Apollo Endosurgery (APEN) 10-Q 2 May 19 2019 Q1 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	3 Months Ended
	Mar. 31, 2019	Apr. 30, 2019
Document and Entity Information [Abstract]
Entity Registrant Name	APOLLO ENDOSURGERY, INC.
Entity Central Index Key	0001251769
Document Type	10-Q
Document Period End Date	Mar. 31, 2019
Amendment Flag	false
Current Fiscal Year End Date	--12-31
Entity Filer Category	Accelerated Filer
Entity Common Stock, Shares Outstanding		21,922,344
Entity Small Business	true
Entity Emerging Growth Company	false
Document Fiscal Year Focus	2019
Document Fiscal Period Focus	Q1

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018
Current assets:
Cash and cash equivalents	$ 29,974	$ 23,996
Accounts receivable, net of allowance for doubtful accounts of $483 and $559, respectively	10,633	11,391
Inventory	10,407	9,932
Prepaid expenses and other current assets	3,254	2,801
Total current assets	54,268	48,120
Restricted cash	1,018	1,011
Property, equipment and right-of-use assets	8,008	5,897
Goodwill	5,290	5,290
Intangible assets, net of accumulated amortization of $9,942 and $9,455, respectively	9,323	9,859
Other assets	4,360	4,291
Total assets	82,267	74,468
Current liabilities:
Accounts payable	8,146	15,292
Accrued expenses	11,434	9,156
Total current liabilities	19,580	24,448
Long-term debt	33,891	21,190
Long-term liabilities	3,254	0
Total liabilities	56,725	45,638
Commitments and contingencies
Stockholders' equity:
Common stock; $0.001 par value; 100,000,000 shares authorized; 21,922,344 and 21,899,522 shares issued and outstanding at March 31, 2019 and December 31, 2018, respectively	22	22
Additional paid-in capital	249,441	249,115
Accumulated other comprehensive income	1,613	2,501
Accumulated deficit	(225,534)	(222,808)
Total stockholders' equity	25,542	28,830
Total liabilities and stockholders' equity	$ 82,267	$ 74,468

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018
Statement of Financial Position [Abstract]
Allowance for doubtful accounts	$ 483	$ 559
Accumulated amortization	$ 9,942	$ 9,455
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)	21,922,344	21,899,522
Common stock, shares outstanding (shares)	21,922,344	21,899,522

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations and Comprehensive Loss - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Income Statement [Abstract]
Revenues	$ 13,211	$ 15,743
Cost of sales	5,970	6,553
Gross margin	7,241	9,190
Operating expenses:
Sales and marketing	7,697	9,245
General and administrative	3,717	3,319
Research and development	3,428	2,456
Amortization of intangible assets	553	1,802
Settlement gain	(5,609)	0
Total operating expenses	9,786	16,822
Loss from operations	(2,545)	(7,632)
Other expenses:
Interest expense, net	959	960
Other income	(751)	(516)
Net loss before income taxes	(2,753)	(8,076)
Income tax expense	51	58
Net loss	(2,804)	(8,134)
Other comprehensive income (loss):
Foreign currency translation	(888)	(386)
Comprehensive loss	$ (3,692)	$ (8,520)
Net loss per share, basic and diluted (USD per share)	$ (0.13)	$ (0.47)
Shares used in computing net loss per share, basic and diluted (shares)	21,907,281	17,299,414

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Changes in Stockholders’ Equity - 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
Exercise of common stock options	103		103
Exercise of common stock options, shares		44,418
Stock based compensation	323		323
Foreign currency translation	(386)			(386)
Net loss	(8,134)				(8,134)
Ending balance at Mar. 31, 2018	41,819	$ 17	225,548	1,409	(185,155)
Ending balance, shares at Mar. 31, 2018		17,335,627
Beginning balance at Dec. 31, 2018	$ 28,908	$ 22	249,115	2,501	(222,730)
Beginning balance, shares at Dec. 31, 2018	21,899,522	21,899,522
Exercise of common stock options	$ 3		3
Exercise of common stock options, shares		1,573
Issuance of restricted stock units, shares		21,249
Stock based compensation	323		323
Foreign currency translation	(888)			(888)
Net loss	(2,804)				(2,804)
Ending balance at Mar. 31, 2019	$ 25,542	$ 22	$ 249,441	$ 1,613	$ (225,534)
Ending balance, shares at Mar. 31, 2019	21,922,344	21,922,344

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Cash flows from operating activities:
Net loss	$ (2,804)	$ (8,134)
Adjustments to reconcile net loss to net cash used in operating activities:
Settlement gain	(5,609)	0
Depreciation and amortization	1,104	2,358
Amortization of deferred financing costs	298	58
Non-cash interest	3	92
Provision for doubtful accounts receivable	(37)	0
Inventory impairment	40	102
Stock based compensation	323	323
Unrealized foreign currency gain on short-term intercompany loans	(936)	(403)
Changes in operating assets and liabilities:
Accounts receivable	790	62
Inventory	(502)	(1,206)
Prepaid expenses and other assets	(350)	(210)
Accounts payable and accrued expenses	1,618	272
Net cash used in operating activities	(6,062)	(6,686)
Cash flows from investing activities:
Purchases of property and equipment	(112)	(1,173)
Purchases of intangibles and other assets	(65)	(120)
Net cash used in investing activities	(177)	(1,293)
Cash flows from financing activities:
Proceeds from exercise of stock options	3	103
Proceeds from long-term debt	35,000	0
Payments of deferred financing costs	(1,129)	(353)
Payment of long-term debt	(21,668)	0
Net cash provided by financing activities	12,206	(250)
Effect of exchange rate changes on cash	18	68
Net increase/(decrease) in cash, cash equivalents and restricted cash	5,985	(8,161)
Cash, cash equivalents and restricted cash at beginning of year	25,007	31,418
Cash, cash equivalents and restricted cash at end of period	30,992	23,257
Supplemental disclosure of cash flow information:
Cash paid for interest	1,160	889
Cash paid for income taxes	0	14
Right-of-use assets recognized in exchange for new lease obligations (non-cash)	$ 2,789	$ 0

Organization and Business Descr

Organization and Business Description	3 Months Ended
	Mar. 31, 2019
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 gastroenterologists and surgeons in a variety of settings to provide interventional therapy to patients who suffer from various gastrointestinal conditions including obesity and the many co-morbidities associated with obesity. The Company's core products include the OverStitch™ Endoscopic Suturing System ("ESS") and the Orbera ® Intragastric Balloon System ("IGB"), which together comprise the Company's Endo-bariatric products. All devices are regulated by the U.S. Food and Drug Administration ("FDA") or an equivalent regulatory body outside the U.S. We have sales distribution offices in England, Australia, Italy, and Brazil that oversee regional sales and distribution activities outside the U.S., a products 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	3 Months Ended
	Mar. 31, 2019
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, impairment of long-lived assets and goodwill, 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, 2018. (c) Other Revenue In connection with the December 2018 sale of the Surgical product line, the Company entered into a transition services agreement, supply agreement and distribution agreement pursuant to which the Company will provide specific transition services for designated periods of time for each service, will manufacture Surgical products for up to two one Transition service and supply agreement revenue are included in other revenue and distribution agreement revenue are reflected as Surgical product sales (see Note 14). (d) Recent Accounting Pronouncements On January 1, 2019, the Company adopted the provisions of ASU 2016-02, Leases ("ASU 2016-02") under the modified retrospective approach, chose not to adjust comparative periods, and elected the package of practical expedients permitted under the transition guidance, which among other things, allowed us to carry forward the historical lease classification. The cumulative-effect adjustment made to the opening balance of retained earnings as of January 1, 2019 was $78. All significant lease arrangements are generally recognized at lease commitment. Operating lease right-of-use assets and liabilities are recognized at commencement, except for leases with an initial term of 12 months or less, for which lease expense is recognized as incurred over the lease term. Right-of-use assets represent the Company’s right to use an underlying asset during the reasonably certain lease term, and lease liabilities represent the Company’s obligation to make lease payments arising from the lease. Lease terms may include options to extend or terminate the lease when its reasonably certain that the Company will exercise that option. Operating lease right-of-use assets and liabilities are recognized at commencement date based on the present value of lease payments over the lease term. The Company primarily uses its incremental borrowing rate based on the information available at commencement date in determining the present value of lease payments. Operating lease right-of-use assets include any lease payments related to initial direct costs and prepayments and excludes lease incentives. Lease expense is recognized on a straight-line basis over the lease term. The Company has lease agreements with lease and non-lease components, which are generally accounted for separately. In January 2017, the FASB issued ASU 2017-04, Intangibles - Goodwill and Other: Simplifying the Test for Goodwill Impairment (“ASU 2017-04”) to simplify the accounting for goodwill impairment. The guidance removes step two of the goodwill impairment test, which requires a hypothetical purchase price allocation. A goodwill impairment will now be the amount by which a reporting unit’s carrying value exceeds its fair value, not to exceed the carrying amount of goodwill. Entities will continue to have the option to perform a qualitative assessment to determine if a quantitative impairment test is necessary. ASU 2017-04 will be effective for the Company for annual and interim reporting in fiscal years beginning after December 15, 2019.

Concentrations

Concentrations	3 Months Ended
	Mar. 31, 2019
Risks and Uncertainties [Abstract]
Concentrations	Concentrations Consolidated financial instruments that potentially subject the Company to a concentration of credit risk principally consist of cash and cash equivalents and accounts receivable. At March 31, 2019, the Company's cash, cash equivalents and restricted cash are held in deposit accounts at four different banks totaling $30,992. 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	3 Months Ended
	Mar. 31, 2019
Inventory Disclosure [Abstract]
Inventory	Inventory Inventory consists of the following as of: March 31, 2019 December 31, 2018 (unaudited) Raw materials $ 3,723 $ 3,806 Work in progress 281 352 Finished goods 6,403 5,774 Total inventory $ 10,407 $ 9,932

Property, Equipment and Right-o

Property, Equipment and Right-of-Use Assets	3 Months Ended
	Mar. 31, 2019
Property, Plant and Equipment [Abstract]
Property, Equipment and Right-of-Use Assets	Property, Equipment and Right-of-Use Assets Property, equipment and right-of-use assets consists of the following: Depreciable Lives March 31, 2019 December 31, 2018 Equipment 5 years $ 7,583 $ 7,510 Right-of-use asset 2,789 — Furniture, fixtures and tooling 4-8 years 2,231 2,223 Computer hardware 3-5 years 1,337 1,326 Leasehold improvements 3-5 years 1,400 1,400 Construction in process 104 130 15,444 12,589 Less accumulated depreciation (7,436) (6,692) Property and equipment, net $ 8,008 $ 5,897 The Company has operating leases for office space in Texas, California, the United Kingdom, Australia, Italy, and Brazil, and for the manufacturing facility located in Costa Rica. The Company also has various lease agreements for equipment and vehicles. As of March 31, 2019, the maturities of the Company's operating lease liabilities are as follows: 2019 $ 944 2020 1,023 2021 820 2022 142 2023 96 Thereafter 30 Total lease payments 3,055 Less imputed interest (490) Total operating lease liabilities $ 2,565

Accrued Expenses

Accrued Expenses	3 Months Ended
	Mar. 31, 2019
Payables and Accruals [Abstract]
Accrued Expenses	Accrued Expenses Accrued expenses consist of the following as of: March 31, 2019 December 31, 2018 (unaudited) Accrued employee compensation and expenses $ 2,808 $ 3,804 Accrued professional service fees 3,274 2,983 Settlement liability (see note 15) 1,625 — Transition service liability 1,086 — Lease liability 936 — Accrued returns and rebates 231 331 Accrued insurance and taxes 506 625 Other 968 1,413 Total accrued expenses $ 11,434 $ 9,156

Long-Term Debt

Long-Term Debt	3 Months Ended
	Mar. 31, 2019
Debt Disclosure [Abstract]
Long-Term Debt	Long-Term Debt Long-term debt consists of the following as of: March 31, 2019 December 31, 2018 (unaudited) Term loan facililty $ 35,000 $ — Senior secured credit facility — $ 19,500 Payment-in-kind interest — 2,142 Discount on long-term debt — (175) Deferred financing costs (1,109) (277) Long-term debt $ 33,891 $ 21,190 Future minimum principal payments of long-term debt by year are as follows: 2019 $ — 2020 — 2021 11,667 2022 14,000 2023 9,333 Thereafter — $ 35,000

Long-Term Liabilities

Long-Term Liabilities	3 Months Ended
	Mar. 31, 2019
Other Liabilities Disclosure [Abstract]
Long-Term Liabilities	Long-Term Liabilities  Long-term liabilities consists of $1,629 for the long-term lease liability and $1,625 for the non-current portion of a dispute settlement (see note 15).

Stock Based Compensation

Stock Based Compensation	3 Months Ended
	Mar. 31, 2019
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Stock Based Compensation	Stock Based Compensation In 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 March 31, 2019 is presented below. Options Weighted Average Exercise Price Weighted Average Remaining Contractual Term Aggregate Intrinsic Value Options outstanding, December 31, 2018 1,502,756 $5.63 7.7 years $217 Options exercised (1,573) $1.82 Options forfeited (19,552) $6.23 Options vested and expected to vest, March 31, 2019 1,481,631 $5.63 7.5 years $361 Options exercisable 860,420 $4.85 6.7 years $321 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: Three Months Ended March 31, 2018 Risk free interest rate 2.7 % Expected dividend yield — % Estimated volatility 63.2 % Expected life 5.8 years No options were granted during the three months ended March 31, 2019. Additional information regarding options is as follows: Three Months Ended March 31, 2019 Three Months Ended March 31, 2018 Stock compensation cost $ 323 $ 323 Weighted-average grant date fair value of options granted during the period $ — $ 3.86 Aggregate intrinsic value of options exercised during the period $ 2 $ 170 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 March 31, 2019 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 March 31, 2019 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. Unrecognized compensation expense related to unvested options was approximately $2,287 at March 31, 2019, with a remaining amortization period of 2.5 years. A summary of the restricted stock unit activity under the Company's Equity Plans as of March 31, 2019 is presented below. Units Weighted Average Grant Date Fair Value Aggregate Intrinsic Value Unvested units, December 31, 2018 94,940 $6.21 $328 Restricted stock units vested (21,249) $6.58 Unvested units, March 31, 2019 73,691 $6.11 $276 Unrecognized compensation expense related to unvested restricted stock units was approximately $387 at March 31, 2019, with a remaining amortization period of 2.6 years.

Income Taxes

Income Taxes	3 Months Ended
	Mar. 31, 2019
Income Tax Disclosure [Abstract]
Income Taxes	Income Taxes The provision for income taxes for the three months ended March 31, 2019 and 2018 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.

Net Loss Per Share

Net Loss Per Share	3 Months Ended
	Mar. 31, 2019
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 that 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 March 31, 2019 2018 Warrants for common stock 251,189 251,891 Common stock options 1,481,631 1,525,688 Restricted stock units 73,691 80,579 1,806,511 1,858,158

Liquidity and Capital Resources

Liquidity and Capital Resources	3 Months Ended
	Mar. 31, 2019
Debt Disclosure [Abstract]
Liquidity and Capital Resources	Liquidity and Capital Resources The Company has experienced operating losses since inception and occasional debt covenant violations and has an accumulated deficit of $225,534 as of March 31, 2019. 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 and meet debt covenant requirements will depend upon its level of future revenue and operating cash flow and its ability to access additional funding through either equity offerings, issuances of debt instruments or both. Management believes its existing cash and cash equivalents and product revenues will be sufficient to meet covenant, liquidity and capital requirements for at least the next twelve months, although there can be no assurances that the Company will be able to do so. The Company believes it has additional sources of liquidity through the remaining capacity of their shelf registration statement or cost reduction actions. The Company periodically evaluates its liquidity requirements, alternative uses of capital, capital needs and available resources. As a result of this process, the Company has in the past, and may in the future, explore alternatives to finance its business plan, including, but not limited to, a public offering of its common stock, private equity or debt financings, reduction of planned expenditures, or other sources.  In March 2019, the Company entered into the Facility with Solar to borrow $35,000 of which $22,372 of the proceeds were used to repay the Company's previous senior secured credit facility. The Facility includes affirmative, negative and financial covenants, including maintenance of a minimum cash balance of $10,000 and minimum product revenue requirements. While the Company believes it will remain in compliance with these covenants, if it is unable to do so, the Company would seek covenant waivers which may or may not be granted by the lender and in the event the lender may also require the repayment of the Term Loan Facility could be accelerated at the lender's discretion.

Fair Value Measurements

Fair Value Measurements	3 Months Ended
	Mar. 31, 2019
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 $35,000 at March 31, 2019. 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	3 Months Ended
	Mar. 31, 2019
Segment Reporting [Abstract]
Segment and Geographic Information	Segment and Geographic Information Operating 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. The Company's products are principally sold in the U.S. No other countries are individually significant. 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 March 31, 2019 Three Months Ended March 31, 2018 (unaudited) U.S. OUS Total Revenues % Total Revenues U.S. OUS Total Revenues % Total Revenues ESS $ 3,007 $ 3,491 $ 6,498 49.2 % $ 2,497 $ 3,270 $ 5,767 36.6 % IGB 1,459 2,863 4,322 32.7 % 1,611 2,918 4,529 28.8 % Endo-bariatric 4,466 6,354 10,820 81.9 % 4,108 6,188 10,296 65.4 % Surgical — 1,700 1,700 12.9 % 2,938 2,266 5,204 33.1 % Other 683 8 691 5.2 % 233 10 243 1.5 % Total revenues $ 5,149 $ 8,062 $ 13,211 100.0 % $ 7,279 $ 8,464 $ 15,743 100.0 % % Total revenues 39.0 % 61.0 % 46.2 % 53.8 % Total distributor sales were 27.9% and 19.7% of total OUS revenues for the three months ended March 31, 2019 and 2018, respectively. The next largest individual country outside the U.S. was 9.2% and 7.7% of total revenues for the three months ended March 31, 2019 and 2018, respectively. The following table represents property, equipment and right-of-use assets, net based on the physical geographic location of the asset: March 31, 2019 December 31, 2018 (unaudited) United States $ 3,384 $ 2,337 Costa Rica 4,027 3,347 Other 597 213 Total property, equipment and right-of-use assets, net $ 8,008 $ 5,897

Subsequent Event

Subsequent Event	3 Months Ended
	Mar. 31, 2019
Subsequent Events [Abstract]
Subsequent Event	Subsequent Event In April 2019, the Company entered into a settlement agreement with Allergan, Inc., to resolve the dispute related to amounts charged for inventory purchases and transition services provided through 2016, after the asset acquisition of the obesity intervention business in December 2013. The settlement agreement provides for the payment of $3,250 to completely discharge all remaining responsibility for these charges. The settlement amount is due in two equal installments in May 2019 and April 2020. Prior to this settlement, the Company's accounts payable and accrued liabilities included $8,859 related to charged and disputed purchases and services. The Company recognized a gain of $5,609 for the three months ended March 31, 2019, as a result of this settlement agreement.

Significant Accounting Polici_2

Significant Accounting Policies (Policies)	3 Months Ended
	Mar. 31, 2019
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 gastroenterologists and surgeons in a variety of settings to provide interventional therapy to patients who suffer from various gastrointestinal conditions including obesity and the many co-morbidities associated with obesity. The Company's core products include the OverStitch™ Endoscopic Suturing System ("ESS") and the Orbera ® Intragastric Balloon System ("IGB"), which together comprise the Company's Endo-bariatric products. All devices are regulated by the U.S. Food and Drug Administration ("FDA") or an equivalent regulatory body outside the U.S. We have sales distribution offices in England, Australia, Italy, and Brazil that oversee regional sales and distribution activities outside the U.S., a products manufacturing facility in Costa Rica and a device analysis lab in California. All other activities are managed and operated from facilities in Austin, Texas.
Other Revenue	Other Revenue In connection with the December 2018 sale of the Surgical product line, the Company entered into a transition services agreement, supply agreement and distribution agreement pursuant to which the Company will provide specific transition services for designated periods of time for each service, will manufacture Surgical products for up to two one
Recent Accounting Pronouncements	Recent Accounting Pronouncements On January 1, 2019, the Company adopted the provisions of ASU 2016-02, Leases ("ASU 2016-02") under the modified retrospective approach, chose not to adjust comparative periods, and elected the package of practical expedients permitted under the transition guidance, which among other things, allowed us to carry forward the historical lease classification. The cumulative-effect adjustment made to the opening balance of retained earnings as of January 1, 2019 was $78. All significant lease arrangements are generally recognized at lease commitment. Operating lease right-of-use assets and liabilities are recognized at commencement, except for leases with an initial term of 12 months or less, for which lease expense is recognized as incurred over the lease term. Right-of-use assets represent the Company’s right to use an underlying asset during the reasonably certain lease term, and lease liabilities represent the Company’s obligation to make lease payments arising from the lease. Lease terms may include options to extend or terminate the lease when its reasonably certain that the Company will exercise that option. Operating lease right-of-use assets and liabilities are recognized at commencement date based on the present value of lease payments over the lease term. The Company primarily uses its incremental borrowing rate based on the information available at commencement date in determining the present value of lease payments. Operating lease right-of-use assets include any lease payments related to initial direct costs and prepayments and excludes lease incentives. Lease expense is recognized on a straight-line basis over the lease term. The Company has lease agreements with lease and non-lease components, which are generally accounted for separately. In January 2017, the FASB issued ASU 2017-04, Intangibles - Goodwill and Other: Simplifying the Test for Goodwill Impairment (“ASU 2017-04”) to simplify the accounting for goodwill impairment. The guidance removes step two of the goodwill impairment test, which requires a hypothetical purchase price allocation. A goodwill impairment will now be the amount by which a reporting unit’s carrying value exceeds its fair value, not to exceed the carrying amount of goodwill. Entities will continue to have the option to perform a qualitative assessment to determine if a quantitative impairment test is necessary. ASU 2017-04 will be effective for the Company for annual and interim reporting in fiscal years beginning after December 15, 2019.
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)	3 Months Ended
	Mar. 31, 2019
Inventory Disclosure [Abstract]
Schedule of Inventory	Inventory consists of the following as of: March 31, 2019 December 31, 2018 (unaudited) Raw materials $ 3,723 $ 3,806 Work in progress 281 352 Finished goods 6,403 5,774 Total inventory $ 10,407 $ 9,932

Property, Equipment and Right_2

Property, Equipment and Right-of-Use Assets (Tables)	3 Months Ended
	Mar. 31, 2019
Property, Plant and Equipment [Abstract]
Schedule of Property and Equipment	Property, equipment and right-of-use assets consists of the following: Depreciable Lives March 31, 2019 December 31, 2018 Equipment 5 years $ 7,583 $ 7,510 Right-of-use asset 2,789 — Furniture, fixtures and tooling 4-8 years 2,231 2,223 Computer hardware 3-5 years 1,337 1,326 Leasehold improvements 3-5 years 1,400 1,400 Construction in process 104 130 15,444 12,589 Less accumulated depreciation (7,436) (6,692) Property and equipment, net $ 8,008 $ 5,897
Operating Lease Maturity	As of March 31, 2019, the maturities of the Company's operating lease liabilities are as follows: 2019 $ 944 2020 1,023 2021 820 2022 142 2023 96 Thereafter 30 Total lease payments 3,055 Less imputed interest (490) Total operating lease liabilities $ 2,565

Accrued Expenses (Tables)

Accrued Expenses (Tables)	3 Months Ended
	Mar. 31, 2019
Payables and Accruals [Abstract]
Schedule of Accrued Expenses	Accrued expenses consist of the following as of: March 31, 2019 December 31, 2018 (unaudited) Accrued employee compensation and expenses $ 2,808 $ 3,804 Accrued professional service fees 3,274 2,983 Settlement liability (see note 15) 1,625 — Transition service liability 1,086 — Lease liability 936 — Accrued returns and rebates 231 331 Accrued insurance and taxes 506 625 Other 968 1,413 Total accrued expenses $ 11,434 $ 9,156

Long-Term Debt (Tables)

Long-Term Debt (Tables)	3 Months Ended
	Mar. 31, 2019
Debt Disclosure [Abstract]
Schedule of Long-term Debt	Long-term debt consists of the following as of: March 31, 2019 December 31, 2018 (unaudited) Term loan facililty $ 35,000 $ — Senior secured credit facility — $ 19,500 Payment-in-kind interest — 2,142 Discount on long-term debt — (175) Deferred financing costs (1,109) (277) Long-term debt $ 33,891 $ 21,190
Schedule of Maturities of Long-term Debt	Future minimum principal payments of long-term debt by year are as follows: 2019 $ — 2020 — 2021 11,667 2022 14,000 2023 9,333 Thereafter — $ 35,000

Stock Based Compensation (Table

Stock Based Compensation (Tables)	3 Months Ended
	Mar. 31, 2019
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 March 31, 2019 is presented below. Options Weighted Average Exercise Price Weighted Average Remaining Contractual Term Aggregate Intrinsic Value Options outstanding, December 31, 2018 1,502,756 $5.63 7.7 years $217 Options exercised (1,573) $1.82 Options forfeited (19,552) $6.23 Options vested and expected to vest, March 31, 2019 1,481,631 $5.63 7.5 years $361 Options exercisable 860,420 $4.85 6.7 years $321
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: Three Months Ended March 31, 2018 Risk free interest rate 2.7 % Expected dividend yield — % Estimated volatility 63.2 % Expected life 5.8 years
Schedule of Other Stock Option Information	Additional information regarding options is as follows: Three Months Ended March 31, 2019 Three Months Ended March 31, 2018 Stock compensation cost $ 323 $ 323 Weighted-average grant date fair value of options granted during the period $ — $ 3.86 Aggregate intrinsic value of options exercised during the period $ 2 $ 170
Schedule of Restricted Stock Unit Activity	A summary of the restricted stock unit activity under the Company's Equity Plans as of March 31, 2019 is presented below. Units Weighted Average Grant Date Fair Value Aggregate Intrinsic Value Unvested units, December 31, 2018 94,940 $6.21 $328 Restricted stock units vested (21,249) $6.58 Unvested units, March 31, 2019 73,691 $6.11 $276

Net Loss Per Share (Tables)

Net Loss Per Share (Tables)	3 Months Ended
	Mar. 31, 2019
Earnings Per Share [Abstract]
Schedule of Antidilutive Securities Excluded from Computation of Diluted Loss Per Share	Potentially dilutive securities that 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 March 31, 2019 2018 Warrants for common stock 251,189 251,891 Common stock options 1,481,631 1,525,688 Restricted stock units 73,691 80,579 1,806,511 1,858,158

Segment and Geographic Inform_2

Segment and Geographic Information (Tables)	3 Months Ended
	Mar. 31, 2019
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 March 31, 2019 Three Months Ended March 31, 2018 (unaudited) U.S. OUS Total Revenues % Total Revenues U.S. OUS Total Revenues % Total Revenues ESS $ 3,007 $ 3,491 $ 6,498 49.2 % $ 2,497 $ 3,270 $ 5,767 36.6 % IGB 1,459 2,863 4,322 32.7 % 1,611 2,918 4,529 28.8 % Endo-bariatric 4,466 6,354 10,820 81.9 % 4,108 6,188 10,296 65.4 % Surgical — 1,700 1,700 12.9 % 2,938 2,266 5,204 33.1 % Other 683 8 691 5.2 % 233 10 243 1.5 % Total revenues $ 5,149 $ 8,062 $ 13,211 100.0 % $ 7,279 $ 8,464 $ 15,743 100.0 % % Total revenues 39.0 % 61.0 % 46.2 % 53.8 %
Schedule of Long-Lived Assets by Geographic Area	The following table represents property, equipment and right-of-use assets, net based on the physical geographic location of the asset: March 31, 2019 December 31, 2018 (unaudited) United States $ 3,384 $ 2,337 Costa Rica 4,027 3,347 Other 597 213 Total property, equipment and right-of-use assets, net $ 8,008 $ 5,897

Organization and Business Des_2

Organization and Business Description (Details) $ in Thousands	1 Months Ended
	Dec. 31, 2018USD ($)
Surgical Product Line [Member] | Disposal [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Proceeds from sale of assets	$ 10,000

Significant Accounting Polici_3

Significant Accounting Policies (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Jan. 01, 2019
ASU 2016-02 [Member] | Retained Earnings [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Cumulative effect adjustment		$ 78
Surgical Product Line [Member] | Disposal [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Product manufacture period	2 years
Distributor period	1 year

Concentrations (Details)

Concentrations (Details) $ in Thousands	Mar. 31, 2019USD ($)bank	Dec. 31, 2018USD ($)	Mar. 31, 2018USD ($)	Dec. 31, 2017USD ($)
Risks and Uncertainties [Abstract]
Number of banks | bank	4
Cash and cash equivalents and restricted cash | $	$ 30,992	$ 25,007	$ 23,257	$ 31,418

Inventory (Details)

Inventory (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018	Dec. 31, 2018
Inventory Disclosure [Abstract]
Raw materials	$ 3,723		$ 3,806
Work in progress	281		352
Finished goods	6,403		5,774
Total inventory	10,407		$ 9,932
Inventory impairment	40	$ 102
Consigned inventory	$ 354

Property, Equipment and Right_3

Property, Equipment and Right-of-Use Assets (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Dec. 31, 2018
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 15,444	$ 12,589
Less accumulated depreciation	(7,436)	(6,692)
Property and equipment, net	8,008	5,897
Equipment [Member]
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 7,583	7,510
Depreciable Lives	5 years
Right of Use Asset [Member]
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 2,789	0
Furniture Fixtures and Tooling [Member]
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 2,231	2,223
Furniture Fixtures and Tooling [Member] | Minimum [Member]
Property, Plant and Equipment [Line Items]
Depreciable Lives	4 years
Furniture Fixtures and Tooling [Member] | Maximum [Member]
Property, Plant and Equipment [Line Items]
Depreciable Lives	8 years
Computer Hardware [Member]
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 1,337	1,326
Computer Hardware [Member] | Minimum [Member]
Property, Plant and Equipment [Line Items]
Depreciable Lives	3 years
Computer Hardware [Member] | Maximum [Member]
Property, Plant and Equipment [Line Items]
Depreciable Lives	5 years
Leasehold Improvements [Member]
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 1,400	1,400
Leasehold Improvements [Member] | Minimum [Member]
Property, Plant and Equipment [Line Items]
Depreciable Lives	3 years
Leasehold Improvements [Member] | Maximum [Member]
Property, Plant and Equipment [Line Items]
Depreciable Lives	5 years
Construction in Progress [Member]
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 104	$ 130

Property, Equipment and Right_4

Property, Equipment and Right-of-Use Assets (Lease Maturity) (Details) $ in Thousands	Mar. 31, 2019USD ($)
Property, Plant and Equipment [Abstract]
2019	$ 944
2020	1,023
2021	820
2022	142
2023	96
Thereafter	30
Total lease payments	3,055
Less imputed interest	(490)
Total operating lease liabilities	$ 2,565

Property, Equipment and Right_5

Property, Equipment and Right-of-Use Assets (Lease Narrative) (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2019USD ($)
Property, Plant and Equipment [Abstract]
Cash paid within operating cash flows for operating leases	$ 333
Weighted average remaining lease term	2 years 9 months 18 days
Weighted average discount rate, percent	9.90%

Accrued Expenses (Details)

Accrued Expenses (Details) - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018
Payables and Accruals [Abstract]
Accrued employee compensation and expenses	$ 2,808	$ 3,804
Accrued professional service fees	3,274	2,983
Settlement liability (see note 15)	1,625	0
Transition service liability	1,086	0
Lease liability	936	0
Accrued returns and rebates	231	331
Accrued insurance and taxes	506	625
Other	968	1,413
Total accrued expenses	$ 11,434	$ 9,156

Long-Term Debt (Schedule of Lon

Long-Term Debt (Schedule of Long-term Debt) (Details) - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018
Debt Instrument [Line Items]
Discount on long-term debt	$ 0	$ (175)
Deferred financing costs	(1,109)	(277)
Long-term debt	33,891	21,190
Payment in Kind Interest [Member]
Debt Instrument [Line Items]
Long-term debt	0	2,142
Line of Credit [Member] | Term Loan Facility [Member]
Debt Instrument [Line Items]
Long-term debt	35,000	19,500
Line of Credit [Member] | Secured Debt [Member] | Credit Facility [Member]
Debt Instrument [Line Items]
Long-term debt	$ 35,000	$ 19,500

Long-Term Debt (Schedule of Mat

Long-Term Debt (Schedule of Maturity of Long-term Debt) (Details) $ in Thousands	Mar. 31, 2019USD ($)
Debt Disclosure [Abstract]
2019	$ 0
2020	0
2021	11,667
2022	14,000
2023	9,333
Thereafter	0
Total	$ 35,000

Long-Term Debt (Narrative) (Det

Long-Term Debt (Narrative) (Details) - USD ($)	1 Months Ended	3 Months Ended
	Mar. 18, 2019	Mar. 31, 2019
Debt Instrument [Line Items]
Line of credit		$ 35,000,000
Line of Credit [Member] | Term Loan Facility [Member]
Debt Instrument [Line Items]
Line of credit		35,000,000
Increase in limit		15,000,000
Minimum cash balance required		$ 10,000,000
Line of Credit [Member] | Term Loan Facility [Member] | LIBOR [Member]
Debt Instrument [Line Items]
Basis spread on variable rate		7.50%
Line of Credit [Member] | Senior Secured Credit Facility [Member]
Debt Instrument [Line Items]
Repayments of debt		$ 22,372,000
Unamortized deferred financing costs and discount	$ 388,000

Long-Term Liabilities (Details)

Long-Term Liabilities (Details) $ in Thousands	Mar. 31, 2019USD ($)
Other Liabilities Disclosure [Abstract]
Long-term lease liability	$ 1,629
Settlement of the dispute	$ 1,625

Stock Based Compensation (Stock

Stock Based Compensation (Stock Option Activity) (Details) - Stock Option [Member] - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2019	Dec. 31, 2018
Options
Options outstanding, beginning balance (in shares)		1,502,756
Options exercised (in shares)	(1,573)
Options forfeited (in shares)	(19,552)
Options vested and expected to vest (in shares)	1,481,631
Options exercisable (in shares)	860,420
Weighted Average Exercise Price
Weighted average exercise price, beginning balance (in USD per share)		$ 5.63
Options exercised (in USD per share)	$ 1.82
Options forfeited (in USD per share)	6.23
Options vested and expected to vest (in USD per share)	5.63
Options exercisable (in USD per share)	$ 4.85
Weighted Average Remaining Contractual Term
Weighted Average Remaining Contractual Term		7 years 8 months 12 days
Options vested and expected to vest	7 years 6 months
Options exercisable	6 years 8 months 12 days
Aggregate Intrinsic Value
Aggregate intrinsic value		$ 217
Options vested and expected to vest	$ 361
Options exercisable	$ 321

Stock Based Compensation (Fair

Stock Based Compensation (Fair Value of Stock Options) (Details) - Stock Option [Member]	3 Months Ended
	Mar. 31, 2019
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Risk free interest rate	2.70%
Expected dividend yield	0.00%
Estimated volatility	63.20%
Expected life	5 years 9 months 18 days

Stock Based Compensation (Addit

Stock Based Compensation (Additional Information) (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018	Dec. 31, 2018
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock compensation cost	$ 323	$ 323
Unrecognized compensation expense related to unvested options	$ 2,287
Remaining amortization period	2 years 6 months
Stock Option [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Options granted (in shares)	0
Stock compensation cost	$ 323	$ 323
Weighted-average grant date fair value of options granted during the period (in USD per share)	$ 0	$ 3.86
Aggregate intrinsic value of options exercised during the period	$ 2	$ 170
Options granted in period (in shares)			1,502,756
Restricted stock units [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Remaining amortization period	2 years 7 months 6 days
Unrecognized compensation expense related to unvested restricted stock units	$ 387

Stock Based Compensation (Restr

Stock Based Compensation (Restricted Stock Units Activity) (Details) - Restricted stock units [Member] - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended
	Mar. 31, 2019	Dec. 31, 2018
Number of Units
Unvested Units (shares)	94,940
Restricted stock units vested (shares)	(21,249)
Unvested Units (shares)	73,691
Weighted-Average Grant Date Fair Value
Unvested Units (USD per share)	$ 6.21
Restricted stock units vested (USD per share)	6.58
Unvested Units (USD per share)	$ 6.11
Aggregate Intrinsic Value
Aggregate Intrinsic Value	$ 276	$ 328

Income Taxes (Details)

Income Taxes (Details)	Mar. 31, 2019USD ($)
Income Tax Disclosure [Abstract]
Unrecognized tax benefits	$ 0
Accrued interest	0
Tax penalties	$ 0

Net Loss Per Share (Details)

Net Loss Per Share (Details) - shares	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of diluted loss per share	1,806,511	1,858,158
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	251,189	251,891
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	1,481,631	1,525,688
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	73,691	80,579

Liquidity and Capital Resourc_2

Liquidity and Capital Resources (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2019	Dec. 31, 2018
Debt Instrument [Line Items]
Accumulated deficit	$ 225,534	$ 222,808
Line of credit	35,000
Term Loan Facility [Member] | Line of Credit [Member]
Debt Instrument [Line Items]
Line of credit	35,000
Minimum cash balance required	10,000
Senior Secured Credit Facility [Member] | Line of Credit [Member]
Debt Instrument [Line Items]
Repayments of debt	$ 22,372

Fair Value Measurements (Detail

Fair Value Measurements (Details) $ in Thousands	Mar. 31, 2019USD ($)
Fair Value Disclosures [Abstract]
Fair value of long-term debt	$ 35,000

Segment and Geographic Inform_3

Segment and Geographic Information (Segment Information) (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2019USD ($)segment	Mar. 31, 2018USD ($)
Segment Reporting [Abstract]
Number of reportable segments | segment	1
Revenue, Major Customer [Line Items]
Revenues	$ 13,211	$ 15,743
Segment Revenue [Member] | Product Risk [Member]
Revenue, Major Customer [Line Items]
Percentage of revenue or sales	100.00%	100.00%
United States [Member]
Revenue, Major Customer [Line Items]
Revenues	$ 5,149	$ 7,279
United States [Member] | Segment Revenue [Member] | Product Risk [Member]
Revenue, Major Customer [Line Items]
Percentage of revenue or sales	39.00%	46.20%
OUS [Member]
Revenue, Major Customer [Line Items]
Revenues	$ 8,062	$ 8,464
OUS [Member] | Segment Revenue [Member] | Product Risk [Member]
Revenue, Major Customer [Line Items]
Percentage of revenue or sales	61.00%	53.80%
OUS [Member] | Distributor Sales [Member] | Product Risk [Member]
Revenue, Major Customer [Line Items]
Percentage of revenue or sales	27.90%	19.70%
Non-US, Next Largest Single Country [Member] | Distributor Sales [Member] | Product Risk [Member]
Revenue, Major Customer [Line Items]
Percentage of revenue or sales	9.20%	7.70%
ESS [Member]
Revenue, Major Customer [Line Items]
Revenues	$ 6,498	$ 5,767
ESS [Member] | Segment Revenue [Member] | Product Risk [Member]
Revenue, Major Customer [Line Items]
Percentage of revenue or sales	49.20%	36.60%
ESS [Member] | United States [Member]
Revenue, Major Customer [Line Items]
Revenues	$ 3,007	$ 2,497
ESS [Member] | OUS [Member]
Revenue, Major Customer [Line Items]
Revenues	3,491	3,270
IGB [Member]
Revenue, Major Customer [Line Items]
Revenues	$ 4,322	$ 4,529
IGB [Member] | Segment Revenue [Member] | Product Risk [Member]
Revenue, Major Customer [Line Items]
Percentage of revenue or sales	32.70%	28.80%
IGB [Member] | United States [Member]
Revenue, Major Customer [Line Items]
Revenues	$ 1,459	$ 1,611
IGB [Member] | OUS [Member]
Revenue, Major Customer [Line Items]
Revenues	2,863	2,918
Endo-bariatric [Member]
Revenue, Major Customer [Line Items]
Revenues	$ 10,820	$ 10,296
Endo-bariatric [Member] | Segment Revenue [Member] | Product Risk [Member]
Revenue, Major Customer [Line Items]
Percentage of revenue or sales	81.90%	65.40%
Endo-bariatric [Member] | United States [Member]
Revenue, Major Customer [Line Items]
Revenues	$ 4,466	$ 4,108
Endo-bariatric [Member] | OUS [Member]
Revenue, Major Customer [Line Items]
Revenues	6,354	6,188
Surgical [Member]
Revenue, Major Customer [Line Items]
Revenues	$ 1,700	$ 5,204
Surgical [Member] | Segment Revenue [Member] | Product Risk [Member]
Revenue, Major Customer [Line Items]
Percentage of revenue or sales	12.90%	33.10%
Surgical [Member] | United States [Member]
Revenue, Major Customer [Line Items]
Revenues	$ 0	$ 2,938
Surgical [Member] | OUS [Member]
Revenue, Major Customer [Line Items]
Revenues	1,700	2,266
Other [Member]
Revenue, Major Customer [Line Items]
Revenues	$ 691	$ 243
Other [Member] | Segment Revenue [Member] | Product Risk [Member]
Revenue, Major Customer [Line Items]
Percentage of revenue or sales	5.20%	1.50%
Other [Member] | United States [Member]
Revenue, Major Customer [Line Items]
Revenues	$ 683	$ 233
Other [Member] | OUS [Member]
Revenue, Major Customer [Line Items]
Revenues	$ 8	$ 10

Segment and Geographic Inform_4

Segment and Geographic Information (Long-Lived Assets by Geographic Area) (Details) - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018
Revenues from External Customers and Long-Lived Assets [Line Items]
Total property, equipment and right-of-use assets, net	$ 8,008	$ 5,897
United States [Member]
Revenues from External Customers and Long-Lived Assets [Line Items]
Total property, equipment and right-of-use assets, net	3,384	2,337
Costa Rica [Member]
Revenues from External Customers and Long-Lived Assets [Line Items]
Total property, equipment and right-of-use assets, net	4,027	3,347
Other [Member]
Revenues from External Customers and Long-Lived Assets [Line Items]
Total property, equipment and right-of-use assets, net	$ 597	$ 213

Subsequent Event (Details)

Subsequent Event (Details) $ in Thousands	1 Months Ended	3 Months Ended
	Apr. 30, 2019USD ($)installment	Mar. 31, 2019USD ($)	Mar. 31, 2018USD ($)	Mar. 30, 2019USD ($)
Subsequent Event [Line Items]
Accounts payable and accrued liabilities				$ 8,859
Settlement gain		$ 5,609	$ 0
Subsequent Event [Member]
Subsequent Event [Line Items]
Settlement agreement	$ 3,250
Number of installments | installment	2