Skip to main content

Advertisement

SpringerLink
Log in

Brazilian Consensus on Endoscopic Sleeve Gastroplasty

  • Original Contributions
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

Purpose

Bariatric endoscopy is a less invasive approach for obesity management, with better efficacy than pharmacological treatment and low morbidity. Endoscopic sleeve gastroplasty (ESG) is the remodeling of the stomach using a suturing device showing technical feasibility, safety, and sustained weight loss. With growing numbers of procedures worldwide, there is a need to standardize the procedure.

Materials and Methods

A consensus meeting was held in São Caetano do Sul-SP, Brazil, in June 2019, bringing together 47 Brazilian endoscopists with experience in ESG from all regions of the country. Topics on indications and contraindications of the procedure, pre-procedure evaluation and multidisciplinary follow-up, technique and post-procedure follow-up, and training requirements were discussed. An electronic voting was carried, and a consensus was defined as ≥ 70% agreement.

Results

The panel’s experience consisted of 1828 procedures, with a mean percentage total body weight loss (TBWL) of 18.2% in 1 year. Adverse events happened in 0.8% of the cases, the most common being hematemesis. The selected experts discussed and reached a consensus on several questions concerning patient selection, contraindications for the procedure, technical details such as patient preparation, procedure technique, and patient follow-up.

Conclusions

This consensus establishes practical guidelines for performance of ESG. The experience of 1828 procedures shows the expertise of the selected specialists participating in this consensus statement. The group’s experience has a satisfactory weight loss with low adverse events rate. The main points discussed in this paper may serve as a guide for endoscopists performing ESG. Practical recommendations and technique standardization are described.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Courcoulas AP, Christian NJ, Belle SH, et al. Weight change and health outcomes at 3 years after bariatric surgery among individuals with severe obesity. JAMA. 2013;310(22):2416–25.

    CAS  PubMed  PubMed Central  Google Scholar 

  2. Buchwald H, Oien DM. Metabolic/bariatric surgery worldwide 2011. Obes Surg. 2013;23(4):427–36.

    Article  Google Scholar 

  3. Force ABET, Committee AT, Abu Dayyeh BK, et al. Endoscopic bariatric therapies. Gastrointest Endosc. 2015;81(5):1073–86.

    Article  Google Scholar 

  4. Force ABET, Committee AT, Abu Dayyeh BK, et al. ASGE Bariatric Endoscopy Task Force systematic review and meta-analysis assessing the ASGE PIVI thresholds for adopting endoscopic bariatric therapies. Gastrointest Endosc. 2015;82(3):425–38. e5

    Article  Google Scholar 

  5. Lopez-Nava G, Galvao MP, Bautista-Castano I, et al. Endoscopic sleeve gastroplasty: how I do it? Obes Surg. 2015;25(8):1534–8.

    Article  CAS  Google Scholar 

  6. Lopez-Nava G, Sharaiha RZ, Vargas EJ, et al. Endoscopic sleeve gastroplasty for obesity: a multicenter study of 248 patients with 24 months follow-up. Obes Surg. 2017;27(10):2649–55.

    Article  Google Scholar 

  7. Galvao-Neto MD, Grecco E, Souza TF, et al. Endoscopic sleeve gastroplasty - minimally invasive therapy for primary obesity treatment. Arq Bras Cir Dig. 2016;29Suppl 1(Suppl 1):95–7.

    Article  Google Scholar 

  8. Abu Dayyeh BK, Rajan E, Gostout CJ. Endoscopic sleeve gastroplasty: a potential endoscopic alternative to surgical sleeve gastrectomy for treatment of obesity. Gastrointest Endosc. 2013;78(3):530–5.

    Article  Google Scholar 

  9. Sharaiha R. Endoscopic sleeve gastroplasty for obesity management. Gastroenterol Hepatol. 2019;15(7):390–2.

    Google Scholar 

  10. Kumar N, Abu Dayyeh BK, Lopez-Nava Breviere G, et al. Endoscopic sutured gastroplasty: procedure evolution from first-in-man cases through current technique. Surg Endosc. 2018;32(4):2159–64.

    Article  Google Scholar 

  11. Neto MG, Moon RC, de Quadros LG, et al. Safety and short-term effectiveness of endoscopic sleeve gastroplasty using overstitch: preliminary report from a multicenter study. Surg Endosc. 2019;

  12. Barrichello S, Hourneaux de Moura DT, Hourneaux de Moura EG, et al. Endoscopic sleeve gastroplasty in the management of overweight and obesity: an international multicenter study. Gastrointest Endosc. 2019;90(5):770–80.

    Article  Google Scholar 

  13. de Miranda Neto AA, de Moura DTH, Ribeiro IB, et al. Efficacy and safety of endoscopic sleeve gastroplasty at mid term in the management of overweight and obese patients: a systematic review and meta-analysis. Obes Surg. 2020;30(5):1971–87.

    Article  Google Scholar 

  14. Sharaiha RZ, Kumta NA, Saumoy M, et al. Endoscopic sleeve gastroplasty significantly reduces body mass index and metabolic complications in obese patients. Clin Gastroenterol Hepatol. 2017;15(4):504–10.

    Article  Google Scholar 

  15. Hedjoudje A, Abu Dayyeh BK, Cheskin LJ, et al. Efficacy and safety of endoscopic sleeve gastroplasty: a systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2020;18(5):1043–53. e4

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Endovitta Institute, Santo Andre, Brazil

    Manoel Galvão Neto, Eduardo Grecco & Thiago Ferreira de Souza

  2. Medicine of ABC, Santo Andre, Brazil

    Manoel Galvão Neto, Luiz Gustavo de Quadros, Eduardo Grecco, Admar Concon Filho & Thiago Ferreira de Souza

  3. Federal University of Pernambuco, Recife, Brazil

    Lyz Bezerra Silva

  4. Kaiser Clinic, Sao Jose do Rio Preto, Brazil

    Luiz Gustavo de Quadros

  5. Galileo Hospital, Valinhos, Brazil

    Admar Concon Filho

  6. 9 de Julho Hospital, Sao Paulo, Brazil

    Artagnan Menezes Barbosa de Amorim

  7. Instituto Falcao de Endoscopia e Cirurgia, Salvador, Brazil

    Marcelo Falcao de Santana

  8. Hospital Rios Dor, Rio de Janeiro, Brazil

    Newton Teixeira dos Santos

  9. Endobatel Endoscopia Digestiva, Curitiba, Brazil

    Joao Henrique Felicio de Lima

  10. Digestive Center, Fortaleza, Brazil

    Helmut Wagner Poti de Morais

  11. Endodiagnostic Clinic, Rio de Janeiro, Brazil

    Felipe Matz Vieira

  12. Department of Bariatric Surgery, Orlando Regional Medical Center, Orlando Health, 89 W Copeland Dr, 1st Floor, Orlando, FL, USA

    Rena Moon & André F. Teixeira

Authors
  1. Manoel Galvão Neto
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lyz Bezerra Silva
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Luiz Gustavo de Quadros
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Eduardo Grecco
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Admar Concon Filho
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Artagnan Menezes Barbosa de Amorim
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Marcelo Falcao de Santana
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Newton Teixeira dos Santos
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Joao Henrique Felicio de Lima
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Thiago Ferreira de Souza
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Helmut Wagner Poti de Morais
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Felipe Matz Vieira
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Rena Moon
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. André F. Teixeira
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

for the Brazilian Endoscopic Sleeve Gastroplasty Collaborative

  • Adriano Tomas Vasconcelos Alexandre
  • , Leonardo Salles de Almeida
  • , Jose Rubes Arnoni
  • , Fermanda Nascimento Bueno
  • , Keila Regina Matos Cantanhebe
  • , Rafael Pasqualini de Carvalho
  • , Alexandre Cenatti
  • , Bruna Durelli
  • , Elaine Moreira Ferreira
  • , Luiz Henrique de Sousa Filho
  • , Idiberto Jose Zotarelli Filho
  • , Anna Carolina Hoff
  • , Mauro Rodrigues Coelho Jacome
  • , Muhammad Jawad
  • , Igor Marchetti
  • , Luis Augusto Matta
  • , Tulio Medeiros
  • , Luiz Henrique Mazzonetto Mestieri
  • , Marcius Vinicius de Moraes
  • , Joao de Siqueira Neto
  • , Alvaro Oliveira Neto
  • , Joffre Rezende Neto
  • , Harley Pandolfi
  • , Andre Pupo
  • , Flavio Metidieri Ramos
  • , Almino Cardoso Ramos
  • , Leonardo Teixeira Rodrigues
  • , Guilherme Becker Sander
  • , Rodrigo Dallegrave Correa da Silva
  • , Jose Americo Gomides de Sousa
  • , Mauricio Spagnol
  • , Eduardo Nobuyki Usuy
  • , Julio Cesar de Soares Veloso
  • , Hans Roman Wulf Vieira
  •  & Jorge Luiz de Mattos Zeve

Corresponding author

Correspondence to André F. Teixeira.

Ethics declarations

Conflict of Interest

Drs. Manoel Galvão Neto, Luiz Gustavo de Quadros, Thiago Ferreira de Souza, Eduardo Grecco, Admar Concon Filho, and Felipe Matz are consultants for Apollo Endosurgery. Dr. Andre Teixeira is a consultant for Intuitive Surgical.

Ethical Approval

For this type of study, formal consent is not required.

Informed Consent

Does not apply.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Appendix

Appendix

Brazilian Endoscopic Sleeve Gastroplasty Collaborative:

Adriano Tomas Vasconcelos Alexandre, Digestive Center, Fortaleza, Brazil.

Leonardo Salles de Almeida, Instituto Mineiro de Obesidade, Belo Horizonte, Brazil.

Jose Rubes Arnoni, Clinica Imec, Sao Paulo, Brazil.

Fermanda Nascimento Bueno, Endovale Clinica, Sao Jose dos Campos, Brazil.

Keila Regina Matos Cantanhebe, Hospital Sao Domingos, Sao Luis, Brazil.

Rafael Pasqualini de Carvalho, Medicina de Ribeirao Preto-USP, Ribeiro Preto, Brazil.

Alexandre Cenatti, Unimed Hospital, Casias do Sul, Brazil.

Bruna Durelli, Clinica Scoppo, Sao Paulo, Brazil.

Elaine Moreira Ferreira, Endovitta Institute, Santo Andre, Brazil.

Luiz Henrique de Sousa Filho, Clinica Cirurgica Digestiva e Obesidade, Goiania, Brazil.

Idiberto Jose Zotarelli Filho, Kaiser Clinic, Sao Jose do Rio Preto, Brazil.

Anna Carolina Hoff, Angioskope Vale, Sao Jose dos Campos, Brazil.

Mauro Rodrigues Coelho Jacome, Clinica Cronos Endoscopia, Belo Horizonte, Brazil.

Muhammad Jawad, Orlando Regional Medical Center, Orlando, FL, USA.

Igor Marchetti, Servico de Endoscopia Diagnostica e Terepeutica, Sorocaba, Brazil.

Luis Augusto Matta, Clinica Lev, Uberlandia, Brazil.

Tulio Medeiros, Clinica Scoppo, Sao Paulo, Brazil.

Luiz Henrique Mazzonetto Mestieri, Clinica Mestieri, Salto, Brazil.

Marcius Vinicius de Moraes, Instituto Endogastro, Goiania, Brazil.

Joao de Siqueira Neto, Universidade Federal do Espirito Santo, Vitoria, Brazil.

Alvaro Oliveira Neto, Nucleo Integrado de Obesidade e Diabetes, Itabuna, Brazil.

Joffre Rezende Neto, Instituto de Gastroenterologia de Goiania, Goiania, Brazil.

Harley Pandolfi, Gastroclinica de Palmas, Palmas, Brazil.

Andre Pupo, Ipiranga Hospital, Mogi das Cruzes, Brazil.

Flavio Metidieri Ramos, Endodiagnostic Clinic, Rio de Janeiro, Brazil.

Almino Cardoso Ramos, Gastro-Obeso-Center, Sao Paulo, Brazil.

Leonardo Teixeira Rodrigues, Compexo Hospitalar de Niteroi, Niteroi, Brazil.

Guilherme Becker Sander, Ernesto Dornelles Hospital, Porto Alegre, Brazil.

Rodrigo Dallegrave Correa da Silva, Clinobeso, Porto Alegre, Brazil.

Jose Americo Gomides de Sousa, Clinica Lev, Uberlandia, Brazil.

Mauricio Spagnol, Clinica Cirurgica Chapeco, Chapeco, Brazil.

Eduardo Nobuyki Usuy, Clinica Gastrica, Florianopolis, Brazil.

Julio Cesar de Soares Veloso, Instituto do Aparelho Digestivo, Brasilia, Brazil.

Hans Roman Wulf Vieira, Hansgastroclinica, Blumenau, Brazil.

Jorge Luiz de Mattos Zeve, Gastrocentro de Palmas, Palmas, Brazil.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Neto, M.G., Silva, L.B., de Quadros, L.G. et al. Brazilian Consensus on Endoscopic Sleeve Gastroplasty. OBES SURG 31, 70–78 (2021). https://doi.org/10.1007/s11695-020-04915-4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-020-04915-4

Keywords

Search

Navigation