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. 2020 Jan 17;5(3):91-93.
doi: 10.1016/j.vgie.2019.11.010. eCollection 2020 Mar.

Modified primary obesity surgery endoluminal (POSE-2) procedure for the treatment of obesity

Gontrand Lopez-Nava  1 , Ravishankar Asokkumar  1   2 , Roman Turró Arau  3 , Manoel Galvao Neto  4 , Barham Abu Dayyeh  5
Affiliations

Modified primary obesity surgery endoluminal (POSE-2) procedure for the treatment of obesity

Gontrand Lopez-Nava et al. VideoGIE. .
No abstract available

Keywords: POSE, primary obesity surgery endoluminal.

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Figures

Figure 1
Figure 1
POSE-2 suturing technique. A, We insert the transport with the patient in a supine position and use a laparoscopic CO2 insufflator. We maintain a neutral position throughout the procedure so that the accessories are aligned at a 5 o’clock to 6 o’clock position. We advance the g-Lix and capture the tissue at the distal body. We make sure the g-Lix can be pulled easily and is not capturing adjacent structures. B, We open the jaws of the g-Prox and orient it in an anteroposterior direction for the first plication in the distal body. C, We traction the helix, and at the same time advance the g-Prox so that the tissue fills the space between the jaws to ensure capturing 6.6 cm of tissue. We then close the jaws of the g-Prox to hold the tissue. D, We advance the needle through the tissue fold. E, We release the distal snowshoe anchor. F, We retract the g-Lix. G, We open the jaws of the g-Prox in a controlled fashion and avoid trapping of the distal anchor at the tip of the jaw. We release the proximal snowshoe anchor. H, We cinch the anchors together to form a plicated fold. I, We create a suture excess by gently removing and reloading the g-Cath. J, We then cut the excess suture using the cutting mechanism at the distal end of the g-Prox. We follow these steps and place 16 to 18 plications throughout the body of the stomach to reduce its size and volume.
Figure 2
Figure 2
Narrowing and shortening of the stomach in POSE-2. A, B, To narrow the stomach, we orient the g-Prox perpendicular to the rugal folds along the anteroposterior diameter and create a plication. C,D, To shorten the stomach, we orient the g-Prox along the direction of rugal folds and create a plication.
See this image and copyright information in PMC

References

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