2
Bariatric Devices and
Nonsurgical Procedures
Key Points
1. Bariatric devices and nonsurgical procedures are often
considered by patients seeking a less invasive and organ-sparing
option for bariatric treatment.
2. Devices are used as a temporary measure to assist with weight loss
before subsequent operations, such as joint repair or hernia repair.
3. Some patients may seek out these procedures for cosmetic
reasons, such as losing weight before a wedding or a significant
life event.
4. Bariatric devices necessitate comparable preoperative and
postoperative evaluation and monitoring as standard bariatric
surgery procedures.
5. Access can be limited due to factors such as surgeon expertise,
institutional barriers, the volume of procedures, insurance
coverage, and socioeconomic factors that affect access to care.
6. These devices are authorized for use exclusively in adults; they
are not approved for use in children.
Procedures and Devices Currently Available
Endoscopic Sleeve Gastroplasty (ESG), or the OverStitch
Device
➤ Procedure: Endoscopic suturing of the stomach, creating a full-
thickness plication of gastric tissue using permanent or absorbable
sutures (see Endoscopic Sleeve Gastroplasty Procedure figure).
➤ Effect: Shortens the length of the stomach.
➤ Indication: Body mass index (BMI) 30–50 kg/m
2
.
➤ Efficacy: 13% to 18% total body weight loss (TBWL) at one year and
12% to 16% at 5 years.
➤ Comorbidities: Improvement of at least one weight-related chronic
disease in 80% of individuals.
➤ Safety: Risks include stitch failure, upper gastrointestinal bleeding,
perigastric leak/infection, perforation, nausea, vomiting, abdominal
pain, and heartburn. Major adverse events have an incidence of 2.2%.
➤ Mortality: No deaths observed in published ESG literature.
