Evidence mapPaperPMID 41251895Full record

SynthesisObesity surgery2025

Shaping the Future of Restrictive Bariatric Surgery: Clinical, Economic, and Long-Term Perspectives on Endoscopic and Laparoscopic Sleeve.

Swapnil Tripathi, Avinash Kumar Ray, Yashashwi Sinha, Alastair Reid, Saleem Noormohamed

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Obesity surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Swapnil TripathiGeneral and UGI Surgery, Worcestershire Acute Hospitals NHS Trust, Worcester, WR5 1DD, UK. swapnil.tripathi@nhs.net.
Avinash Kumar RayArmed Forces Medical College, Pune, 411040, India.
Yashashwi SinhaGeneral and UGI Surgery, Worcestershire Acute Hospitals NHS Trust, Worcester, WR5 1DD, UK.
Alastair ReidGeneral and UGI Surgery, Worcestershire Acute Hospitals NHS Trust, Worcester, WR5 1DD, UK.
Saleem NoormohamedGeneral and UGI Surgery, Worcestershire Acute Hospitals NHS Trust, Worcester, WR5 1DD, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRestrictive bariatric procedures such as Laparoscopic Sleeve Gastrectomy (LSG) and Endoscopic Sleeve Gastroplasty (ESG) are increasingly utilised to address obesity and its comorbidities. LSG is a well-established and widely adopted bariatric procedure, whereas ESG, supported by recent technological advancements, is increasingly being utilised as a treatment option for obesity. Comparative evaluation of their outcomes is essential to guide clinical decision-making.

objectiveTo systematically review and synthesise evidence from randomised controlled trials (RCTs), meta-analyses, and registry data comparing ESG and LSG in terms of weight loss efficacy, safety, recovery time, economic impact, and impact on obesity-related comorbidities.

methodsA systematic search was conducted across PubMed, Embase, Scopus, and Cochrane Library for studies published between January 2020 and July 2025. Inclusion criteria were RCTs, meta-analyses, and registry-based studies reporting comparative outcomes for ESG and LSG. Data extraction focused on total body weight loss (TBWL), excess weight loss (EWL), complication rates, recovery time, economic implications, and hormonal/metabolic changes. Risk of bias was assessed using the Cochrane RoB 2 and ROBINS-I tools.Certainty of evidence was graded using the GRADE methodology.

resultsFrom 340 records, 24 studies were included (ESG n ≈ 3,800; LSG n ≈ 7,200); 18 contributed to pooled analyses.LSG demonstrated superior long-term EWL (60-70%) and TBWL (25-30%) at 2-5 years Beran et al. (Obes Surg. 32(9):3504-3512 2022); Joseph et al. (SurgEndosc. 38(9):5914-5921 2024); Marincola et al. (EndoscInt Open. 9(1):E87-E95 2021). ESG showed moderate efficacy with TBWL of 13-16% and EWL of 35-45% at 12 months, sustained up to 3 years Fehervari et al. (Obes Surg. 33(12):4567-4579, 2023); NICE (2024). ESG had lower serious adverse event rates (< 2%) and faster recovery (2-3 days) compared to LSG (5-10% adverse events; 2-6 weeks recovery) Beran et al. (Obes Surg. 32(9):3504-3512,2022); Marincola et al. (EndoscInt Open. 9(1):E87-E95, 2021); Salminen et al. (JAMA Surg. 157(8):656-666, 2022). Both procedures improved glycaemic control, hypertension, and NAFLD, with LSG showing greater metabolic remission Joseph et al. (SurgEndosc. 38(9):5914-5921, 2024); Salminen et al. (JAMA Surg. 157(8):656-666, 2022); Mocanu D, et al. (SurgEndosc. 2025). Hormonal analyses revealed distinct patterns: LSG reduced ghrelin and increased PYY and adiponectin; ESG preserved ghrelin levels and improved insulin secretory dynamics NICE (2024); Alhayo & Devadas (J Surg Case Rep.(12):rjz315,2019); López-Nava et al. (Obes Surg. 30(7):2640-2648, 2020).

conclusionESG offers a safe, outpatient alternative to LSG with moderate efficacy, rapid recovery and potential short-term economic benefits. LSG remains superior in long-term weight loss and metabolic impact. ESG may serve as a complementary option in tiered obesity management. Further head-to-head trials and mechanistic studies are warranted.

Indexed as

Bariatric SurgeryGastrectomyGastroplastyLaparoscopyObesity, MorbidHumansRandomized Controlled Trials as TopicTreatment OutcomeWeight LossBariatric surgeryEndoscopic sleeve gastroplastyLaparoscopic sleeve gastrectomyMetabolic hormonesObesityRecovery timeSystematic review

Identifiers

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.