Endoscopic band ligation, a novel technique for obesity management. Obesity is a global health challenge with limited affordable treatment options. Current therapies are often expensive, require extensive training, or involve costly equipment. Endoscopic band ligation has been safely used in the stomach for over 20 years to treat gait. This study evaluates band ligation as a safe, affordable, and effective alternative for weight loss. Our case is a 47-year-old female with a BMI of 55. She failed multiple attempts at weight loss with diet and exercise. She refused surgical and drug therapies due to safety concerns and costs, and she decided to do band ligation. 15 bands placed in the gastric antrum in a random pattern as seen in the picture. The procedure took 12 minutes with no immediate complications. The patient was discharged in 2 hours, and she complained of my nausea and pain managed pharmacologically in the first 2 days only. Endoscopy was done in the endoscopy suite using propofol for deep sedation and oxygen for air insufflation. We started the band ligation in the gastric antrum. We placed 15 bands in a random pattern. Endoscopy and the procedure were very easy and required minimal training. After 12 minutes, we placed 15 bands as seen in the video. Full up endoscopy after 2 weeks revealed multiple scars of healing ulcers in the antrum. Full up endoscopy after 3 months revealed normal looking mucosa with marginal narrowing of the lumen. Our patient lost 30 kg at 3 months representing 21% total weight loss. Her weight dropped 110 kg, her BMI dropped 43. She experienced early satiety and prolonged satiation. Her GCSI score increased from 0 to 1. Endoscopic band ligation is safe, effective and repeatable. Short learning curve, minimal complications, affordable. Promising results warrant large-scale studies for optimization and long-term efficacy.

Endoscopic band ligation

Obesity management

Weight loss

Gastric antrum

Satiety