Establishing standards of practice for endoscopic sleeve gastroplasty: a global expert consensus using a modified Delphi method - 15/07/25

Doi : 10.1016/j.gie.2025.03.642

Pichamol Jirapinyo, MD, MPH ^1,^2,^⁎^{^{∗
Drs Jirapinyo and Advani are co–first authors.}} , Rashmi Advani, MD ^3,^{^{∗
Drs Jirapinyo and Advani are co–first authors.}}, Abdulhameed Al-Sabban, MBBS ⁴, Christopher McGowan, MD, MSCR ⁵, Reem Sharaiha, MD, MSc ⁶, Aayed Alqahtani, MD ⁷, Michael Larsen, MD ⁸, Janese Laster, MD ⁹, Daniel Maselli, MD ¹⁰, Shailendra Singh, MD ^11,^{^{†
Drs Singh and Thompson are co–senior authors.}}, Christopher C. Thompson, MD, MSc ^1,^2,^{^{†
Drs Singh and Thompson are co–senior authors.}}
¹ Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women’s Hospital, Boston, Massachusetts, USA
² Harvard Medical School, Boston, Massachusetts, USA
³ Division of Gastroenterology and Hepatology, Icahn School of Medicine at Mount Sinai and Mount Sinai Hospital South Nassau, Oceanside, New York, USA
⁴ University of Maryland, Baltimore, Maryland, USA
⁵ True You Weight Loss, Cary, North Carolina, USA
⁶ Division of Gastroenterology and Hepatology, Weill Cornell Medicine, New York, New York, USA
⁷ New You Medical Center, King Saud University, Riyadh, Saudi Arabia
⁸ Division of Gastroenterology, University of California San Francisco, San Francisco, California, USA
⁹ Gut Theory Total Digestive Care, Georgetown University Medical Center, Washington, DC, USA
¹⁰ True You Weight Loss, Atlanta, Georgia, USA
¹¹ Section of Gastroenterology and Hepatology, West Virginia University, Morgantown, West Virginia, USA

^∗Corresponding author: Pichamol Jirapinyo, MD, MPH, Brigham and Women’s Hospital, Harvard Medical School, Division of Gastroenterology, Hepatology and Endoscopy, 75 Francis St, Boston, MA 02115.Brigham and Women’s HospitalHarvard Medical SchoolDivision of GastroenterologyHepatology and Endoscopy75 Francis StBostonMA02115

Abstract

Background and Aims

Endoscopic sleeve gastroplasty (ESG) is a minimally invasive treatment for obesity with established efficacy and safety. However, procedural techniques vary. In this study, our aim was to develop a standardized ESG approach.

Methods

A modified Delphi method was used to define key ESG steps. Global ESG experts (≥300 procedures) participated in 3 survey rounds. Items with ≥70% agreement were included, and those with <70% consensus were discussed. Only items with unanimous final agreement were retained.

Results

Six experts participated. The final list of key ESG steps included 27 statements: 6 on cognitive skills (100% consensus) and 21 on technical skills (all with high consensus). The latter covered diagnostic endoscopy and presuturing steps (97%), fundamental suturing steps (100%), and suture patterns (97%). Key procedural elements with the highest consensus included starting at the incisura, using at least 6 sutures, and avoiding the fundus.

Conclusions

This expert consensus provides step-by-step guidance for safe and effective performance of ESG.

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Abbreviations : APC, ESG, FITE

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Methods

Phase 1: recruitment of the expert panel

Phase 2: modified Delphi process

Statistical analysis

Results

Discussion

Esportazione

Vol 102 - N° 2

P. 285-289 - agosto 2025 Ritorno al numero

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Establishing standards of practice for endoscopic sleeve gastroplasty: a global expert consensus using a modified Delphi method - 15/07/25

Abstract

Background and Aims

Methods

Results

Conclusions

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