EFFICACY AND SAFETY OF THE POSE PROCEDURE

Aims Primary obesity surgery endolumenal method (POSE) is an incisionless weight-loss procedure in which full-thickness suture anchors are placed endoscopically in the stomach of obese subjects modifying gastric anatomy and helping the patients to change their nutritional habits and life style. Our aim was to describe its efficacy and safety.

Methods Prospective, non-comparative, observational evaluation of the POSE procedure efficacy and adverse events in a cohort of 222 obese subjects enrolled to a 12 months multidisciplinary schedule including nutritional and psychological assessment, who completed at least 6-months of follow-up, during 2015–2017. All patients signed the proper informed consent, and were performed by a single endoscopist (AJPG) with a previous background of 300 procedures, under antibiotics and GA in an inpatient basis. The patients took 12–18 gastric suture anchor plications. Demographic, technical features, clinical symptoms, and were described. Main outcomes were TBWL, TBWL%, EWL%, and final BMI, at 3, 6 and 12 months.

Results n = 222 obese 1–3 patients (41,1 years, 99.8 kg, BMI 36,92 kg/m2) were operated without intraprocedural major adverse events; 219 and 111 reached the 6 and 12 months f-up endpoints, respectively. Initial weight and BMI were significantly reduced at 3, 6 and 12 months, with a TBWL% of 9.2, 14.7 and 21.3 % at 3, 6 and 12 months and an EWL% at 3, 6 and 12 months of 66.7, 82.5 and 96.2%. Abdominal pain was the predominant symptom, 20% requiring opioids. Mean operating time = 22 minutes. There were 2 upper bleedings and 1 asymptomatic pneumoperitoneum, all managed conservatively; 98.6% were discharged within the first 24 hours.

Conclusions POSE is a safe, short interventional time, and well tolerated procedure for classes I–III obesity patients, and, associated to nutritional counseling and assessment shows good efficacy in terms of total body and excess weight loss at 6 and 12 months.