To the best of our knowledge, this is the first study to use endoscopic band ligation
for weight loss in a 30-year-old woman, who had an initial weight of 85 kg (height
155 cm; body mass index [BMI] 35.4 kg/m2). Endoscopy was performed with the patient sedated using propofol. All ligatures
were applied in the gastric body, starting at the distal body; five parallel rows
were created, with the last one in the proximal body, using 33 bands ([Fig. 1]). The entire procedure was completed in 30 minutes. Oxygen was used for endoscopic
air insufflation. Notably, no immediate complications occurred during endoscopy ([Video 1]).
Fig. 1 Endoscopic view showing the band ligation cap.
Video 1 Endoscopic band ligation for weight loss, with 33 bands applied in five parallel
rows throughout the gastric body, producing well-healed linear scars on follow-up
1 month later.
The patient did well after the procedure and was discharged after 2 hours. In the
first 3 days, she complained of mild nausea, vomiting, and epigastric pain, which
were controlled by medications (pantoprazole 40 mg twice daily for the first month,
plus antiemetics and antispasmodics on demand). For 2 weeks, she was given a fully
liquid diet, followed by an 800-calorie soft diet for another 2 weeks. The patient
reported early satiety following the procedure. Follow-up endoscopy after 1 month
revealed nice linear scars of healed ulcers in the gastric body ([Fig. 2]), causing marginal narrowing of the lumen. In addition, the patient’s weight had
decreased from 85 to 79 kg and her BMI from 35.4 to 32.9 kg/m2, corresponding to a 7 % total weight loss and a 24 % excess weight loss after 1 month.
Fig. 2 Endoscopic views 1 month after the procedure showing nice linear scars of healed
post-band ulcers in the body a on forward view; b on retroversion.
Endoscopic band ligation for weight loss is a novel technique that could assist in
obesity management. The technique appears safe, repeatable, and cost-effective, with
a short learning curve. Nevertheless, further large-scale studies are warranted using
more bands, longer caps, and prolonged follow-up to assess the efficacy and safety
of the technique as a primary and secondary endoscopic weight loss procedure [1]
[2].
Endoscopy_UCTN_Code_TTT_1AO_2AN
Endoscopy E-Videos is a free access online section, reporting on interesting cases and new techniques
in gastroenterological endoscopy. All papers include a high
quality video and all contributions are
freely accessible online.
This section has its own submission
website at
https://mc.manuscriptcentral.com/e-videos
