Post written by Aayed Alqahtani, MD, FRCSC, FACS, from the Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.

For many patients with obesity, bariatric surgery is not a suitable option. Some patients are not eligible for weight-loss surgery under current conventional criteria. Additionally, many patients who are eligible for bariatric surgery prefer less-invasive solutions due to fear of adverse events and hesitation to undergo surgery. For these reasons, the search for an effective nonsurgical option continues. Endoscopic bariatric therapy (EBT) and, namely, endoscopic sleeve gastroplasty came at the right time to bridge the gap between bariatric surgery and lifestyle modification and medical weight loss. However, many questions are still unanswered with regards to how safe ‘Endosleeve’ is, as well as questions on how effective it is.

At 1-year of follow-up, patients lost two-thirds of their excess weight. This weight loss appeared to be maintained at the 18-month visit. Additionally, resolution of obesity-related co-morbidities occurred in the majority of patients. All cases of hypertension, three-quarters of type 2 diabetes cases, and more than half of dyslipidemia cases underwent complete remission.

The procedure appeared to be well-tolerated and safe. From the first 1,000 patients who underwent the procedure, 24 were re-admitted for investigation of a fever, a peri-gastric collection, blood loss, or significant abdominal pain. There was no mortality or significant morbidity in this cohort.

The Apollo OverStitch technique provides a great solution for those who are overweight or obese and desire to lose about 15 kilograms from their weight. However, we need to improve on the technique to increase effectiveness and durability of weight loss.

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