Frequently Asked Questions – Sutures

  1. How often do the sutures break? 

Suture breakage is a rare occurrence following ESG as the sutures are designed to remain intact long term. However, breakage may happen due to episodes of vomiting after the procedure, or from stress on the suture from eating larger portions of food at one sitting. It is unclear how often this occurs, as routine examinations after the ESG procedure not typically performed. It is also unclear what the overall impact of one or two sutures breaking has on long term weight loss outcomes.

  1. Does suture breakage usually happen soon after the procedure or down the line when people start eating bigger portions?

While rare, suture breakage may occur after the ESG procedure. It is not clear what the most common timeframe is, though it is most likely to occur later in the post-procedure period. Sutures may also ‘pull-through’ the tissue from normal movement of the stomach resulting in the loss of the stitch. This also tends to occur later in recovery phase.

  1. What’s the way to verify if a stitch breaks?

Sometimes an X-ray study can show if the sleeve has loosened. But the most reliable  way to evaluate the sutures is a repeat endoscopy to visualize the sleeve directly.

  1. Is this verification a standard part of follow up on the procedure?

Evaluation for suture breakage is not a standard part of the follow up process.  If, however, there is a reason to be concerned about suture breakage, a diagnostic upper G.I endoscopy will allow us to determine exactly what is or has occurred.  Contact us should you have concerns about suture breakage or anything else, following your procedure.

  1. If a stitch gets undone, what are the signs? (How would I know?) How quickly can a revision be done?

If there is loosening of the sleeve or suture breakage, you may experience a loss of the restriction sensation you had felt following the ESG procedure. This may also lead to weight gain. Importantly, hunger signaling is complex and changes in your hunger most likely do not indicate a problem with your anatomy.

Revisions can be performed at any time, though it is preferable to avoid repeating an endoscopy less than one month after the first procedure to allow the tissues to heal properly.

  1. Is there anything I can do to better my chances to avoid stitches getting undone?

This is a common concern/question. Really the only thing you need to focus on is eating mindfully. This means chewing your food thoroughly, eating slowly, and remaining sensitive to your feelings of ‘fullness’. Otherwise there isn’t much you can do to make things better or worse.