Reinforced POSE: the 18-Plication Solution

Abstract

Background: Obesity is one of the main challenges in the first world nowadays. New alternatives are needed and endoscopic endoluminal approaches are gaining importance against the risky surgery and the non-efficient pharmacological treatments. Nevertheless, these techniques seem to be inefficient in obese III patients. The aim of the study is to demonstrate the safety and efficiency of the new reinforced POSE 18-plication protocol.

Methods: Mean body mass index (BMI) ≈ 47 kg/m² obese type III patients were treated in different Spanish centers with the new POSE method consisting of 18 plications in the stomach body. On the other hand, 15 lower body mass patients BMI ≈ 40 kg/m² were treated with the standard POSE method previously described.

Results: Three months follow-up shows an overall % total weight loss (TWL) and % excess weight loss (EWL) of 15% and 41% respectively for standard POSE and 17% and 36% for the new reinforced POSE18. Both are equally safe and the endpoint weight loss objectives are reached. Endoluminal procedures have been demonstrated to be useful in overweight and obese type I/II. However, bariatric surgery is recommended for higher BMI > 40 kg/m². We successfully applied a non-standard POSE protocol and the patients reached 17%TWL in 3 months.

Conclusions: Our study shows that reinforced POSE 18 can be successfully applied in obese type III; it is safer than bariatric surgery and there are no associated risks when compared with standard endoscopic surgery.

Keywords: Bariatric; Endoscopic; Meta-analysis; POSE; Satiety; Weight loss.