Post written by Chase Wooley, BS, from True You Weight Loss, Cary, North Carolina, USA.

In this video case, we demonstrate the advantages of using a mixed-tooth grasping forceps rather than the traditional tissue helix to acquire full-thickness gastric folds during the endoscopic sleeve gastroplasty (ESG) procedure.

A customized animation highlights the risk of transmural tissue injury and involvement of extragastric structures when using the traditional tissue helix, which can be averted with a mixed-tooth grasping forceps. We showcase a successful ESG case using the mixed-tooth grasping forceps (Boston Scientific, Marlborough, Mass, USA) and a follow-up routine endoscopy to discuss the advantages in terms of safety, recovery, and efficiency.

To our knowledge, this is the first description of ESG performed with grasping forceps rather than the traditional tissue helix device. We believe patients, clinicians, and the field of endoscopic bariatrics may benefit from broader adoption of this technique as a safer, more efficient alternative.

Although safe, the design and implementation of the tissue helix may increase the risk of rare but serious adverse events associated with ESG, namely transmural passage of the gastric wall. Other endoscopists may learn of the potential advantages of the grasper in terms of safety, recovery, and efficiency based on the combined experience of more than 500 cases of grasper-driven ESG cases without a serious adverse event at True You Weight Loss.

Recognizing these risks, True You Weight Loss now exclusively uses a mixed-tooth grasping forceps for tissue acquisition during ESG.

Potential risks during tissue acquisition using the tissue helix versus the mixed-tooth grasping forceps. A, Tissue helix passing transmurally through gastric tissue, accessing extragastric structures. B, Inadvertent suturing of extragastric structure. C, Tissue acquisition without penetration through the gastric wall using the mixed-tooth grasping forceps.

Read the full article online.

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