NICE approves endoscopic sleeve gastroplasty for weight loss management

The UK’s National Institute for Health and Care Excellence (NICE) has approved the use of endoscopic sleeve gastroplasty (ESG) for weight loss management. NICE guidance that ESG is safe in the short and long term when combined with lifestyle changes and could help with weight loss in people, who have not lost weight with lifestyle modifications alone, and who are not suitable or do not wish to undergo bariatric surgery.

Figure 1: Currently ESG is available in seven NHS hospitals including London, Berkshire, the Midlands, and County Durham

“The NICE guidance is fantastic news for patients by giving them another treatment option,” said Dr Jamie Kelly, Upper Gastro-Intestinal lead surgeon at University Hospital Southampton. “Increasing patient access to treatment requires making them aware of this option and training more surgeons and physicians to perform the procedure.”

NICE reviewed the evidence on the safety and efficacy of ESG, which includes Boston Scientific’s Apollo OverStitch Endoscopic Suturing System. Patients selected by a multidisciplinary team can be offered this procedure in specialist centres by a clinician, who has received specific training.

The procedure, conducted under general anaesthetic, takes around 90 minutes to complete and involves a flexible endoscope with a suturing device being passed through the patient’s mouth into the stomach. Parts of the stomach wall are stitched together and folded in on themselves to create a sleeve, reducing the volume of the stomach by 70-80%. This reduces the amount of food that can be eaten at one time. The procedure may also delay gastric emptying and increase the feeling of satiety to facilitate weight loss.

“Women in the UK experience higher obesity rates than men. Data also shows this is the case in some ethnic minority groups8, both of which lead to health inequalities as obesity is a serious chronic disease,” said Astrid Monteau, vice president EMEA of endoscopy at Boston Scientific. “The publication of NICE’s guidance offers a pathway to reduce pressure on the healthcare system as patients have shorter recovery times and because this procedure can be performed as a day case.”