Tomato Incision

Progress on a Nonsurgical Gastric Sleeve Procedure

People don’t like surgery. No matter how you put it, knives are scary. Even though data on the benefits of bariatric surgery could hardly be stronger, less than one percent of the people who could benefit actually choose to have bariatric surgery. So it shouldn’t be a surprise that new data on a nonsurgical gastric sleeve procedure is causing quite a stir.

Endoscopic Sleeve Gastroplasty

This procedure is endoscopic. That means a scope goes down your throat and into your stomach. The specialized scope puts stitches into the stomach from inside it and reduces the size of your stomach to about a third of its original size.

This week at the DDW meeting in Chicago, researchers from Weill Cornell presented comparative data on this endoscopic sleeve gastroplasty versus surgical procedures: gastric banding or sleeve gastrectomy in a total of 278 patients. It wasn’t randomized and there were differences between the three groups of patients.

Less Complicated, Less Expensive, and Less Effective

People in the nonsurgical sleeve group had a lower initial BMI, an average of 39. That compares to average starting BMI of 47 for sleeve surgery patients and 45 for band patients. With the nonsurgical sleeve, people lost less weight, but they had fewer complications and spent much less time in the hospital.

The endoscopic sleeve procedure was also less expensive, costing on average $12,000. That compares to $15,000 for a band and $22,000 for a surgical sleeve.

It’s still early days for this procedure. Though this data can give you a rough idea of how it compares to other options, it’s not a randomized trial. Patients who got the endoscopic sleeve in this study were clearly different from the others. Nonetheless, for patients who need obesity treatment beyond behavioral strategies and drug therapy, endoscopic sleeves are looking like a promising option.

Click here for the study, and here for more from the American Journal of Managed Care. For additional recent publications, click here and here.

Tomato Incision, photograph © Kate Ter Haar / flickr

Subscribe by email to follow the accumulating evidence and observations that shape our view of health, obesity, and policy.


May 12, 2017

2 Responses to “Progress on a Nonsurgical Gastric Sleeve Procedure”

  1. May 14, 2017 at 12:07 am, Emily Cooper MD said:

    One of the nice benefits of surgical VSG is removal of most of the ghrelin secreting tissue from the lower curvature of the stomach. If this remains in the body ghrelin can become excessive as in RYGB and lap band patients, a potential promoter of weight regain complicating long term successful management. I assume the endoscopic sleeve procedure does not remove this tissue from the body.

  2. May 17, 2017 at 10:05 pm, Allen Browne said:

    Historically a big problem with durability – long term data is sorely needed.