Establishing standards of practice for endoscopic sleeve gastroplasty: a global expert consensus using a modified...

Area of Science:

• Gastroenterology
• Bariatric Endoscopy
• Minimally Invasive Surgery

Background:

• Endoscopic sleeve gastroplasty (ESG) is a safe and effective minimally invasive obesity treatment.
• Variations in procedural techniques can impact outcomes.
• A standardized approach is needed to optimize ESG performance.

Purpose of the Study:

• To develop a standardized procedural approach for endoscopic sleeve gastroplasty (ESG).
• To establish consensus on key cognitive and technical steps for ESG.
• To provide clear guidance for performing ESG safely and effectively.

Main Methods:

• Modified Delphi method utilized for consensus building.
• Global ESG experts with over 300 procedures participated.
• Three survey rounds were conducted, with consensus defined as ≥70% agreement.

Main Results:

• 27 key ESG steps were identified with high expert consensus.
• Cognitive skills achieved 100% consensus; technical skills showed high agreement.
• Key technical elements included starting at the incisura, using ≥6 sutures, and avoiding the fundus.

Conclusions:

• This expert consensus provides a standardized, step-by-step guide for ESG.
• The guidance aims to enhance the safety and efficacy of ESG procedures.
• Standardization can lead to more predictable and successful patient outcomes.