Gastric clipping for morbid obesity: the initial results of a clinical trial

Abstract

Objective: We inaugurated a clinical trial using laparoscopic gastric clipping to treat morbid obesity patients. We report the 2-year results.

Design: Ten patients with morbid obesity underwent laparoscopic gastric clipping to promote weight loss. A novel metallic clip was applied to the outside wall of the upper fundus of the stomach by a laparoscopic technique. The clip allowed a restricted passage of meals through a mucosa tunnel 0.4-0.6 cm in diameter.

Measurements: The body weight and feeding status of the patients were monitored periodically. Barium meal studies at 1 day and 2 years after the clipping were compared.

Results: Ten patients (3 men, 7 women) with body weight of 117 +/- 18.2 kg (101.8-156.5) and body mass index (BMI) 43.4 +/- 5.2 (40-56) were included. The gastric clips were successfully applied laparoscopically in all patients. The operation time ranged from 65 to 210 minutes and showed a learning curve. The excess body weight loss was progressive and long lasting postoperatively. The mean BMI and percentage of excess body weight loss at the 2-year period was 32.01 +/- 4.89 kg/m(2) and 64.4%, respectively. The mean BMI 2 years after surgery was significantly decreased compared with that before surgery. Barium meal studies did not show significant sliding or migration of the clips at 2-year follow-up. No mortality or late complications occurred.

Conclusions: Our results indicate that laparoscopic gastric clipping is a safe, simple, and effective treatment for patients with morbid obesity.