Endoscopic sleeve gastroplasty – Current status and future perspectives

Obesity is a worldwide epidemic and present significant health-care burdens for individuals and health-care systems. Bariatric endoscopy is an evolving field known for benefits including being minimally invasive, reversible, and organ preserving, providing a promising alternative to traditional bariatric surgery. Various endoscopic procedures targeting on the stomach and small bowel have been developed. Amongst all, endoscopic sleeve gastroplasty (ESG) is shown to be more effective, durable, and safe. It utilizes endoscopic suturing device to perform full-thickness plication of gastric wall, thereby restricting stomach volume and altering gastric mobility to induce satiety. Its application was recently addressed by the National Institute for Health Care Excellence (NICE), the American Society for Gastrointestinal Endoscopy (ASGE), the European Society for Gastrointestinal Endoscopy (ESGE), the International Federation for the Surgery of Obesity and Metabolic Diseases (IFSO) and the World Gastroenterology Organization (WGO). This review aims to provide a comprehensive summary of ESG and discusses potential future developments.