The Primary Obesity Surgery Endolumenal (POSE) procedure: one-year patient weight loss and safety outcomes.

BACKGROUND: Obesity is at epidemic proportions and increasing. Bariatric surgical procedures have demonstrated better durable weight loss than diet and exercise; however, risk may limit adoption of these procedures. Endoscopic procedures may offer less risk, lower cost, and satisfactory results, but limited safety and outcome data is available. The present report describes the Primary Obesity Surgery Endolumenal (POSE(™)) procedure, perioperative care, and 1-year safety and weight loss outcomes for a single center. METHODS: One hundred forty-seven patients undergoing the POSE procedure between July 2011 and January 2013 were followed for 1 year. Overall patient status and weight data were collected at baseline and at 3, 6, and 12 months. Outcomes included change in total weight loss (TWL), percentage of TWL (%TWL), percentage of excess weight loss (%EWL), and adverse events. RESULTS: Patients tolerated the procedure well with no serious short-term or long-term adverse events. All but 1 patient were discharged within 24 hours of the procedure. Baseline body mass index (BMI) was 38.0 ± 4.8 kg/m(2). Initial weight (106.8 ± 18.2 kg) was significantly reduced at 3, 6, and 12 months. At 1 year, 116 patients (79% of total) who were available for follow-up had a mean TWL of 16.6 ± 9.7 kg, %TWL of 15.1 ± 7.8, and %EWL of 44.9 ± 24.4. CONCLUSION: After 1-year follow-up, POSE was considered an effective, safe and well tolerated procedure for the treatment of patients with obesity.

Endoscopic sleeve gastroplasty for the treatment of obesity.

BACKGROUND AND STUDY AIMS: Emerging endoscopic techniques are minimally invasive and can mimic the anatomic alterations achieved by surgical sleeve gastrectomy. The objective of this study was to evaluate endoscopic sleeve gastroplasty. PATIENTS AND METHODS: This was a prospective, single-center study of 20 patients who underwent flexible endoscopic suturing for endoluminal gastric volume reduction. A multidisciplinary team provided postprocedure care. Patient status and weight were recorded at baseline, and at 1, 3, and 6 months after the procedure. RESULTS: There were no adverse events and all patients were discharged in less than 24 hours. Baseline mean body mass index was 38.5 kg/m(2), and mean age was 45.8 years. Initial body weight (108.5 ±â€Š14.9 kg) was significantly reduced. Following the procedure, the mean body weight reduction was 8.2 ±â€Š2.5 kg at 1 month (% of initial weight loss 7.6 %; P < 0.05), 13.6 ±â€Š4.8 kg at 3 months (12.4 % weight loss; P < 0.05), and 19.3 ±â€Š8.9 kg at 6 months (17.8 % weight loss; P < 0.05). CONCLUSION: Endoscopic sleeve gastroplasty can be effective for the treatment of patients with obesity.