Nonsurgical Weight-Loss Treatment Option Reduces Costs, Length of Stay

A study presented at Digestive Disease Week 2017 found that nonsurgical endoscopic sleeve gastroplasty may be an effective option for treating obesity in patients who are not candidates for surgery.

“Obesity continues to be a problem in America and it is an epidemic rapidly spreading around the world,” Reem Z Sharaiha, MD, an assistant professor of medicine at Weill Cornell Medicine, said in a press release. “Our research—the first to compare these treatments—demonstrates that endoscopic sleeve gastroplasty is safe and effective in helping patients lead healthier lives. It should be considered as another tool available to clinicians and patients in the fight against obesity.”

According to the study, endoscopic sleeve gastroplasty is a nonsurgical procedure where an endoscope is inserted through the mouth to accordion the stomach by suturing it to reduce its size.

Dr Sharaiha and colleagues studied 278 patients who received one of three weight-loss treatments, including 91 patients who underwent endoscopic sleeve gastroplasty, 120 patients who underwent laparoscopic sleeve gastrectomy, and 67 patients who underwent laparoscopic banding.

Study results showed that patients who underwent laparoscopic sleeve gastrectomy surgery achieved the greatest outcomes. However, between the nonsurgical options, percentage of total body weight loss was 17.57% among patients who underwent endoscopic sleeve gastroplasty and 14.46% among laparoscopic banding patients.

Additionally, patients who underwent endoscopic sleeve gastroplasty had reduced complications related to the procedure and reduced time spent in inpatient recovery. The researchers noted that patients who undergo endoscopic sleeve gastroplasty leave the hospital on the same day, compared to up to 3 days hospitalization among patients who undergo the surgical options.

Furthermore, Dr Sharaiha and colleagues found that costs were reduced among patients who underwent endoscopic sleeve gastroplasty. According to the study, average institutional procedure costs associated with endoscopic sleeve gastroplasty $12,000, compared to $22,000 for laparoscopic sleeve gastrectomy and $15,000 for laparoscopic banding.

“For years, patients seeking weight-loss interventions had limited options because they could not tolerate or did not want surgery, or it was not even an option for them,” Dr Sharaiha said. “Our research shows that endoscopic sleeve gastroplasty can be the treatment they’ve been looking for. It’s less invasive than surgery and helps them reach their health goals.”

Dr Sharaiha and colleagues emphasized that their findings do not support the use of endoscopic sleeve gastroplasty as a replacement for surgery; but rather highlight an effective and cost-effective option for patients who are not candidates for surgery.

—David Costill