Step-by-step approach to endoscopic gastroplasty by a novel single-channel endoscopic suturing system

摘要

Endoscopic gastroplasty (EG) reduces gastric volume by use of a series of full-thickness internal plications and mimics the surgical sleeve gastrectomy.' EG with use of the Overstitch device (Apollo Endosurgery, Austin, Tex, USA) is shown to be safe and effective in achieving weight loss.** However, the device has certain limitations: (1) it requires a dual-channel endoscope, which is not widely available; (2) the endoscope is stiff and less maneu- verable; (3) the field of vision gets impaired when the de- vice is mounted; and (4) the suction ability decreases with the accessories in the working channel. Recently, a novel single-channel endoscopic suturing device was designed to overcome these limitations and ease the performance of full-thickness suturing. We describe the technique of EG with the novel single-channel suturing system, and we provide tips for successful gastroplasty (Video 1, available online at www.VideoGIE.org).