C0627 - Global Adoption of Bariatric Endoscopic Procedures and Practice Patterns in Performing Endoscopic Sleeve Gastroplasty

Ramzi Mulki, MD¹, Kirtan Chauhan, MD², Ahmad Bazarbashi, MD³, Diogo De Moura, MD, MSC, PhD⁴, Janese Laster, MD⁵, Vivek Kumbhari, MD, PhD⁶, Majidah Bukhari, MD⁷, Marvin Ryou, MD⁸, Christopher Thompson, MD, MSc, FACG⁸, Violeta Popov, MD, PhD, FACG^9
1University of Alabama at Birmingham, Birmingham, AL; ²Baylor College of Medicine, Houston, TX; ³Washington University School of Medicine, St. Louis, MO; ⁴The Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Sao Paulo, Brazil; ⁵Gut Theory Total Digestive Care, Washington, DC; ⁶Mayo Clinic Florida, Jacksonville, FL; ⁷American Hospital Dubai, Dubai, Dubai, United Arab Emirates; ⁸Brigham and Women's Hospital, Boston, MA; ⁹NYU Langone Health, New York, NY

Introduction: Bariatric endoscopic (BE) procedures are an important bridge to address the unmet need of curbing the obesity epidemic. Endoscopic sleeve gastroplasty (ESG) has gained popularity over the past few years as studies have shown promising results. However, there are no practice guidelines or consensus on its implementation in practice. We aimed to perform a survey to inquire about ESG practice patterns across the globe.

Methods: A survey evaluating ESG practice patterns was distributed online via a digital platform to BE practitioners, participants in virtual international seminars in BE and in-person to participants of the annual Association for Bariatric Endoscopy and Flexible Endoscopic Surgery meetings. The survey consisted of three parts. 1- physician demographics (practicing specialty, type and location of practice), 2- types of bariatric procedures offered 3- practice patterns of each procedure offered. The main comparisons were among geographic areas (Western, Middle East and Asia, South America), private vs. academic, and surgical vs. gastroenterology practice, using Pearson chi-square test, with p< 0.05 considered significant.

Results: In total, 110 participants responded to our survey: 37% from South America, 35.4% from the Middle East and Asia, and 30% from the US and Europe (Western). From the total cohort, 79 (73.8%) were gastroenterologists, 25 (23.3%) were surgeons, and 3 (2.6%) participants were obesity medicine specialists. The majority were practicing in academic centers (62.8%) and performing procedures in ambulatory surgical center (ASC) settings (50%) with a median multidisciplinary team size of 4 providers (table 1). The use of perioperative antibiotics was significantly higher in those practicing in South America when compared to those in the Middle East/Asia (84.6% vs 40%; 0.022). There was a trend for a shorter duration of post-operative liquid diet in private compared to academic practices (p=0.05). Otherwise, there was no difference in number of ESG procedures performed, type of sedation, setting (ASC vs hospital), and adverse events among the different groups (Figure 1a,b,c).

Discussion: Across the globe, most ESG procedures are currently performed by gastroenterologists in academic centers. Practice patterns of ESG are consistent across the globe in regard to use of general anesthesia, peri-procedural antibiotics and post-operative liquid diet, with some variations across regions and practices. Larger studies are needed to inform best practice recommendations.




Disclosures:


Ramzi Mulki, MD¹, Kirtan Chauhan, MD², Ahmad Bazarbashi, MD³, Diogo De Moura, MD, MSC, PhD⁴, Janese Laster, MD⁵, Vivek Kumbhari, MD, PhD⁶, Majidah Bukhari, MD⁷, Marvin Ryou, MD⁸, Christopher Thompson, MD, MSc, FACG⁸, Violeta Popov, MD, PhD, FACG⁹. C0627 - Global Adoption of Bariatric Endoscopic Procedures and Practice Patterns in Performing Endoscopic Sleeve Gastroplasty, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.