Laparoscopic sleeve gastrectomy after endoscopic sleeve gastroplasty: Feasible or dangerous revisional surgery?

Endoscopic sleeve gastroplasty (ESG) uses endoscopic sutures to decrease the volume of the stomach. There is no evidence about whether ESG sutures and anchors increase the risk of staple line leakage in revisional laparoscopic sleeve gastrectomy (LSG). In this video, we demonstrate the performance of LSG after a previous ESG due to weight regained (BMI 31) and associated metabolic syndrome. The risks of leakage were minimized, eliminating the anchors present in the path of the stapler and reinforcing them with a manual suture. The patient was discharged the next day without complications.