Endoscopic Revision of Sleeve Gastrectomy

Laparoscopic sleeve gastrectomy is the most frequently performed bariatric surgery in the United States. Weight regain occurs in a subset of patients after surgery, occurring in up to one third of patients. It has been suggested that excessive dilation or stretching of the sleeve contributes to the risk of weight regain.

Revisions of the sleeve for weight regain have primarily taken the form of repeat surgery including conversion to gastric bypass. A surgical revision procedure carries increased risk, with overall complication rates ranging from 5 to 20%, much higher than the risk associated with the initial surgical intervention.

Revisional endoscopic sleeve gastroplasty (R-ESG) is an endoscopic approach to repair a dilated sleeve gastrectomy. It has multiple advantages over traditional surgical revision options, including improved safety, technical ease, and faster recovery time. We recently published a multi-center study which low adverse events and demonstrated nearly 13% total body weight loss (TBWL) at 1 year with >55% of patients achieving > 15% TBWL.