Position statement and guidelines about Endoscopic Sleeve Gastroplasty (ESG) also known as "Endo-sleeve"

Area of Science:

• Bariatric and Metabolic Surgery
• Gastroenterology
• Endoscopic Procedures

Background:

• Obesity is a complex chronic disease requiring effective therapeutic interventions.
• Endoscopic Sleeve Gastroplasty (ESG) has emerged as a less invasive option for weight management.
• Evaluating ESG's efficacy, safety, and indications is crucial for clinical practice.

Purpose of the Study:

• To assess the effectiveness of Endoscopic Sleeve Gastroplasty (ESG) in treating obesity and associated comorbidities.
• To evaluate the safety profile and risks associated with ESG.
• To define the indications, management methods, and healthcare professionals qualified to perform ESG.

Main Methods:

• Systematic review of literature on ESG effectiveness and safety.
• Analysis of perioperative management protocols and multidisciplinary care requirements.
• Review of international scientific society recommendations and guidelines.

Main Results:

• ESG demonstrates greater effectiveness than lifestyle modifications alone for weight loss and comorbidity improvement.
• ESG shows comparable comorbidity resolution to Laparoscopic Sleeve Gastrectomy (LSG) with a low complication rate (1.5-2.3%).
• New-onset GERD is rare after ESG, occurring less frequently than after SG.

Conclusions:

• ESG is an effective and safe treatment option for obesity, particularly for patients with class I and II obesity or those unsuitable for metabolic bariatric surgery.
• Multidisciplinary care in accredited centers and adherence to follow-up are vital for successful ESG outcomes.
• International societies endorse ESG as a valuable therapeutic tool, emphasizing patient selection and long-term outcome evaluation.