IBC Oxford University Oral Abstract 47 - 12-years’ experience with the endoscopic sleeve gastroplasty: suggestion for an upgraded device

Abstract Introduction The Endoscopic Sleeve Gastroplasty represents an innovative and successful solution in the bariatric field. Starting in 2011, we introduced it in our practice in Lyon. Methods We performed 92 EGP till 2023, both primary (N = 71) and secondary (N = 21). The learning curve has been steep concerning at least one device (Apollo Endosurgery, N = 55), while easier with Endomina (N = 16) and POSE (USGI Medical) (N = 20). Results All patients stayed overnight, 5 stayed 2 days or more. 19 patients were included into a re-do protocol in former bypass (aimed at narrowing a gastro-jejunal anastomosis). There were mild complications in 32 patients (35%), mostly abdominal pain with marginal pneumoperitoneum in 10, non-specific abdominal pain in 30, and nausea in 21, and SAE in one patient (pneumo-mediastinum, spontaneously resolutive). Weight loss at 2 months was 5.5%, 9% at 6 months and 8% at 12 months. Conclusion Endogastric plication is a safe method, current material being unsatisfactory in many regards, because of frequent upgrades and variations regarding the advised pattern of plication. Real life results do not match those found in most publications. Still, this method represents probably the promising innovative endoscopic bariatric tool for the time being. We wish to develop a simpler and more ergonomic device that could be easily robotized. Research is going on with a new prototype called ENDOPLY, with a pilot study starting in Prague in May 2024, and pending upgrades.