Endoscopic Sleeve Gastroplasty

With the modern lifestyle and changes in eating habits, societies are rapidly gaining weight. In countries like Turkey, about one-third of the population is now classified as obese. Due to this weight increase, societies are not only witnessing a rise in diabetes, hypertension, and vascular diseases, but also a significant decline in quality of life. The question "how to lose weight or maintain weight?" is becoming a major concern for many.

Weight Loss Methods

The primary solution is lifestyle change, while other methods focus on inducing weight loss. Established weight loss methods include:

• Dietary changes, targeting approximately 5% weight loss.
• Medications, targeting 7-10% weight loss.
• Endoscopic methods, with variable weight loss targets depending on the method.
• Surgeries, aiming for 35-45% weight loss.

Endoscopic Sleeve Gastroplasty

Studies have shown the short-term safety and efficacy of endoscopic sleeve gastroplasty. Compared to other weight loss methods, evidence suggests satisfactory efficacy in weight reduction. However, due to limited applications and short follow-up durations, uncertainties remain regarding long-term weight loss, post-procedure weight gain, changes in gut hormones, and the effects of race or ethnicity on the procedure. More clinical studies are needed.

What is Endoscopic Sleeve Gastroplasty?

Using an endoscope, without any incision on the abdomen, stitches are placed inside the stomach. By placing these internal stitches, the stomach's capacity is reduced, and significant weight loss is achieved. To achieve long-term success with endoscopic sleeve gastroplasty, it's essential to maintain a healthy lifestyle, incorporating permanent dietary changes and consistent exercise.

Why Choose Sleeve Gastroplasty?

Endoscopic sleeve gastroplasty primarily assists in weight loss. It's also performed to potentially reduce health issues believed to be related to weight, including:

• Type 2 diabetes
• Heart diseases and stroke
• High blood pressure
• Non-alcoholic fatty liver disease (NASH)
• Sleep apnea
• Gastroesophageal reflux disease (GERD)
• Osteoarthritis (joint pain).

Who is Eligible?

It's suitable for individuals with a BMI of 30-35, who haven't been successful in maintaining weight loss through lifestyle changes or who have gained weight after traditional bariatric surgery. Commitment to a healthy lifestyle, regular medical check-ups, and willingness to receive psychological support are crucial.

Can it be Applied to Those Who Have Previously Undergone Obesity Surgery But Have Gained Weight Again?

For patients who have undergone surgical methods but haven't lost enough weight or have regained weight, endoscopic methods should be the primary choice. However, endoscopic sleeve gastroplasty isn't applicable to all revision cases. Although not designed as a temporary procedure, it can be later converted to bariatric surgery.

Is it a Risky Procedure?

So far, no adverse effects associated with endoscopic sleeve gastroplasty have been reported. Most people feel better within days.

Who Isn't Eligible?

It isn't suitable for those with a large hiatal hernia, gastritis, or peptic ulcer disease linked to gastrointestinal bleeding. Morbidly obese patients with very high BMI values, like 40-45, should consider individual surgical techniques.

Preparation for the Procedure

Before the procedure, an initial consultation provides information about the process. Full recovery occurs within a few days post endoscopic sleeve gastroplasty.

How Does the Post-Procedure Period Progress?

After the procedure, a hospital stay might be required, but this is rare. Early and frequent meals with limited amounts are recommended. Consuming liquids and foods together is not recommended.

Conclusion

Endoscopic sleeve gastroplasty offers a middle ground between lifestyle changes and invasive surgical interventions. It's important to remember, as with all weight loss methods, long-term success hinges on commitment to a healthy lifestyle. It's not a magic solution, but a tool aiding weight loss.