow-up session were extracted, pooled, and analyzed. Forest plots were graphed based on random effects models.


A total of 1542 patients from nine studies were eligible for analysis. The pooled results of %TBWL at 1, 3, 6, and 12 months were 8.78% (p = 0.000), 11.85% (p = 0.000), 14.47% (p = 0.024), and 16.09% (p = 0.063), respectively. The pooled results of %EWL at 1, 3, 6, and 12 months were 31.16% (p = 0.000), 43.61% (p = 0.000), 53.14% (p = 0.000), and 59.08% (p = 0.015), respectively. Finally, the pooled rate of mild adverse events was 72% (p < 0.01), and the pooled estimate of severe adverse events was only 1% (p = 0.08).


Although the conventional surgical sleeve gastrectomy is the gold standard for bariatric surgery, ESG could be a promising minimally invasive alternative for treating obesity with satisfactory efficacy and low risk.

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Special thanks to Dr. Bin Ma for his selfless teaching and helping Dr. Peiwen Li to conduct this study.


This study was supported by the Natural Science Foundation of Liaoning Province (Grant No. 2015020561), the Fund for Scientific Research of The First Hospital of China Medical University (Grant No. fsfh1514), and Wu Jieping Medical Foundation (Grant No. 320.6750.18293).

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Correspondence to Wenya Li.

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Dr. Peiwen Li, Dr. Bin Ma, Dr. Shulei Gong, Dr. Xinyu Zhang, and Dr. Wenya Li have no conflicts of interest or financial ties to disclose.

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Li, P., Ma, B., Gong, S. et al. Efficacy and safety of endoscopic sleeve gastroplasty for obesity patients: a meta-analysis. Surg Endosc 34, 1253–1260 (2020).

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  • Endoscopic sleeve gastroplasty
  • Bariatric surgery
  • Endoscopic bariatric therapy
  • Sleeve gastroplasty