The sleeve gastroplasty: an alternative for obese patients not eligible for surgery?

Sleeve gastroplasty, an innovative endoscopic technique to reduce the size of the stomach is proposed to patients not eligible for bariatric surgery, either because they have a BMI between 30 and 40., or because they have a contraindication procedure. It has been developing for several years abroad and has been marketed in France for 2 years.

Article written by Dr. Vianna Costil, published on the website of the  CREGG, “Club of Reflexion of the Cabinets and Groups of Hepato-Gastroenterology “

How it works?

Sleeve gastroplasty can reduce the volume of the stomach using non-resorbable sutures made by natural means, without incision (and therefore without scarring), thanks to the technique of Overstitch.

The procedure is performed by a gastroenterologist, during a gastroscopy and under general anesthesia. These sutures help to limit the expansion of the stomach during the meal and slow down the emptying of food.

Thus, the patient regains a feeling of satiety, with smaller amounts of food.

Balance sheets

• A consultation with the doctor, who validates the indication and checks the absence of absence of contraindication,
• A complete nutritional and behavioral report,
• A biological assessment,
• A gastroscopy.

Profits

The advantage of sleeve gastroplasty is to have simple consequences (less pain and quick recovery) and fewer complications than the gastric balloon.

The effectiveness of this technique has been demonstrated by published results 1-2-3. % TBWL (weight loss percentage) is 15% at 6 months and 17.8% at 1 year.

Weight loss and its maintenance over time depend on the patient's adherence to the multidisciplinary follow-up program (behavioral, psychological dietary) and the resumption of regular physical activity.

Information and bibliography

1. Endoscopic Sleeve Gastroplasty Alters Gastric Physiology and Induces The Weight of Obese Individuals by Barbara K. Abu Dayyeh, et al; Clinical Gastroenterology and Hepatology 2017; 15: 37-43

2. Endoscopic Sleeve Gastroplasty for Obesity: a MulticenterStudy of 248 Patients with 24 MonthsFollow-Up. Gontrand Lopez-Nava et al. Obesity Surgery October 2017, Volume 27, Issue 10, 2649-2655

3. Endoscopic Sleeve Gastroplasty Significantly Reduces Body Mass Index and Metabolic Complications in Obese Patients Reem Z. Sharaiha, et al Clinical Gastroenterology and Hepatology 2017; 15: 504-510