Published online Mar 21, 2020. doi: 10.3748/wjg.v26.i11.1107
Peer-review started: November 12, 2019
First decision: February 24, 2020
Revised: February 27, 2020
Accepted: March 9, 2020
Article in press: March 9, 2020
Published online: March 21, 2020
Bariatric surgeries have been demonstrated to be safe and effective treatment options for morbid obesity patients, but operative risks and high health care costs limit their clinical application. Endoscopic bariatric therapies are emerging as valuable alternatives for patients with doubts about bariatric surgery or ineligible for it. Endoscopic sleeve gastroplasty (ESG), a relatively novel technique of endoscopic bariatric therapies, has gained standing in the past few years. The safety, feasibility, repeatability, and potential for reversibility of ESG have been proven by multicenter studies. Compared to other weight loss strategies, current evidence demonstrates that ESG offers satisfactory efficacy in weight loss. Even though it is inferior to laparoscopic sleeve gastrectomy, it has lower risks of adverse events than surgical interventions and intragastric balloon within one-year follow-up. Furthermore, ESG may be the ideal weight control strategy for patients who have poor adherence to behavioral interventions. Even so, trends in decreased weight loss effect over time, post-procedure weight regain, post-procedure gut hormone alteration, and possible effects of race and ethnicity on ESG still remain undetermined due to very limited reports and very short follow-ups. Further clinical trials are required to validate and answer these questions.
Core tip: Endoscopic sleeve gastroplasty offers satisfactory efficacy in weight loss, even though it is inferior to laparoscopic sleeve gastrectomy and has lower risks of adverse events than surgical interventions and intragastric balloon within one-year follow-up. Furthermore, it may be the ideal weight control strategy for patients who have poor adherence to behavioral interventions.