Response to Letter to the Editor Re: “EUS-Guided Intragastric Injection of Botulinum Toxin A in the Preoperative Treatment of Super-Obese Patients: a Randomized Clinical Trial”

  • Igor Braga RibeiroEmail author
  • Diogo Turiani Hourneaux de Moura
  • Eduardo Guimarães Hourneaux de Moura
Letter to Editor/LED Reply

Thank you for your interest in our randomized controlled trial of EUS-guided intragastric injection of botulinum toxin A (BTX-A) in super obese patients [1]. We agree that injection of botulinum toxin A is a very controversial topic and we are happy to answer your questions.

First, Regarding a BTX-A Injection

On page three of the article in the left column, we briefly described that 40 units of BTX-A were injected in five different regions with a total of 200 BTX-A units injected per patient. Then, in the right column, we describe the injections in further detail. First, 12 microinjections containing 10 units of BTX-A were performed at respective points: four microinjections at 3 cm from the pyloric sphincter (region 1), repeated twice in the direction of gastric cardia (region 2 and 3), at 2 cm intervals, followed by four injections performed around the gastric cardia (region 4), and four injections in the region of the greater curvature (region 5).

To clarify, we divided the...


Author Contributions

IBR, DTHdM, and EGHdM wrote the response letter and approved the final draft of this manuscript.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Gastrointestinal Endoscopy Unit, Hospital das Clínicas, School of MedicineUniversity of Sao PauloSão PauloBrazil
  2. 2.Instituto CentralSão PauloBrazil

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