Apollo Endosurgery (APEN) 10-Q 8 Aug 18 2018 Q2 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	6 Months Ended
	Jun. 30, 2018	Jul. 31, 2018
Document and Entity Information [Abstract]
Entity Registrant Name	APOLLO ENDOSURGERY, INC.
Entity Central Index Key	1,251,769
Document Type	10-Q
Document Period End Date	Jun. 30, 2018
Amendment Flag	false
Current Fiscal Year End Date	--12-31
Entity Filer Category	Smaller Reporting Company
Entity Common Stock, Shares Outstanding		21,878,896
Document Fiscal Year Focus	2,018
Document Fiscal Period Focus	Q2

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Jun. 30, 2018	Dec. 31, 2017
Current assets:
Cash and cash equivalents	$ 34,377	$ 30,513
Accounts receivable, net of allowance for doubtful accounts of $565 and $452, respectively	11,497	11,729
Inventory, net	14,952	14,343
Prepaid expenses and other current assets	1,295	1,015
Total current assets	62,121	57,600
Restricted cash	1,068	905
Property and equipment, net of accumulated depreciation of $7,636 and $6,658, respectively	6,910	6,885
Goodwill	6,828	6,828
Intangible assets, net of accumulated amortization of $32,088 and $28,415, respectively	33,116	36,421
Other assets	387	422
Total assets	110,430	109,061
Current liabilities:
Accounts payable	14,345	18,327
Accrued expenses	7,325	7,500
Total current liabilities	21,670	25,827
Long-term debt	33,306	33,321
Total liabilities	54,976	59,148
Commitments and contingencies
Stockholders' equity:
Common stock; $0.001 par value; 100,000,000 shares authorized; 21,877,332 and 17,291,209 shares issued and outstanding at June 30, 2018 and December 31, 2017, respectively	22	17
Additional paid-in capital	248,336	225,122
Accumulated other comprehensive income	1,792	1,795
Accumulated deficit	(194,696)	(177,021)
Total stockholders' equity	55,454	49,913
Total liabilities and stockholders' equity	$ 110,430	$ 109,061

Condensed Consolidated Balance3

Condensed Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Jun. 30, 2018	Dec. 31, 2017
Statement of Financial Position [Abstract]
Allowance for doubtful accounts	$ 565	$ 452
Accumulated depreciation	7,636	6,658
Accumulated amortization	$ 32,088	$ 28,415
Common stock, par value (USD per share)	$ 0.001	$ 0.001
Common stock, shares authorized (shares)	100,000,000	100,000,000
Common stock, shares issued (shares)	21,877,332	17,291,209
Common stock, shares outstanding (shares)	21,877,332	17,291,209

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations and Comprehensive Loss - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Income Statement [Abstract]
Revenues	$ 15,788	$ 17,109	$ 31,531	$ 31,626
Cost of sales	6,607	6,636	13,160	11,732
Gross margin	9,181	10,473	18,371	19,894
Operating expenses:
Sales and marketing	8,489	8,580	17,734	16,854
General and administrative	3,249	3,248	6,568	7,435
Research and development	3,154	2,285	5,610	4,242
Amortization of intangible assets	1,802	1,827	3,604	3,641
Total operating expenses	16,694	15,940	33,516	32,172
Loss from operations	(7,513)	(5,467)	(15,145)	(12,278)
Other expenses:
Interest expense, net	1,019	1,046	1,979	2,516
Other expense	981	282	465	168
Net loss before income taxes	(9,513)	(6,795)	(17,589)	(14,962)
Income tax expense	28	63	86	113
Net loss	(9,541)	(6,858)	(17,675)	(15,075)
Other comprehensive income (loss):
Foreign currency translation	383	243	(3)	385
Comprehensive loss	$ (9,158)	$ (6,615)	$ (17,678)	$ (14,690)
Net loss per share, basic and diluted (USD per share)	$ (0.53)	$ (0.64)	$ (1)	$ (1.41)
Shares used in computing net loss per share, basic and diluted (shares)	18,005,759	10,702,627	17,654,777	10,700,431

Condensed Consolidated Stateme5

Condensed Consolidated Statements of Changes in Stockholders’ Equity - 6 months ended Jun. 30, 2018 - USD ($) $ in Thousands	Total	Common Stock [Member]	Additional Paid-in Capital [Member]	Accumulated Other Comprehensive Income [Member]	Accumulated Deficit [Member]
Beginning balance at Dec. 31, 2017	$ 49,913	$ 17	$ 225,122	$ 1,795	$ (177,021)
Beginning balance, shares at Dec. 31, 2017	17,291,209	17,291,209
Exercise of common stock options	$ 687		687
Exercise of common stock options, shares		260,797
Issuance of restricted stock units, shares		16,236
Issuance of common stock, net of issuance cost of $1,843	21,857	$ 5	21,852
Issuance of common stock, net of issuance costs of $1,843, shares		4,309,090
Stock based compensation	675		675
Foreign currency translation	(3)			(3)
Net loss	(17,675)				(17,675)
Ending balance at Jun. 30, 2018	$ 55,454	$ 22	$ 248,336	$ 1,792	$ (194,696)
Ending balance, shares at Jun. 30, 2018	21,877,332	21,877,332

Condensed Consolidated Stateme6

Condensed Consolidated Statements of Changes in Stockholders’ Equity (Parenthetical) $ in Thousands	6 Months Ended
	Jun. 30, 2018USD ($)
Statement of Stockholders' Equity [Abstract]
Issuance costs	$ 1,843

Condensed Consolidated Stateme7

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017
Cash flows from operating activities:
Net loss	$ (17,675)	$ (15,075)
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation and amortization	4,687	4,877
Amortization of deferred financing costs	144	215
Non-cash interest expense	194	392
Provision for doubtful accounts receivable	105	36
Change in inventory reserve	261	169
Stock based compensation	675	327
Foreign currency exchange on short-term intercompany loans	494	(74)
Changes in operating assets and liabilities:
Accounts receivable	(90)	(2,014)
Inventory	(1,010)	653
Prepaid expenses and other assets	(266)	119
Accounts payable and accrued expenses	(3,734)	4,839
Net cash used in operating activities	(16,215)	(5,536)
Cash flows from investing activities:
Purchases of property and equipment	(1,490)	(1,046)
Purchases of intangibles and other assets	(406)	(329)
Net cash used in investing activities	(1,896)	(1,375)
Cash flows from financing activities:
Proceeds from exercise of stock options	687	46
Proceeds from the issuance of common stock	21,857	0
Payments of deferred financing costs	(353)	0
Payment of debt	0	(7,000)
Net cash provided by (used in) financing activities	22,191	(6,954)
Effect of exchange rate changes on cash	(53)	64
Net increase/(decrease) in cash, cash equivalents and restricted cash	4,027	(13,801)
Cash, cash equivalents and restricted cash at beginning of year	31,418	20,041
Cash, cash equivalents and restricted cash at end of period	35,445	6,240
Supplemental disclosure of cash flow information:
Cash paid for interest	1,799	1,966
Cash paid for income taxes	$ 42	$ 37

Organization and Business Descr

Organization and Business Description	6 Months Ended
	Jun. 30, 2018
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Organization and Business Description	Organization and Business Description Apollo Endosurgery, Inc. is a Delaware corporation with both domestic and foreign wholly-owned subsidiaries. Throughout these Notes "Apollo" and the "Company" refer to Apollo Endosurgery, Inc. and its consolidated subsidiaries. Apollo is a medical technology company primarily focused on the design, development, and commercialization of innovative medical devices. The Company's products are used by surgeons and gastroenterologists in a variety of settings to provide interventional therapy to patients who suffer from obesity and the many co-morbidities associated with obesity as well as to treat various other gastrointestinal conditions. The Company's core products include the OverStitch™ Endoscopic Suturing System, our Intragastric Balloon System products (most often branded as Orbera®), which together comprise the Company's Endo-bariatric" products and the Lap-Band® Adjustable Gastric Banding System ("Surgical" products). In the U.S., the Company also offers Orbera® Coach, a digital and remotely delivered aftercare program. The Company has sales distribution offices in England, Australia, Italy and Brazil that oversee regional sales and distribution activities outside the U.S., a manufacturing facility in Costa Rica and a device analysis lab in California. All other activities are managed and operated from facilities in Austin, Texas.

Significant Accounting Policies

Significant Accounting Policies	6 Months Ended
	Jun. 30, 2018
Accounting Policies [Abstract]
Significant Accounting Policies	Significant Accounting Policies (a) Basis of Presentation The Company prepared its interim condensed consolidated financial statements in conformity with accounting principles generally accepted in the United States of America ("GAAP"). They do not include all of the information and footnotes required by GAAP for complete financial statements. The accompanying condensed consolidated financial statements include the Company's accounts and the accounts of its wholly-owned subsidiaries. The Company has eliminated all intercompany balances and transactions. The Company has made estimates and judgments affecting the amounts reported in its condensed consolidated financial statements and the accompanying notes. The actual results that the Company experiences may differ materially from the Company's estimates. The accounting estimates that require the Company's most significant, difficult and subjective judgments include revenue recognition, useful lives of intangible assets and long-lived assets, valuation of inventory, allowance for doubtful accounts, stock compensation, and deferred tax asset valuation. (b) Unaudited Interim Results In management's opinion, the unaudited financial information for the interim periods presented includes all adjustments necessary for a fair presentation of the results of operations, financial position, and cash flows. All adjustments are of a normal recurring nature unless otherwise disclosed. Revenues, expenses, assets and liabilities can vary during each quarter of the year. Therefore, the results and trends in these interim financial statements may not be the same as those for the full year. This interim information should be read in conjunction with the audited consolidated financial statements in our Annual Report on Form 10-K for the year ended December 31, 2017. Certain reclassifications of prior period amounts have been made to conform to the current presentation. (c) Revenue Recognition The Company's principal source of revenue is from the sale of its products. Revenue is recognized when control of the promised goods is transferred to our customers, in an amount that reflects the consideration we expect to be entitled to in an exchange for those goods. Generally, these conditions are met under the Company's agreements with most customers upon product shipment. This includes sales to distributors, who sell the products to their customers, take title to the products and assume all risks of ownership at the time of shipment. Our distributors are obligated to pay within specified terms regardless of when, if ever, they sell the products. Customers and distributors generally have the right to return or exchange products purchased from the Company for up to thirty days from the date of product shipment. At the end of each period, the Company determines the extent to which its revenues need to be reduced to account for expected returns and exchanges. Certain customers may receive volume rebates or discounts, which are accounted for as variable consideration. We estimate these amounts based on the expected amount to be provided to customers and reduce revenues recognized. We record deferred revenues when cash payments are received in advance of the transfer of goods. The Company accounts for taxes collected from customers and remitted to governmental authorities on a net basis. Accordingly, such amounts are excluded from revenues. Amounts billed to customers related to shipping and handling are included in revenues. Shipping and handling costs related to revenue producing activities are included in cost of sales. (d) Recent Accounting Pronouncements On January 1, 2018, the Company adopted the provisions of ASU 2014-09, Revenue from Contracts with Customers ("ASC 606"), which requires an entity to recognize revenue when it transfers control of promised goods or services to customers in an amount that reflects the consideration to which it expects to be entitled in exchange for those goods or services. The Company adopted this new standard using the modified retrospective method and applied this method only to contracts that were not completed as of January 1, 2018. Prior periods were not retrospectively adjusted. There was no material impact on the Company's financial statement upon adoption of the new revenue recognition standard. In February 2016, the FASB issued ASU 2016-02, Leases ("ASU 2016-02") which requires a lessee to recognize assets and liabilities for leases with a maximum possible term of more than 12 months. A lessee would recognize a liability to make lease payments (the lease liability) and a right-of-use asset representing its right to use the leased asset (the underlying asset) for the lease term which will require companies to recognize most leases on the balance sheet, thereby increasing reported assets and liabilities. ASU 2016-02 will be effective for the Company on January 1, 2019. Upon initial evaluation, the Company believes the key change upon adoption will be the balance sheet recognition. The income statement recognition of lease expense appears similar to the Company's current methodology. The Company is continuing to evaluate other potential impacts on the consolidated financial statements. In January 2017, the FASB issued ASU 2017-04, Intangibles - Goodwill and Other: Simplifying the Test for Goodwill Impairment

Concentrations

Concentrations	6 Months Ended
	Jun. 30, 2018
Risks and Uncertainties [Abstract]
Concentrations	ConcentrationsConsolidated financial instruments that potentially subject the Company to a concentration of credit risk principally consist of cash, cash equivalents, restricted cash, and accounts receivable. At June 30, 2018, the Company's cash, cash equivalents and restricted cash are held in deposit accounts at three different banks totaling $35,445. The Company has not experienced any losses in such accounts, and management does not believe the Company is exposed to any significant credit risk. Management further believes that the concentration of credit risk in the Company's accounts receivable is substantially mitigated by the Company's evaluation process, relatively short collection terms, and the high level of creditworthiness of its customers. The Company continually evaluates the status of each of its customers, but generally requires no collateral.

Inventory

Inventory	6 Months Ended
	Jun. 30, 2018
Inventory Disclosure [Abstract]
Inventory	Inventory Inventory consists of the following as of: June 30, 2018 December 31, 2017 (unaudited) Raw materials $ 5,092 $ 4,937 Work in progress 449 493 Finished goods 11,603 10,947 Less inventory reserve (2,192) (2,034) Total inventory, net $ 14,952 $ 14,343 The Company recorded an inventory impairment charge of $159 and $261 for the three and six months ended June 30, 2018, respectively. Finished goods included $364 of consigned inventory at June 30, 2018. In the six months ended June 30, 2018, the Company disposed of $103 of expired product which was fully reserved.

Accrued Expenses

Accrued Expenses	6 Months Ended
	Jun. 30, 2018
Payables and Accruals [Abstract]
Accrued Expenses	Accrued Expenses Accrued expenses consist of the following as of: June 30, 2018 December 31, 2017 (unaudited) Accrued employee compensation and expenses $ 3,650 $ 4,243 Accrued professional service fees 935 522 Accrued returns and rebates 361 438 Accrued insurance and taxes 687 527 Other 1,692 1,770 Total accrued expenses $ 7,325 $ 7,500

Long-Term Debt

Long-Term Debt	6 Months Ended
	Jun. 30, 2018
Debt Disclosure [Abstract]
Long-Term Debt	Long-Term Debt Long-term debt consists of the following as of: June 30, 2018 December 31, 2017 (unaudited) Senior secured credit facility $ 32,000 $ 32,000 Payment-in-kind interest 2,294 2,223 Discount on long-term debt (411) (534) Deferred financing costs (577) (368) Long-term debt $ 33,306 $ 33,321 On February 28, 2018, the Company entered into a Sixth Amendment to the Credit Agreement with its lender, Athyrium Opportunities II Acquisition LP ("Athyrium") which removed the minimum quarterly revenue requirement and increased the maximum debt-to-revenue ratio to 0.54 from 0.49 with the maximum debt-to-revenue ratio declining gradually each quarter over the remaining term of the facility. As of June 30, 2018, the Company was not in compliance with the financial covenants and in July 2018 entered into a Waiver Agreement ("Waiver") with Athyrium that increased the maximum debt-to-revenue ratio for the three months ended June 30, 2018 to 0.56 from 0.53 and waived the existing default under such ratio. As a condition to the effectiveness of the Waiver, the Company prepaid $1,500 of the principal amount outstanding under the Credit Agreement, together with accrued interest and certain fees and expenses.

Stock Based Compensation

Stock Based Compensation	6 Months Ended
	Jun. 30, 2018
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Stock Based Compensation	Stock Based CompensationIn June 2017, the 2017 Equity Incentive Plan (the "2017 Plan") was approved by the Company's stockholders and replaced the Company's 2016 Equity Incentive Plan (the "2016 Plan"), which was the successor to the 2006 Stock Option Plan ("the 2006 Plan")(collectively with the 2016 Plan, the "Prior Plans"). Grants will no longer be made under the Prior Plans, but the awards that remain outstanding will continue to be governed by the terms of the applicable Prior Plan and the applicable award agreement. A summary of the stock option activity under the Company's 2017 Plan and Prior Plans (collectively, the "Equity Plans") as of June 30, 2018 is presented below. Options Weighted Average Exercise Price Weighted Average Remaining Contractual Term Aggregate Intrinsic Value Options outstanding, December 31, 2017 1,390,428 $ 4.64 7.0 years $ 2,432 Options granted 580,901 $ 6.58 Options exercised (260,797) $ 2.63 Options forfeited (50,092) $ 5.10 Options vested and expected to vest, June 30, 2018 1,660,440 $ 5.62 8.3 years $ 2,940 Options exercisable 596,676 $ 4.31 6.7 years $ 1,839 Shares subject to awards granted under the 2017 Plan which expire, are repurchased, or are canceled or forfeited will again become available for issuance under the 2017 Plan. The shares available will not be reduced by awards settled in cash or by shares withheld to satisfy tax withholding obligations. Only the net number of shares issued upon the exercise of options by means of a net exercise will be deducted from the shares available under the 2017 Plan. The fair value of stock option grants has been estimated at the date of grant using the Black-Scholes option pricing model with the following weighted average assumptions: Six Months Ended Six Months Ended Risk free interest rate 2.7 % 1.9 % Expected dividend yield — % — % Estimated volatility 63.2 % 65.3 % Expected life 5.8 years 3.2 years Additional information regarding options is as follows: Six Months Ended Six Months Ended Weighted-average grant date fair value of options granted during the period $ 3.86 $ 3.28 Aggregate intrinsic value of options exercised during the period $ 859 $ 151 The total compensation cost recognized for stock-based awards was $352 and $675 for the three and six months ended June 30, 2018 and $217 and $327 for the three and six months ended June 30, 2017. The aggregate intrinsic value in the table above represents the total pre-tax value of the options shown, calculated as the difference between the Company’s closing stock price on June 30, 2018 and the exercise prices of the options shown, multiplied by the number of in-the money options. This is the aggregate amount that would have been received by the option holders if they had all exercised their options on June 30, 2018 and sold the shares thereby received at the closing price of the Company’s stock on that date. This amount changes based on the closing price of the Company’s stock. The Company has 243,500 options outstanding to purchase common shares that vest upon the Company's achievement of certain revenue targets for calendar year 2018. Achievement of the performance targets deemed probable are included in total stock compensation expense. Unrecognized compensation expense related to unvested options was approximately $3,578 at June 30, 2018, with a remaining amortization period of 3.1 years. A summary of the restricted stock unit activity under the Company's Equity Plans as of June 30, 2018 is presented below. Units Weighted Average Grant Date Fair Value Aggregate Intrinsic Value Unvested units, December 31, 2017 61,198 $ 5.60 $ 343 Restricted stock units granted 58,863 $ 6.58 Restricted stock units vested (16,236) $ 6.24 Restricted stock units forfeited (4,117) $ 6.53 Unvested units, June 30, 2018 99,708 $ 6.04 $ 696 Unrecognized compensation expense related to unvested restricted stock units was approximately $537 at June 30, 2018, with a remaining amortization period of 3.2 years.

Income Taxes

Income Taxes	6 Months Ended
	Jun. 30, 2018
Income Tax Disclosure [Abstract]
Income Taxes	Income Taxes The provision for income taxes for the three and six months ended June 30, 2018 and 2017 includes both domestic and foreign income taxes at applicable statutory rates. The provision primarily consists of foreign income taxes. The Company has established a valuation allowance equal to the total net domestic deferred tax asset due to uncertainties regarding the realization of deferred tax assets based on the Company's lack of earnings history. As of June 30, 2018, the Company has no unrecognized tax benefits or accrued interest or penalties associated with uncertain tax positions. As of June 30, 2018, the Company has not completed its accounting for the tax effects of the Tax Cut and Jobs Act but has made reasonable estimates of the effects on the remeasurement of its gross presentation of deferred tax assets and liabilities as well as its transition tax liability. The Company will continue to make and refine its calculations as additional analysis is completed but expects no change in its net domestic deferred tax asset, which is currently $0. No revisions were recorded during the six months ended June 30, 2018.

Net Loss Per Share

Net Loss Per Share	6 Months Ended
	Jun. 30, 2018
Earnings Per Share [Abstract]
Net Loss Per Share	Net Loss Per Share The basic and diluted net loss per common share presented in the condensed consolidated statements of operations and comprehensive loss is calculated by dividing net loss attributable to common stockholders by the weighted-average number of common shares outstanding during the period, without consideration for common stock equivalents. Potentially dilutive shares, which include warrants for the purchase of common stock, restricted stock units, and options outstanding under the Company's equity incentive plans, are considered to be common stock equivalents and are only included in the calculation of diluted net loss per share when their effect is dilutive. Potentially dilutive securities are not included in the calculation of diluted net loss per share attributable to common stockholders because to do so would be anti-dilutive are as follows (in common stock equivalent shares on a weighted-average basis): Three Months Ended June 30, Six Months Ended June 30, 2018 2017 2018 2017 Warrants for common stock 251,891 251,943 251,891 256,460 Common stock options 1,660,440 1,304,881 1,475,235 1,212,484 Restricted stock units 99,708 15,566 80,946 7,826 2,012,039 1,572,390 1,808,072 1,476,770

Liquidity and Capital Resources

Liquidity and Capital Resources	6 Months Ended
	Jun. 30, 2018
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Liquidity and Capital Resources	Liquidity and Capital ResourcesThe Company has experienced operating losses since inception and occasional debt covenant violations and has an accumulated deficit of $194,696 as of June 30, 2018. To date, the Company has funded its operating losses and acquisitions through equity offerings and the issuance of debt instruments. The Company's ability to fund future operations will depend upon its level of future operating cash flow and its ability to access additional funding through either equity offerings, issuances of debt instruments or both. In December 2017, the Company filed a shelf registration statement on Form S-3 with the Securities and Exchange Commission ("SEC"), which permits the offering, issuance and sale by it of up to $50,000 of its common stock. In December 2017, the Company also entered into a sales agreement with Cantor Fitzgerald & Co. for the sale and issuance of shares of its common stock of up to $16,000 from time to time in an "at-the-market" program. The "at-the-market" program was terminated in June 2018 following the below public offering of common stock, although the sales agreement remains in effect. In June 2018, the Company entered into an underwriting agreement with Craig-Hallum Capital Group LLC and completed a public offering of 4,309,090 shares of common stock at a price of $5.50 per share, including 562,055 shares issued upon the full exercise of the underwriter's option to purchase additional shares, resulting in net proceeds of $21,857, after deducting underwriting discounts and expenses.

Fair Value Measurements

Fair Value Measurements	6 Months Ended
	Jun. 30, 2018
Fair Value Disclosures [Abstract]
Fair Value Measurements	Fair Value Measurements The carrying amounts of the Company's financial instruments, which primarily include cash, cash equivalents, and restricted cash, accounts receivable, accounts payable and accrued expenses, approximate their fair values due to their short maturities. The fair value of the Company's long-term debt is estimated by management to approximate $31,116 at June 30, 2018. Management's estimates are based on comparisons of the characteristics of the Company's obligations, comparable ranges of interest rates on recently issued debt, and maturity. Such valuation inputs are considered a Level 3 measurement in the fair value valuation hierarchy. The accounting guidance defines fair value, establishes a consistent framework for measuring fair value and expands disclosure for each major asset and liability category measured at fair value on either a recurring or nonrecurring basis. Fair value is defined as an exit price, representing the amount that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants. As such, fair value is a market-based measurement that should be determined based on assumptions that market participants would use in pricing an asset or liability. As a basis for considering such assumptions, the accounting guidance establishes a three-tier fair value hierarchy, which prioritizes the inputs used in measuring fair value as follows: Level 1: Observable inputs such as quoted prices in active markets; Level 2: Inputs, other than the quoted prices in active markets, that are observable either directly or indirectly; and Level 3: Unobservable inputs in which there is little or no market data, which require the reporting entity to develop its own assumptions.

Segment and Geographic Informat

Segment and Geographic Information	6 Months Ended
	Jun. 30, 2018
Segment Reporting [Abstract]
Segment and Geographic Information	Segment and Geographic InformationOperating segments are defined as components of an enterprise for which separate financial information is available and evaluated regularly by the chief operating decision maker, or decision-making group, in deciding how to allocate resources and in assessing performance. The Company globally manages the business within one reportable segment. Segment information is consistent with how management reviews the business, makes investing and resource allocation decisions and assesses operating performance. Product sales by product group and geographic market, based on the location of the customer, whether the U.S. or outside the U.S. ("OUS") for the periods shown were as follows: Three Months Ended June 30, 2018 Three Months Ended June 30, 2017 (unaudited) U.S. OUS Total Revenues % Total Revenues U.S. OUS Total Revenues % Total Revenues ESS $ 2,655 $ 2,825 $ 5,480 34.7 % $ 2,034 $ 1,956 $ 3,990 23.3 % IGB 1,675 3,609 5,284 33.5 % 2,052 3,477 5,529 32.3 % Endo-bariatric 4,330 6,434 10,764 68.2 % 4,086 5,433 9,519 55.6 % Surgical 2,631 2,093 4,724 29.9 % 4,752 2,636 7,388 43.2 % Other 292 8 300 1.9 % 194 8 202 1.2 % Total revenues $ 7,253 $ 8,535 $ 15,788 100.0 % $ 9,032 $ 8,077 $ 17,109 100.0 % % Total revenues 45.9 % 54.1 % 52.8 % 47.2 % Six Months Ended June 30, 2018 Six Months Ended June 30, 2017 (unaudited) U.S. OUS Total Revenues % Total Revenues U.S. OUS Total Revenues % Total Revenues ESS $ 5,152 $ 6,095 $ 11,247 35.7 % $ 3,722 $ 3,111 $ 6,833 21.6 % IGB 3,286 6,527 9,813 31.1 % 3,860 6,160 10,020 31.7 % Endo-bariatric 8,438 12,622 21,060 66.8 % 7,582 9,271 16,853 53.3 % Surgical 5,569 4,359 9,928 31.5 % 8,849 5,559 14,408 45.6 % Other 525 18 543 1.7 % 351 14 365 1.2 % Total revenues $ 14,532 $ 16,999 $ 31,531 100.0 % $ 16,782 $ 14,844 $ 31,626 100.0 % % Total revenues 46.1 % 53.9 % 53.1 % 46.9 % _________________________________________ Endoscopic Suturing System ("ESS") and Intragastric Balloon ("IGB"). Total distributor sales were 22.5% and 29.0% of total OUS revenues for the three months ended June 30, 2018 and 2017, respectively, and 21.1% and 24.3% for the six months ended June 30, 2018 and 2017, respectively. Sales in the next largest individual country outside the U.S. were 8.8% and 6.7% of total revenues for the three months ended June 30, 2018 and 2017, respectively and 8.0% and 7.2% for the six months ended June 30, 2018 and 2017, respectively. The following table represents property and equipment, net based on the physical geographic location of the asset: June 30, 2018 December 31, 2017 (unaudited) United States $ 3,337 $ 2,855 Costa Rica 3,332 3,748 Other 241 282 Total property and equipment, net $ 6,910 $ 6,885

Subsequent Events

Subsequent Events	6 Months Ended
	Jun. 30, 2018
Subsequent Events [Abstract]
Subsequent Events	Subsequent EventsIn July 2018, the Company entered into a Waiver Agreement ("Waiver") under the Credit Agreement with its lender, Athyrium. The Waiver increased the maximum debt-to-revenue ratio for the three months ended June 30, 2018 to 0.56 from 0.53 and waived the existing default under such ratio. As a condition to the effectiveness of the Waiver, the Company prepaid $1,500 of the principal amount outstanding under the Credit Agreement, together with accrued interest and certain fees and expenses.

Significant Accounting Polici21

Significant Accounting Policies (Policies)	6 Months Ended
	Jun. 30, 2018
Accounting Policies [Abstract]
Organization and Business Description	Apollo Endosurgery, Inc. is a Delaware corporation with both domestic and foreign wholly-owned subsidiaries. Throughout these Notes "Apollo" and the "Company" refer to Apollo Endosurgery, Inc. and its consolidated subsidiaries. Apollo is a medical technology company primarily focused on the design, development, and commercialization of innovative medical devices. The Company's products are used by surgeons and gastroenterologists in a variety of settings to provide interventional therapy to patients who suffer from obesity and the many co-morbidities associated with obesity as well as to treat various other gastrointestinal conditions.
Revenue Recognition	Revenue Recognition The Company's principal source of revenue is from the sale of its products. Revenue is recognized when control of the promised goods is transferred to our customers, in an amount that reflects the consideration we expect to be entitled to in an exchange for those goods. Generally, these conditions are met under the Company's agreements with most customers upon product shipment. This includes sales to distributors, who sell the products to their customers, take title to the products and assume all risks of ownership at the time of shipment. Our distributors are obligated to pay within specified terms regardless of when, if ever, they sell the products. Customers and distributors generally have the right to return or exchange products purchased from the Company for up to thirty days from the date of product shipment. At the end of each period, the Company determines the extent to which its revenues need to be reduced to account for expected returns and exchanges. Certain customers may receive volume rebates or discounts, which are accounted for as variable consideration. We estimate these amounts based on the expected amount to be provided to customers and reduce revenues recognized. We record deferred revenues when cash payments are received in advance of the transfer of goods.
Recent Accounting Pronouncements	Recent Accounting Pronouncements On January 1, 2018, the Company adopted the provisions of ASU 2014-09, Revenue from Contracts with Customers ("ASC 606"), which requires an entity to recognize revenue when it transfers control of promised goods or services to customers in an amount that reflects the consideration to which it expects to be entitled in exchange for those goods or services. The Company adopted this new standard using the modified retrospective method and applied this method only to contracts that were not completed as of January 1, 2018. Prior periods were not retrospectively adjusted. There was no material impact on the Company's financial statement upon adoption of the new revenue recognition standard. In February 2016, the FASB issued ASU 2016-02, Leases ("ASU 2016-02") which requires a lessee to recognize assets and liabilities for leases with a maximum possible term of more than 12 months. A lessee would recognize a liability to make lease payments (the lease liability) and a right-of-use asset representing its right to use the leased asset (the underlying asset) for the lease term which will require companies to recognize most leases on the balance sheet, thereby increasing reported assets and liabilities. ASU 2016-02 will be effective for the Company on January 1, 2019. Upon initial evaluation, the Company believes the key change upon adoption will be the balance sheet recognition. The income statement recognition of lease expense appears similar to the Company's current methodology. The Company is continuing to evaluate other potential impacts on the consolidated financial statements. In January 2017, the FASB issued ASU 2017-04, Intangibles - Goodwill and Other: Simplifying the Test for Goodwill Impairment
Net Loss Per Share	The basic and diluted net loss per common share presented in the condensed consolidated statements of operations and comprehensive loss is calculated by dividing net loss attributable to common stockholders by the weighted-average number of common shares outstanding during the period, without consideration for common stock equivalents. Potentially dilutive shares, which include warrants for the purchase of common stock, restricted stock units, and options outstanding under the Company's equity incentive plans, are considered to be common stock equivalents and are only included in the calculation of diluted net loss per share when their effect is dilutive.

Inventory (Tables)

Inventory (Tables)	6 Months Ended
	Jun. 30, 2018
Inventory Disclosure [Abstract]
Schedule of Inventory	Inventory consists of the following as of: June 30, 2018 December 31, 2017 (unaudited) Raw materials $ 5,092 $ 4,937 Work in progress 449 493 Finished goods 11,603 10,947 Less inventory reserve (2,192) (2,034) Total inventory, net $ 14,952 $ 14,343

Accrued Expenses (Tables)

Accrued Expenses (Tables)	6 Months Ended
	Jun. 30, 2018
Payables and Accruals [Abstract]
Schedule of Accrued Expenses	Accrued expenses consist of the following as of: June 30, 2018 December 31, 2017 (unaudited) Accrued employee compensation and expenses $ 3,650 $ 4,243 Accrued professional service fees 935 522 Accrued returns and rebates 361 438 Accrued insurance and taxes 687 527 Other 1,692 1,770 Total accrued expenses $ 7,325 $ 7,500

Long-Term Debt (Tables)

Long-Term Debt (Tables)	6 Months Ended
	Jun. 30, 2018
Debt Disclosure [Abstract]
Schedule of Long-term Debt	Long-term debt consists of the following as of: June 30, 2018 December 31, 2017 (unaudited) Senior secured credit facility $ 32,000 $ 32,000 Payment-in-kind interest 2,294 2,223 Discount on long-term debt (411) (534) Deferred financing costs (577) (368) Long-term debt $ 33,306 $ 33,321

Stock Based Compensation (Table

Stock Based Compensation (Tables)	6 Months Ended
	Jun. 30, 2018
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Schedule of Stock Option Activity	A summary of the stock option activity under the Company's 2017 Plan and Prior Plans (collectively, the "Equity Plans") as of June 30, 2018 is presented below. Options Weighted Average Exercise Price Weighted Average Remaining Contractual Term Aggregate Intrinsic Value Options outstanding, December 31, 2017 1,390,428 $ 4.64 7.0 years $ 2,432 Options granted 580,901 $ 6.58 Options exercised (260,797) $ 2.63 Options forfeited (50,092) $ 5.10 Options vested and expected to vest, June 30, 2018 1,660,440 $ 5.62 8.3 years $ 2,940 Options exercisable 596,676 $ 4.31 6.7 years $ 1,839
Schedule of Fair Value of Stock Options	The fair value of stock option grants has been estimated at the date of grant using the Black-Scholes option pricing model with the following weighted average assumptions: Six Months Ended Six Months Ended Risk free interest rate 2.7 % 1.9 % Expected dividend yield — % — % Estimated volatility 63.2 % 65.3 % Expected life 5.8 years 3.2 years
Schedule of Other Stock Option Information	Additional information regarding options is as follows: Six Months Ended Six Months Ended Weighted-average grant date fair value of options granted during the period $ 3.86 $ 3.28 Aggregate intrinsic value of options exercised during the period $ 859 $ 151
Schedule of Restricted Stock Unit Activity	A summary of the restricted stock unit activity under the Company's Equity Plans as of June 30, 2018 is presented below. Units Weighted Average Grant Date Fair Value Aggregate Intrinsic Value Unvested units, December 31, 2017 61,198 $ 5.60 $ 343 Restricted stock units granted 58,863 $ 6.58 Restricted stock units vested (16,236) $ 6.24 Restricted stock units forfeited (4,117) $ 6.53 Unvested units, June 30, 2018 99,708 $ 6.04 $ 696

Net Loss Per Share (Tables)

Net Loss Per Share (Tables)	6 Months Ended
	Jun. 30, 2018
Earnings Per Share [Abstract]
Schedule of Antidilutive Securities Excluded from Computation of Diluted Loss Per Share	Potentially dilutive securities are not included in the calculation of diluted net loss per share attributable to common stockholders because to do so would be anti-dilutive are as follows (in common stock equivalent shares on a weighted-average basis): Three Months Ended June 30, Six Months Ended June 30, 2018 2017 2018 2017 Warrants for common stock 251,891 251,943 251,891 256,460 Common stock options 1,660,440 1,304,881 1,475,235 1,212,484 Restricted stock units 99,708 15,566 80,946 7,826 2,012,039 1,572,390 1,808,072 1,476,770

Segment and Geographic Inform27

Segment and Geographic Information (Tables)	6 Months Ended
	Jun. 30, 2018
Segment Reporting [Abstract]
Schedule of Product Sales by Product Group and Geographic Market	Product sales by product group and geographic market, based on the location of the customer, whether the U.S. or outside the U.S. ("OUS") for the periods shown were as follows: Three Months Ended June 30, 2018 Three Months Ended June 30, 2017 (unaudited) U.S. OUS Total Revenues % Total Revenues U.S. OUS Total Revenues % Total Revenues ESS $ 2,655 $ 2,825 $ 5,480 34.7 % $ 2,034 $ 1,956 $ 3,990 23.3 % IGB 1,675 3,609 5,284 33.5 % 2,052 3,477 5,529 32.3 % Endo-bariatric 4,330 6,434 10,764 68.2 % 4,086 5,433 9,519 55.6 % Surgical 2,631 2,093 4,724 29.9 % 4,752 2,636 7,388 43.2 % Other 292 8 300 1.9 % 194 8 202 1.2 % Total revenues $ 7,253 $ 8,535 $ 15,788 100.0 % $ 9,032 $ 8,077 $ 17,109 100.0 % % Total revenues 45.9 % 54.1 % 52.8 % 47.2 % Six Months Ended June 30, 2018 Six Months Ended June 30, 2017 (unaudited) U.S. OUS Total Revenues % Total Revenues U.S. OUS Total Revenues % Total Revenues ESS $ 5,152 $ 6,095 $ 11,247 35.7 % $ 3,722 $ 3,111 $ 6,833 21.6 % IGB 3,286 6,527 9,813 31.1 % 3,860 6,160 10,020 31.7 % Endo-bariatric 8,438 12,622 21,060 66.8 % 7,582 9,271 16,853 53.3 % Surgical 5,569 4,359 9,928 31.5 % 8,849 5,559 14,408 45.6 % Other 525 18 543 1.7 % 351 14 365 1.2 % Total revenues $ 14,532 $ 16,999 $ 31,531 100.0 % $ 16,782 $ 14,844 $ 31,626 100.0 % % Total revenues 46.1 % 53.9 % 53.1 % 46.9 % _________________________________________ Endoscopic Suturing System ("ESS") and Intragastric Balloon ("IGB").
Schedule of Long-Lived Assets by Geographic Area	The following table represents property and equipment, net based on the physical geographic location of the asset: June 30, 2018 December 31, 2017 (unaudited) United States $ 3,337 $ 2,855 Costa Rica 3,332 3,748 Other 241 282 Total property and equipment, net $ 6,910 $ 6,885

Concentrations (Details)

Concentrations (Details) $ in Thousands	Jun. 30, 2018USD ($)bank	Dec. 31, 2017USD ($)	Jun. 30, 2017USD ($)	Dec. 31, 2016USD ($)
Risks and Uncertainties [Abstract]
Number of banks | bank	3
Cash and cash equivalents and restricted cash | $	$ 35,445	$ 31,418	$ 6,240	$ 20,041

Inventory (Details)

Inventory (Details) - USD ($) $ in Thousands	3 Months Ended	6 Months Ended
	Jun. 30, 2018	Jun. 30, 2018	Jun. 30, 2017	Dec. 31, 2017
Inventory Disclosure [Abstract]
Raw materials	$ 5,092	$ 5,092		$ 4,937
Work in progress	449	449		493
Finished goods	11,603	11,603		10,947
Less inventory reserve	(2,192)	(2,192)		(2,034)
Total inventory, net	14,952	14,952		$ 14,343
Change in inventory reserve	159	261	$ 169
Consigned inventory	$ 364	364
Disposal of expired product		$ 103

Accrued Expenses (Details)

Accrued Expenses (Details) - USD ($) $ in Thousands	Jun. 30, 2018	Dec. 31, 2017
Payables and Accruals [Abstract]
Accrued employee compensation and expenses	$ 3,650	$ 4,243
Accrued professional service fees	935	522
Accrued returns and rebates	361	438
Accrued insurance and taxes	687	527
Other	1,692	1,770
Total accrued expenses	$ 7,325	$ 7,500

Long-Term Debt (Schedule of Lon

Long-Term Debt (Schedule of Long-term Debt) (Details) - USD ($) $ in Thousands	Jun. 30, 2018	Dec. 31, 2017
Debt Instrument [Line Items]
Discount on long-term debt	$ (411)	$ (534)
Deferred financing costs	(577)	(368)
Long-term debt	33,306	33,321
Payment in Kind Interest [Member]
Debt Instrument [Line Items]
Long-term debt	2,294	2,223
Line of Credit [Member] | Secured Debt [Member] | Credit Facility [Member]
Debt Instrument [Line Items]
Long-term debt	$ 32,000	$ 32,000

Long-Term Debt (Narrative) (Det

Long-Term Debt (Narrative) (Details) - Secured Debt [Member] - Line of Credit [Member]	Feb. 28, 2018	Jul. 31, 2018USD ($)	Jun. 30, 2018	Dec. 31, 2017
Credit Facility Sixth Amendment [Member]
Debt Instrument [Line Items]
Minimum debt to revenue ratio	0.54			0.49
Waiver Agreement [Member]
Debt Instrument [Line Items]
Minimum debt to revenue ratio			0.53
Waiver Agreement [Member] | Subsequent Event [Member]
Debt Instrument [Line Items]
Minimum debt to revenue ratio		0.56
Repayments of debt		$ 1,500,000

Stock Based Compensation (Stock

Stock Based Compensation (Stock Option Activity) (Details) - Stock Option [Member] - USD ($) $ / shares in Units, $ in Thousands	6 Months Ended	12 Months Ended
	Jun. 30, 2018	Dec. 31, 2017
Options
Options outstanding, beginning balance (in shares)		1,390,428
Options granted (in shares)	580,901
Options exercised (in shares)	(260,797)
Options forfeited (in shares)	(50,092)
Options vested and expected to vest (in shares)	1,660,440
Options exercisable (in shares)	596,676
Weighted Average Exercise Price
Weighted average exercise price, beginning balance (in USD per share)		$ 4.64
Options granted (in USD per share)	$ 6.58
Options exercised (in USD per share)	2.63
Options forfeited (in USD per share)	5.10
Options vested and expected to vest (in USD per share)	5.62
Options exercisable (in USD per share)	$ 4.31
Weighted Average Remaining Contractual Term
Weighted Average Remaining Contractual Term		7 years
Options vested and expected to vest	8 years 3 months 18 days
Options exercisable	6 years 8 months 12 days
Aggregate Intrinsic Value
Aggregate intrinsic value		$ 2,432
Options vested and expected to vest	$ 2,940
Options exercisable	$ 1,839

Stock Based Compensation (Fair

Stock Based Compensation (Fair Value of Stock Options) (Details) - Stock Option [Member]	6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Risk free interest rate	2.70%	1.90%
Expected dividend yield	0.00%	0.00%
Estimated volatility	63.20%	65.30%
Expected life	5 years 9 months 18 days	3 years 2 months 12 days

Stock Based Compensation (Addit

Stock Based Compensation (Additional Information) (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017	Dec. 31, 2017
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock compensation cost	$ 352	$ 217	$ 675	$ 327
Unrecognized compensation expense related to unvested options	$ 3,578		$ 3,578
Remaining amortization period			3 years 1 month 6 days
Stock Option [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Weighted-average grant date fair value of options granted during the period (USD per share)			$ 3.86	$ 3.28
Aggregate intrinsic value of options exercised during the period			$ 859	$ 151
Options granted in period (in shares)					1,390,428
Performance Shares [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Options granted in period (in shares)	243,500		243,500
Restricted stock units [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Remaining amortization period			3 years 2 months 12 days
Unrecognized compensation expense related to unvested restricted stock units	$ 537		$ 537

Stock Based Compensation (Restr

Stock Based Compensation (Restricted Stock Units Activity) (Details) - Restricted stock units [Member] - USD ($) $ / shares in Units, $ in Thousands	6 Months Ended
	Jun. 30, 2018	Dec. 31, 2017
Number of Units
Unvested Units (shares)	61,198
Restricted stock units granted (shares)	58,863
Restricted stock units vested (shares)	(16,236)
Restricted stock units forfeited (shares)	(4,117)
Unvested Units (shares)	99,708
Weighted-Average Grant Date Fair Value
Unvested Units (USD per share)	$ 5.60
Restricted stock units granted (USD per share)	6.58
Restricted stock units vested (USD per share)	6.24
Restricted stock units forfeited (USD per share)	6.53
Unvested Units (USD per share)	$ 6.04
Aggregate Intrinsic Value
Aggregate Intrinsic Value	$ 696	$ 343

Income Taxes (Details)

Income Taxes (Details)	Jun. 30, 2018USD ($)
Income Tax Disclosure [Abstract]
Unrecognized tax benefits	$ 0
Accrued interest	0
Tax penalties	0
Deferred tax assets	$ 0

Net Loss Per Share (Details)

Net Loss Per Share (Details) - shares	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of diluted loss per share	2,012,039	1,572,390	1,808,072	1,476,770
Warrants for common [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of diluted loss per share	251,891	251,943	251,891	256,460
Common stock options [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of diluted loss per share	1,660,440	1,304,881	1,475,235	1,212,484
Restricted stock units [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of diluted loss per share	99,708	15,566	80,946	7,826

Liquidity and Capital Resourc39

Liquidity and Capital Resources (Details) $ / shares in Units, $ in Thousands	Feb. 28, 2018	Jun. 30, 2018USD ($)$ / sharesshares	Dec. 31, 2017USD ($)	Jun. 30, 2018USD ($)$ / shares	Jun. 30, 2017USD ($)	Dec. 31, 2017USD ($)
Subsidiary, Sale of Stock [Line Items]
Accumulated deficit		$ 194,696	$ 177,021	$ 194,696		$ 177,021
Sale of stock, number of shares (shares) | shares		4,309,090
Sale of stock, price per share (USD per share) | $ / shares		$ 5.50		$ 5.50
Proceeds from the issuance of common stock				$ 21,857	$ 0
Secured Debt [Member] | Credit Facility Sixth Amendment [Member] | Line of Credit [Member]
Subsidiary, Sale of Stock [Line Items]
Minimum debt to revenue ratio	0.54					0.49
Shelf registration [Member]
Subsidiary, Sale of Stock [Line Items]
Authorized amount			16,000
Shelf registration [Member] | Common Stock [Member]
Subsidiary, Sale of Stock [Line Items]
Authorized amount			$ 50,000
Underwriters [Member]
Subsidiary, Sale of Stock [Line Items]
Sale of stock, number of shares (shares) | shares		562,055

Fair Value Measurements (Detail

Fair Value Measurements (Details) $ in Thousands	Jun. 30, 2018USD ($)
Fair Value Disclosures [Abstract]
Fair value of long-term debt	$ 31,116

Segment and Geographic Inform41

Segment and Geographic Information (Segment Information) (Details) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2018USD ($)	Jun. 30, 2017USD ($)	Jun. 30, 2018USD ($)segment	Jun. 30, 2017USD ($)
Segment Reporting [Abstract]
Number of reportable segments | segment			1
Revenue, Major Customer [Line Items]
Revenues	$ 15,788	$ 17,109	$ 31,531	$ 31,626
Segment Revenue [Member] | Product Risk [Member]
Revenue, Major Customer [Line Items]
Percentage of revenue or sales	100.00%	100.00%	100.00%	100.00%
United States [Member]
Revenue, Major Customer [Line Items]
Revenues	$ 7,253	$ 9,032	$ 14,532	$ 16,782
United States [Member] | Segment Revenue [Member] | Product Risk [Member]
Revenue, Major Customer [Line Items]
Percentage of revenue or sales	45.90%	52.80%	46.10%	53.10%
OUS [Member]
Revenue, Major Customer [Line Items]
Revenues	$ 8,535	$ 8,077	$ 16,999	$ 14,844
OUS [Member] | Segment Revenue [Member] | Product Risk [Member]
Revenue, Major Customer [Line Items]
Percentage of revenue or sales	54.10%	47.20%	53.90%	46.90%
OUS [Member] | Distributor Sales [Member] | Product Risk [Member]
Revenue, Major Customer [Line Items]
Percentage of revenue or sales	22.50%	29.00%	21.10%	24.30%
Next Largest Single Country Outside of U.S [Member] | Distributor Sales [Member] | Product Risk [Member]
Revenue, Major Customer [Line Items]
Percentage of revenue or sales	8.80%	6.70%	8.00%	7.20%
ESS [Member]
Revenue, Major Customer [Line Items]
Revenues	$ 5,480	$ 3,990	$ 11,247	$ 6,833
ESS [Member] | Segment Revenue [Member] | Product Risk [Member]
Revenue, Major Customer [Line Items]
Percentage of revenue or sales	34.70%	23.30%	35.70%	21.60%
ESS [Member] | United States [Member]
Revenue, Major Customer [Line Items]
Revenues	$ 2,655	$ 2,034	$ 5,152	$ 3,722
ESS [Member] | OUS [Member]
Revenue, Major Customer [Line Items]
Revenues	2,825	1,956	6,095	3,111
IGB [Member]
Revenue, Major Customer [Line Items]
Revenues	$ 5,284	$ 5,529	$ 9,813	$ 10,020
IGB [Member] | Segment Revenue [Member] | Product Risk [Member]
Revenue, Major Customer [Line Items]
Percentage of revenue or sales	33.50%	32.30%	31.10%	31.70%
IGB [Member] | United States [Member]
Revenue, Major Customer [Line Items]
Revenues	$ 1,675	$ 2,052	$ 3,286	$ 3,860
IGB [Member] | OUS [Member]
Revenue, Major Customer [Line Items]
Revenues	3,609	3,477	6,527	6,160
Endo-bariatric [Member]
Revenue, Major Customer [Line Items]
Revenues	$ 10,764	$ 9,519	$ 21,060	$ 16,853
Endo-bariatric [Member] | Segment Revenue [Member] | Product Risk [Member]
Revenue, Major Customer [Line Items]
Percentage of revenue or sales	68.20%	55.60%	66.80%	53.30%
Endo-bariatric [Member] | United States [Member]
Revenue, Major Customer [Line Items]
Revenues	$ 4,330	$ 4,086	$ 8,438	$ 7,582
Endo-bariatric [Member] | OUS [Member]
Revenue, Major Customer [Line Items]
Revenues	6,434	5,433	12,622	9,271
Surgical [Member]
Revenue, Major Customer [Line Items]
Revenues	$ 4,724	$ 7,388	$ 9,928	$ 14,408
Surgical [Member] | Segment Revenue [Member] | Product Risk [Member]
Revenue, Major Customer [Line Items]
Percentage of revenue or sales	29.90%	43.20%	31.50%	45.60%
Surgical [Member] | United States [Member]
Revenue, Major Customer [Line Items]
Revenues	$ 2,631	$ 4,752	$ 5,569	$ 8,849
Surgical [Member] | OUS [Member]
Revenue, Major Customer [Line Items]
Revenues	2,093	2,636	4,359	5,559
Other [Member]
Revenue, Major Customer [Line Items]
Revenues	$ 300	$ 202	$ 543	$ 365
Other [Member] | Segment Revenue [Member] | Product Risk [Member]
Revenue, Major Customer [Line Items]
Percentage of revenue or sales	1.90%	1.20%	1.70%	1.20%
Other [Member] | United States [Member]
Revenue, Major Customer [Line Items]
Revenues	$ 292	$ 194	$ 525	$ 351
Other [Member] | OUS [Member]
Revenue, Major Customer [Line Items]
Revenues	$ 8	$ 8	$ 18	$ 14

Segment and Geographic Inform42

Segment and Geographic Information (Long-Lived Assets by Geographic Area) (Details) - USD ($) $ in Thousands	Jun. 30, 2018	Dec. 31, 2017
Revenues from External Customers and Long-Lived Assets [Line Items]
Total property and equipment, net	$ 6,910	$ 6,885
United States [Member]
Revenues from External Customers and Long-Lived Assets [Line Items]
Total property and equipment, net	3,337	2,855
Costa Rica [Member]
Revenues from External Customers and Long-Lived Assets [Line Items]
Total property and equipment, net	3,332	3,748
Other [Member]
Revenues from External Customers and Long-Lived Assets [Line Items]
Total property and equipment, net	$ 241	$ 282

Subsequent Event (Details)

Subsequent Event (Details) - Secured Debt [Member] - Line of Credit [Member] - Waiver Agreement [Member]	1 Months Ended	3 Months Ended
	Jul. 31, 2018USD ($)	Jun. 30, 2018
Subsequent Event [Line Items]
Minimum debt to revenue ratio		0.53
Subsequent Event [Member]
Subsequent Event [Line Items]
Minimum debt to revenue ratio	0.56
Repayments of debt	$ 1,500,000