Anatomical Configuration of the Stomach Post-Endoscopic Sleeve Gastroplasty (ESG)—What Are the Sutures Doing?

Introduction and Aim: Endoscopic sleeve gastroplasty (ESG) is a procedure in which endoscopically placed sutures involute the stomach and promote weight loss. There is limited data on the durability of these sutures. Patients and Methods: This was a single center series of 5 patients who underwent ESG performed by a single endoscopist. Patients underwent repeat endoscopy for different clinical indications. Results: ESGs were successfully reversed at 3 weeks and 1 month following index ESG without significant fibrosis or scaring. At 8 and 14 months, a few sutures had dehisced though there were extensive areas of fibrosis. By 2 years, most of the sutures had dehisced; however, the gastric volume remained reduced. Conclusion: This case series offers an intriguing evaluation of the anatomical changes induced by ESG.