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Impact of Proceduralist Specialty on Outcomes Following Endoscopic Sleeve Gastroplasty

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Abstract

Purpose

Endoscopic sleeve gastroplasty (ESG) is a novel minimally invasive weight loss procedure designed to mimic gastric volume reduction of surgical sleeve gastrectomy. Currently, both bariatric surgeons and gastroenterologists perform ESG, and early reports suggest that ESG is safe and effective for weight loss. However, as gastroenterologists and bariatric surgeons have variations in training backgrounds, it is important to evaluate for potential differences in clinical outcomes. To date, there are no studies comparing the impact of proceduralist specialization on outcomes of ESG. This study aims to assess whether proceduralist specialization impacts short-term safety and efficacy after ESG.

Methods

We retrospectively analyzed over 6,000 patients who underwent ESG from 2016 to 2020 in the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database. ESG patients were stratified into two groups depending on the specialty of the physician performing the procedure, and propensity matched using baseline patient characteristics. We primarily compared adverse events (AE), readmissions, re-operations, and re-interventions within 30 days after procedure. Secondary outcomes included procedure time, length of stay (LOS), early weight loss, and emergency department (ED) visits after procedure.

Results

There was no difference in AE in ESG performed by gastroenterologists and bariatric surgeons. ESG performed by bariatric surgeons demonstrated a trend towards higher rate of re-operations within 30 days. ESG performed by gastroenterologists had more ED visits but did not lead to higher rate of re-intervention. LOS was shorter in ESG performed by gastroenterologists, but procedure time was longer.

Conclusions

ESG is safely performed by both gastroenterologists and bariatric surgeons.

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Authors and Affiliations

  1. Department of Medicine, University of Virginia, Charlottesville, VA, 22903, USA

    Anuragh R. Gudur & Calvin Geng

  2. Department of Surgery, University of Virginia, Charlottesville, VA, 22903, USA

    Peter Hallowell & Bruce Schirmer

  3. Division of Gastroenterology and Hepatology, Department of Medicine, University of Virginia, Charlottesville, VA, 22903, USA

    Vanessa M. Shami, Andrew Y. Wang & Alexander Podboy

Authors
  1. Anuragh R. Gudur
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  2. Calvin Geng
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  3. Peter Hallowell
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  4. Bruce Schirmer
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  5. Vanessa M. Shami
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  6. Andrew Y. Wang
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  7. Alexander Podboy
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Corresponding author

Correspondence to Anuragh R. Gudur.

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

Conflict of Interest

Dr. Vanessa Shami is a consultant for Olympus Medical and Cook Medical. Other co-authors do not have any conflicts of interest to disclose.

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Key Points

• Adverse events were low after ESG by gastroenterologists and bariatric surgeons.

• ESG by gastroenterologists led to more ED visits but not readmission or re-intervention.

• ESG by bariatric surgeons led to a trend towards more re-operations within 30 days.

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Gudur, A.R., Geng, C., Hallowell, P. et al. Impact of Proceduralist Specialty on Outcomes Following Endoscopic Sleeve Gastroplasty. OBES SURG 32, 3714–3721 (2022). https://doi.org/10.1007/s11695-022-06282-8

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  • DOI: https://doi.org/10.1007/s11695-022-06282-8

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