Citations 3
Gastric fundal mucosal ablation followed by endoscopic sleeve gastroplasty in adults with obesity: a first-in-human two-phase pilot clinical trial
Gadi, Sanjay, Maselli, Daniel B. , Donnangelo, Lauren L., Wooley, Chase, Comer, Taylor, Casey, Shannon, Jain, Ankit , Jain, Aditya, Chapman, Christopher G., Bakheet, Nader , Badurdeen, Dilhana, Kumbhari, Vivek , McGowan, Christopher , Gadi, Sanjay R V , Wooley, Chase
Endoscopy | February 28, 2026 | Volume: No volume available | Issue: No issue available | Pages: No page available
Abstract Endoscopic sleeve gastroplasty (ESG) facilitates 13.6%–16.2% total body weight loss (TBWL) at 12 months, but falls short of that seen with surgical vertical sleeve gastrectomy, in part owing to the retention of the gastric fundus. In adults with obesity, gastric fundal mucosal ablation (GFMA) reduces fasting plasma ghrelin (FPG), hunger, cravings, and accommodation. Combined GFMA-ESG could improve TBWL. This study aimed to evaluate the effectiveness and safety of sequential GFMA followed by ESG in adults with obesity, building on previously published 6-month results of GFMA alone. This was a prospective, first-in-human, two-phase clinical trial. Ten participants underwent GFMA, followed by ESG at month 6, and were followed for 12 months post-ESG (18 months total). GFMA was performed using hybrid argon plasma coagulation to lift and ablate the entire gastric fundal mucosa. ESG was performed using standard full-thickness endoscopic suturing of the gastric body. The primary end point was TBWL; secondary end points were safety and changes in FPG, maximum tolerated volume (MTV), and validated appetite questionnaires. Mean TBWL was 22.5% (SD 8.3%) at month 18. Hunger-related behaviors and eating self-efficacy showed sustained improvements. FPG was decreased at month 6 and returned toward baseline by month 18, while MTV remained suppressed. No serious adverse events occurred. Sequential GFMA-ESG is safe and induces substantial weight loss, reduced MTV of ingested nutrients, and improved behavioral measures. This combination approach builds on prior traditional ESG and GFMA-only results and may represent a promising advancement of endoscopic therapeutic options for weight loss.
Correction: American Society for Gastrointestinal Endoscopy–European Society of Gastrointestinal Endoscopy guideline on primary endoscopic bariatric and metabolic therapies for adults with obesity
Jirapinyo, Pichamol , Hadefi, Alia , Huberty, Vincent, Sullivan, Shelby , Thompson, Christopher C. , Patai, Árpád V. , Pannala, Rahul , Goelder, Stefan, Kushnir, Vladimir , Apovian, Caroline M., Chapman, Christopher G., Davidson, Paul , Kumbhari, Vivek , Esker, Janelle, Hucl, Tomáš , Schulman, Allison R. , Zelber‐Sagi, Shira , Bain, Paul , Huberty, Vincent, Barthet, Marc , Boškoski, Ivo , Donatelli, Gianfranco , Hayee, Bu , Pryor, Aurora Dawn , Maselli, Roberta , Pattou, François , Durieux, Valérie , Τriantafyllou, Κonstantinos , Thosani, Nirav C
Endoscopy | July 28, 2025 | Volume: 57 | Issue: 09 | Pages: C12-C12
American Society for Gastrointestinal Endoscopy–European Society of Gastrointestinal Endoscopy guideline on primary endoscopic bariatric and metabolic therapies for adults with obesity
Jirapinyo, Pichamol , Hadefi, Alia , Sullivan, Shelby , Thompson, Christopher C. , Patai, Árpád V. , Pannala, Rahul , Goelder, Stefan, Kushnir, Vladimir , Apovian, Caroline M., Chapman, Christopher G., Davidson, Paul , Kumbhari, Vivek , Esker, Janelle, Hucl, Tomáš , Schulman, Allison R. , Zelber‐Sagi, Shira , Bain, Paul , Huberty, Vincent , Barthet, Marc , Boškoski, Ivo , Donatelli, Gianfranco , Hayee, Bu , Pryor, Aurora Dawn , Maselli, Roberta , Pattou, François , Durieux, Valérie , Τriantafyllou, Κonstantinos , Thosani, Nirav C
Endoscopy | April 19, 2024 | Volume: 56 | Issue: 06 | Pages: 437-456
AbstractThis joint ASGE-ESGE guideline provides an evidence-based summary and recommendations regarding the role of endoscopic bariatric and metabolic therapies (EBMTs) in the management of obesity. The document was developed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework. It evaluates the efficacy and safety of EBMT devices and procedures that currently have CE mark or FDA-clearance/approval, or that had been approved within five years of document development. The guideline suggests the use of EBMTs plus lifestyle modification in patients with a BMI of ≥30 kg/m2, or with a BMI of 27.0–29.9 kg/m2 with at least 1 obesity-related comorbidity. Furthermore, it suggests the utilization of intragastric balloons and devices for endoscopic gastric remodeling (EGR) in conjunction with lifestyle modification for this patient population.