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Endoscopy news
Robotic endoscopic sleeve gastroplasty
  1. Vincenzo Bove1,2,
  2. Maria Valeria Matteo1,2,
  3. Valerio Pontecorvi1,2,
  4. Martina De Siena1,2,
  5. Guido Costamagna1,2,
  6. Ivo Boskoski1,2
  1. 1 Digestive Endoscopy Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
  2. 2 Center for Endoscopic Research Therapeutics and training (CERTT), Università Cattolica del Sacro Cuore, Roma, Italy
  1. Correspondence to Dr Ivo Boskoski, Digestive Endoscopy Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma 00168, Italy; ivo.boskoski{at}policlinicogemelli.it

https://doi.org/10.1136/gutjnl-2022-327548

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    WHAT IS ALREADY KNOWN ON THIS TOPIC

    • Obesity is rapidly rising around the globe. Bariatric endoscopy is evolving fast and is more and more requested by patients and physicians, mostly due to its efficacy and safety. Currently, there are several suturing devices for bariatric endoscopy but these suturing devices are all manual, and procedures are operator and highly skill-dependant.

    WHAT THIS STUDY ADDS

    • The new robotic device for bariatric endoscopy democratises gastric suturing. All sutures are the same and replicable, the procedure is minimal-operator dependent, is fast and basic endoscopy skills are required to accomplish it.

    HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY

    • This new robotic device will standardise the procedure for all patients and will flatten the learning curve. The device has the potential to directly improve weight loss. The robotic endoscopic sleeve gastroplasty has the potential to directly impact the research in all fields of obesity and metabolic diseases.

    Message

    Obesity is a pandemic with significant impact on the healthcare systems; endoscopic bariatric treatments may fill the therapeutic gap between medical and surgical approaches. As part of the rapid technological development in endoscopy, a novel robotic and completely automated suturing system has been developed (EndoZip) and is currently under investigation in a multicentric clinical trial. By using vacuum wall aspiration, strong and standardised full-thickness sutures with much less operator dependence may become possible. We present here in the technology and the technical and morphologic results of the first cases with initial body mass index (BMI) between 30 and 40 kg/m2. Follow-up showed reduced gastric volume maintained at 6 months.

    In more detail

    Obesity is a global pandemic that affects over 650 million adults (13% of the world population).1 Along with the rising prevalence of obesity, the frequency of obesity-related comorbidities such as type 2 diabetes mellitus, arterial hypertension, coronary heart disease, non-alcoholic fatty liver disease is steadily growing with a significant impact on the economy of healthcare system. …

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    Footnotes

    • Twitter @ivoboskoski

    • Contributors VB: conceptualisation, data curation, formal analysis, investigation, resources, validation, writing—original draft; MVM: conceptualisation, data curation, formal analysis, methodology, software, visualisation, writing—original draft, review and editing; VP: conceptualisation, investigation, supervision, writing—original draft; MDS: data curation; investigation; project administration; validation; visualisation; writing—review and editing; GC: conceptualisation; data curation; investigation; supervision; validation; writing—review and editing; IB: guarantor, conceptualisation; data curation; formal analysis; methodology; supervision; validation; visualisation; writing—original draft, review and editing.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests GC: Consultant for food and beverage compensation from Cook Medical, Boston Scientific, and Olympus. IB: Consultant for Apollo Endosurgery, Cook Medical, Boston Scientific and Nitinotes; board member for Endo Tools; research grant recipient from Apollo Endosurgery; food and beverage compensation from Apollo Endosurgery, Cook Medical, Boston Scientific, and Endo Tools. All the other authors have nothing to declare.

    • Provenance and peer review Not commissioned; internally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.