---

Authors: Jaro Van Zande , Klaas Van Den Heede , Yves Van Molhem , Sam Van Slycke

---

Abstract

Background: Alternative and less invasive methods for laparoscopic sleeve gastrectomy include endoscopic sleeve gastroplasty (ESG), where the stomach is transformed into a narrow tube by using an endoscopic suturing device. Despite satisfying weight loss results, severe adverse events, including gastric perforation, have occurred. Case Presentation: This case report describes a 38-year-old woman with acute abdominal pain four days after ESG. An emergency laparoscopic exploration revealed a stomach perforation fixed to the anterior abdominal wall by a suture anchor of the gastroplasty. Conclusion: A full-thickness perforation harming neighboring organs and structures is a possible complication after ESG. Therefore, this procedure should only be performed if morbidity can be monitored during the procedure to avoid situations where dangerous complications remain unrecognized for too long.

---

Keywords: gastroplasty – morbidity – endoscopy, gastrointestinal – bariatric surgery – case report, green

---