ENDO THERAPY
Endoscopic Sleeve Gastroplasty (ESG)
Introduction ESG
ESG is a surgical procedure that reduces the volume of the stomach
and suppresses the patient’s appetite, resulting in weight loss
No incision in the abdomen, so there are no scars, and it has the advantage of being able to be restored to its original shape in the future without
permanently cutting out the stomach
ESG Procedure
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step 01
Inspecting target
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The endoscope is inserted through the mouth into stomach
The aim of this procedure is to reduce the volume of the stomach by approx. 70%
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step 02
Marking
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The front and back walls of the stomach are marked to help guide placement of the sutures
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step 03
Suturing of tissue
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The endoscopic suturing system is attached to the endoscope and used to take full thickness suture through the wall of the stomach
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step 04
Continuous suturing
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Performing a running suture pattern that connects the front and back wall of the stomach
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step 05
Suture tightening
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The sutures are tightened, bringing the wall together
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step 06
Small stomach after ESG
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This pattern is repeated along the stomach to not only reduce volume
Clinical Issues of ESG
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Stitching direction
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The direction of stitching must be appropriately selected for each area in order to effectively reduce the stomach
Manipulating the endoscope to perform stitching in the desired direction can be difficult
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The issue of tangled suture
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The endoscope and suture come into contact and become tangled when adjusting the stitching direction during the procedure
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The issue of long learning curve
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Require long training period and operation time
Endorobotics Solution for ESG
Rolling-Stitch is a stitching device with a mechanism where two arms exchange needles
The stitching direction can be switched 180 degrees by exchanging needles
The device can rotate independently around the distal end of the endoscope, allowing the operator to freely control the stitching direction
