Background

Endoscopic sleeve gastroplasty (ESG) is performed in clinical practice by both gastroenterologists and bariatric surgeons across the nation. Given the increasing regulatory approval and global adoption, our aim is to evaluate real world outcomes in multidisciplinary practices involving bariatric surgeons and gastroenterologists (GI) across the United States.

Methods

We included adult patients with obesity who underwent ESG from January 2013 to August 2022 in clinical US practices. Patients and procedural characteristics, serious adverse events (SAEs), and weight loss outcomes up to 24 months were analyzed. SPSS (version 29.0) was used for all statistical analyses.

Results

1506 patients from 7 sites included 235 (15.6%) treated by surgeons and 1271 (84.4%) treated by GIs. There were no significant baseline differences between groups (Table 1). GIs used Argon Plasma Coagulation (APC) for marking more often than surgeons (34.8% vs. 3.4% p-value < 0.001). There were no differences between providers in overtube use, or intra-procedural complications. The mean number of sutures was 7 and was similar between the two groups. On average, procedural length was 20 minutes longer for surgeons compare to GIs (p<0.001). %TWBL was similar between the two groups at 12, 18, and 24 months (Figure 1). SAEs were low and similar at 1.2% for surgeons and 0.8% for GIs (p>0.05).

Conclusions

Clinical data from a large US cohort showed significant and sustained weight loss with ESG and excellent safety profile in both bariatric surgery and GI practices. This supports the scalability of the procedure across practices in a multidisciplinary setting.