BACKGROUND: Medical treatment of obesity often fails, and surgical treatment, although successful, is aggressive. OBJECTIVE: To evaluate the short-term safety and efficacy of an endoscopic restrictive implant procedure in the treatment of obesity. DESIGN: Prospective, observational study. SETTING: Tertiary-care referral hospital in The Netherlands. PATIENTS: This study involved 13 patients with body mass indexes of between 40 and 50 kg/m(2) or between 35 and 40 kg/m(2) with obesity-related comorbidities. INTERVENTION: A new transoral endoscopic restrictive implant procedure in the treatment of obesity. MAIN OUTCOME MEASUREMENTS: Safety of the procedure, percentage of excess weight loss, change in body mass index. RESULTS: In 1 patient, the procedure was abandoned after a gastric perforation related to stapler malfunctioning. In 2 patients, pneumoperitoneum was detected. This was desufflated with a percutaneous hollow needle in one patient and treated conservatively in the other. After these complications, technical adjustments were made in the procedure, and no subsequent procedural complications were seen. At 3 months postprocedure, patients obtained a median excess weight loss of 28%. Median body mass index decreased from 42.1 to 37.9 kg/m(2). LIMITATIONS: Small number of patients. CONCLUSION: Preliminary results of this transoral endoscopic restrictive implant system for the treatment of obesity showed successful placement in 12 of 13 patients. Procedural complications occurred in 3 patients. Weight loss was comparable to that of laparoscopic gastric band placement. Further long-term studies are under way. Copyright 2010 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.
BACKGROUND: Medical treatment of obesity often fails, and surgical treatment, although successful, is aggressive. OBJECTIVE: To evaluate the short-term safety and efficacy of an endoscopic restrictive implant procedure in the treatment of obesity. DESIGN: Prospective, observational study. SETTING: Tertiary-care referral hospital in The Netherlands. PATIENTS: This study involved 13 patients with body mass indexes of between 40 and 50 kg/m(2) or between 35 and 40 kg/m(2) with obesity-related comorbidities. INTERVENTION: A new transoral endoscopic restrictive implant procedure in the treatment of obesity. MAIN OUTCOME MEASUREMENTS: Safety of the procedure, percentage of excess weight loss, change in body mass index. RESULTS: In 1 patient, the procedure was abandoned after a gastric perforation related to stapler malfunctioning. In 2 patients, pneumoperitoneum was detected. This was desufflated with a percutaneous hollow needle in one patient and treated conservatively in the other. After these complications, technical adjustments were made in the procedure, and no subsequent procedural complications were seen. At 3 months postprocedure, patients obtained a median excess weight loss of 28%. Median body mass index decreased from 42.1 to 37.9 kg/m(2). LIMITATIONS: Small number of patients. CONCLUSION: Preliminary results of this transoral endoscopic restrictive implant system for the treatment of obesity showed successful placement in 12 of 13 patients. Procedural complications occurred in 3 patients. Weight loss was comparable to that of laparoscopic gastric band placement. Further long-term studies are under way. Copyright 2010 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.
Authors: Francesco Maria Carrano; Miroslav P Peev; John K Saunders; Marcovalerio Melis; Valeria Tognoni; Nicola Di Lorenzo Journal: Obes Surg Date: 2020-02 Impact factor: 4.129