The global trends of endoscopic bariatric treatments and the experience of the first clinical case of endoscopic sleeve gastroplasty in Japan.

Various endoscopic bariatric treatments have been explored as an alternative to bariatric surgeries primarily targeting weight loss by controlling appetite and satiety. A series of novel endoscopic devices have been developed to enable endoscopic treatments to mimic both of restrictive and blocking absorption surgeries and achieve similar clinical outcomes with them. The most of the devices were specifically designed to a single bariatric technique, but multitasking devices such as suturing and stenting devices have been also applied to the endoluminal bariatric treatments. Although gastric balloon placement has been most widely tested in Japan as a temporal restrictive treatment for morbid obese patients, more durable techniques (i.e. endoscopic sleeve gastroplasty (ESG), percutaneous gastrostomy placement to aspirate  gastric contents, EUS-guided gastro-jejunal bypass technique, duodenal-jejunal liner placement, and duodenal mucosa resurfacing technique) expecting long-lasting weight reduction as well as metabolic therapeutic effects are available in Western countries. The topics of the presentation are to provide the summary of currently available clinical evidences for the endoscopic bariatric treatments and also report our experience of the first case of ESG in Japan using an endoscopic suturing device ( OverStitch Sx^TM, Apollo Endosurgery, Austin, TX, USA).