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What does it consist in?
The Endoscopic Sleeve Gastroplasty (Endosleeve, Overstitch System by Apollo®), from now on Endosleeve Gastroplasty, is a new endoscopic technique with a greater restrictive capacity than other endoscopic techniques. The Endosleeve Gastroplasty performs a suture through the whole greater curvature of the stomach (from antrum to fundus) via endoscopy, causing an effect that’s similar to a surgical tubular gastrectomy.
The Endosleeve Gastroplasty is a new therapeutic tool for the treatment of obesity which, just like the rest of the treatments (gastric balloon and bariatric surgery), needs to associate a multidisciplinary medical treatment and follow-up for a change of the eating habits and lifestyle.
This technique is a good alternative to the gastric balloon while treating patients who want a more definitive solution, as well as patients who do not have an indication for a bariatric surgery (IMC 30-40) or simply refuse to undergo surgery.
Stages of the Vertical Endoscopic Gastroplasty
Initial assessment and start of the program
A patient going to Clínica IMEBA® has the opportunity to do a free first medical consultation, during which he will get a medical assessment, followed by personalised advice to perform the best treatment or the most convenient preventive program for this case.
Once the doctor recommends the performance of the multidisciplinary treatment program with Endosleeve Gastroplasty, the patient undergoes a multidisciplinary evaluation from a medical, nutritional, psychological, anaesthetic and digestive point of view in order to rate the suitability of the treatment.
A complete medical history is performed, as well as other complementary studies that are necessary (analytics – metabolic profile, renal and hepatic profile, lipid profile, coagulation profile, blood count, etc.) to perform the procedure with maximum security. The basal metabolism, the body-mass-index and the recommended values for fat, muscle mass and water. Based on the obtained results, a custom diet will be worked out to start the follow-up program.
Performance of the Endosleeve Gastroplasty technique
Once the doctor visits and the medical control tests are done, and the indication for the treatment with Endosleeve Gastroplasty is verified, the treatment is scheduled for its performance at Clínica IMEBA® or a concerted hospital.
The technique will be performed by the endoscopic surgeon accredited by Clínica IMEBA® following the protocols that were agreed on by the medical team. The technique will be performed by the endoscopic surgeon accredited by Clínica IMEBA®, following the protocols that were agreed on by the medical team.
When the patient gets to the operating room used for the endoscopy, he is administered an intravenous serum and monitored (electrocardiogram, oxygen saturation, breathing rate, blood pressure, etc.). After this, the patient it administered anaesthesia before the start of the procedure.
On the day of the treatment, once the anaesthesia reaches its full effect and before the start of the Endosleeve Gastroplasty, the endoscopic surgeon performs a control diagnostic endoscopy to make sure there are no organic or functional diseases in the area of the esophagus and the stomach that contraindicate the performance of the technique in that moment.
Once the diagnostic endoscopy is performed, the next step is the Endosleeve Gastroplasty. A double-lighted endoscope is introduced through the mouth, protected by the introductory device, which remains in the mouth. The suture is prepared through a guide and the the helix is introduced through the other channel to initiate the retraction of the stomach wall with said device on the suture point and to move the needle with the suture in a transmural way. The suture begins from antrum to fundus (from distal to proximal).
Once the needle passed 4 or 5 times approximately through each suture on the level of the greater curvature of the stomach, the helix is pulled out and the cinch is prepared to close the suture, this is done after the manual retraction of the suture by the endoscopic surgeon. The next sutures are performed proximally until reaching the fundus (a small reservoir is left on purpose). The usual number of stitches varies depending on the particular anatomy of each patient, the average being 6 per patient.
The Endosleeve Gastroplasty is performed using general anaesthesia with tracheal intubation, applied by the team of medical specialists from the anaesthesiology and reanimation unit.
The procedure usually takes 45-60 minutes. The patient will go through reanimation for about an hour, afterwards he will be moved to his room, where he will stay until he is released. The patient is normally released within a few hours after the procedure.
With this technique, the postoperative discomfort is drastically reduced, resulting in less pain, as well as less risks and complications with regards to the bariatric surgery.
The majority of the patients return to their normal activity 1 or 2 days after the treatment was performed.
The most common initial discomforts are throat pain and unspecific pain in the stomach area, although these will usually disappear within 24-48 hours. There’s also a chance of nausea or vomits showing up.
During the first 12 hours after the treatment, the patient shall not drive vehicles of any type or operate any kind of machinery. Also, a person of trust should go with the patient to take care of him during that period of time.
Continuation of the multidisciplinary follow-up program
The Endosleeve Gastroplasty is an efficient and supportive procedure that helps the diet and the multidisciplinary program that modifies the eating habits. A key factor for the success of the treatment is the compliance with the multidisciplinary follow-up program, which leads to a modification of both eating habits and lifestyle.
Once the procedure is done, the patient will follow a strict follow-up program in order to achieve the desired weight loss, this happens with the helping effects of the technique, as well as the eating habit and lifestyle changes. The aforementioned effects are amplified by our team of doctors and psychologists.
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