Endoscopy 2018; 50(12): 1156-1162
DOI: 10.1055/a-0630-1224
Original article
© Georg Thieme Verlag KG Stuttgart · New York

Endoscopic gastric reduction with an endoluminal suturing device: a multicenter prospective trial with 1-year follow-up

Vincent Huberty
1   Department of Gastroenterology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
,
Evzen Machytka
2   Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
,
Ivo Boškoski
3   Policlinico Gemelli Foundation, Rome, Italy
,
Marie Barea
1   Department of Gastroenterology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
,
Guido Costamagna
4   Catholic University of Rome, Rome, Italy
,
Jacques Deviere
1   Department of Gastroenterology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
› Author Affiliations
TRIAL REGISTRATION: Multicenter prospective trial NCT02582229 at clinicaltrials.gov
Further Information

Publication History

submitted 18 January 2018

accepted after revision 16 April 2018

Publication Date:
15 June 2018 (online)

Abstract

Background Obesity is the pandemic disease of this century. Surgery is the only effective treatment but cannot be offered to every patient. Endoscopic sutured gastroplasty is a minimally invasive technique that may potentially fill the gap between surgery and behavioral therapy. In this study, we prospectively investigated the efficacy and safety of a novel suturing device.

Methods After a pre-bariatric multidisciplinary work-up, class 1 and 2 obese patients were included. Using a simple triangulation platform, transmural sutures with serosa-to-serosa apposition were performed in the gastric cavity. Patients were followed according to the same routines as those performed for bariatric procedures.

Results Between November 2015 and December 2016, 51 patients were included across three European Centers. Mean body mass index at baseline was 35.1 kg/m2 (SD 3.0). Excess weight loss and total body weight loss at 1 year were 29 % (SD 28) and 7.4 % (SD 7), respectively, for the whole cohort (45 patients). At follow-up gastroscopy, 88 % of sutures were still in place (30 patients). No severe adverse events were observed.

Conclusions Endoscopic sutured gastroplasty using this novel device is safe and achieved weight loss results in line with criteria expected for these endoluminal techniques. Further prospective studies vs. placebo or nutritional support are needed.

 
  • References

  • 1 Wang YC, McPherson K, Marsh T. et al. Health and economic burden of the projected obesity trends in the USA and the UK. Lancet 2011; 378: 815-825
  • 2 Sjöström L, Narbro K, Sjöström CD. et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med 2007; 357: 741-752
  • 3 Buchwald H, Avidor Y, Braunwald E. et al. Bariatric surgery: a systematic review and meta-analysis. JAMA 2004; 292: 1724-1737
  • 4 American College of Cardiology/American Heart Association Task Force on Practice Guidelines, Obesity Expert Panel 2013. Executive summary: Guidelines (2013) for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Obesity Society published by the Obesity Society and American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Based on a systematic review from the The Obesity Expert Panel, 2013. Obesity (Silver Spring) 2014; 22: S5-39
  • 5 Fried M, Yumuk V, Oppert JM. et al. Interdisciplinary European guidelines on metabolic and bariatric surgery. Obes Surg 2014; 24: 42-55
  • 6 Mechanick JI, Youdim A, Jones DB. et al. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient – 2013 update: cosponsored by American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery. Obesity (Silver Spring) 2013; 21: S1-27
  • 7 Turk MW, Yang K, Hravnak M. et al. Randomized clinical trials of weight loss maintenance: a review. J Cardiovasc Nurs 2009; 24: 58-80
  • 8 Sullivan S, Edmundowicz SA, Thompson CC. Endoscopic bariatric and metabolic therapies: new and emerging technologies. Gastroenterology 2017; 152: 1791-1801
  • 9 Sullivan S, Swain JM, Woodman G. et al. Randomized sham-controlled trial evaluating efficacy and safety of endoscopic gastric plication for primary obesity: The ESSENTIAL trial. Obesity (Silver Spring) 2017; 25: 294-301
  • 10 ASGE Bariatric Endoscopy Task Force and ASGE Technology Committee, Abu Dayyeh BK, Kumar N et al. ASGE Bariatric Endoscopy Task Force systematic review and meta-analysis assessing the ASGE PIVI thresholds for adopting endoscopic bariatric therapies. Gastrointest Endosc 2015; 82: 425-438.e5
  • 11 Huberty V, Ibrahim M, Hiernaux M. et al. Safety and feasibility of an endoluminal-suturing device for endoscopic gastric reduction (with video). Gastrointest Endosc 2017; 85: 833-837
  • 12 Jain D, Bhandari BS, Arora A. et al. Endoscopic sleeve gastroplasty – a new tool to manage obesity. Clin Endosc 2017; 50: 552-561
  • 13 Thompson CC, Abu Dayyeh BK, Kushner R. et al. Percutaneous gastrostomy device for the treatment of class II and class III obesity: results of a randomized controlled trial. Am J Gastroenterol 2017; 112: 447-457
  • 14 Lopez-Nava G, Sharaiha RZ, Vargas EJ. et al. Endoscopic sleeve gastroplasty for obesity: a multicenter study of 248 patients with 24 months follow-up. Obes Surg 2017; 27: 2649-2655