Primary obesity surgery endoluminal (POSE-2) procedure for treatment of obesity in clinical practice

Abstract

Introduction POSE-2 procedure shortens and narrows the stomach using multiple full-thickness plications in the gastric body. We studied the efficacy and safety of POSE-2 for obesity at 1-year in a real-world setting. Methods We reviewed the records of 75 patients who underwent POSE-2 at our unit. The primary outcome was to evaluate the %total body weight loss (%TBWL) at 1-year. Our secondary outcome was to assess the safety and durability. We used linear mixed model analysis. RESULTS: Forty-six patients completed 1-year. The rest are in various phases of follow-up. The mean(SD) age and BMI was 49.3(10.2) years and 38.2(6.6) kg/m2, respectively. The technical success rate was 98.7% (n=74). The mean(SD) TBWL, %TBWL, and the BMI decline at 1-year were 20(12.7) kg, 17.8(9.5)%, 7(4.3) kg/m2. Adverse events occurred in 4 patients. The average length of stay was 1-day. Endoscopy at 1-year in 15 patients showed intact sutures and a reduction in gastric length compared to baseline [35.7(3.5) cm vs. 26.9(5.3) cm, p<0.001] CONCLUSION: POSE-2 induced significant weight loss at 1-year. It is safe, durable and required only a short hospital stay.

Regression of Hepatic Fibrosis After Endoscopic Gastric Plication in Nonalcoholic Fatty Liver Disease

“…Specifically, at 1 year, the patients experienced an average of 15.5% TWL, with 63% of the cohort experiencing at least 10% TWL. It is important to note that in this series, the serious adverse event (SAE) rate was 4.4%, which is substantially higher than that in the published literature for this procedure, which so far has primarily focused on patients without advanced fibrosis (31,32), likely reflecting the higher-risk patient population. This risk profile emphasizes the need to screen patients who undergo bariatric endoscopy for advanced hepatic fibrosis and a low threshold to further investigate with cross-sectional imaging and potentially direct portal pressure gradient measurement when indicated.…”

Novel Endoscopic Bariatric Therapies for the Management of Nonalcoholic Steatohepatitis

“…49 The POSE 2.0 utilizes the same IOP to create multiple full-thickness interrupted plications at the level of the gastric body while sparing the fundus and has a much more favorable safety profile. 50 51 POSE 2.0 demonstrates favorable weight loss outcomes in several trials in which TBWL for patients post-POSE ranged between 15.7 and 17.3% at 6 months. 50 51 52 In a recent prospective multicenter trial, 41 subjects underwent POSE 2.0 and were assessed for weight loss and other outcomes, and were found to have %TBWL of 13.9, 17.3, and 17.5% at 3, 6, and 9 months, respectively.…”

“…50 51 POSE 2.0 demonstrates favorable weight loss outcomes in several trials in which TBWL for patients post-POSE ranged between 15.7 and 17.3% at 6 months. 50 51 52 In a recent prospective multicenter trial, 41 subjects underwent POSE 2.0 and were assessed for weight loss and other outcomes, and were found to have %TBWL of 13.9, 17.3, and 17.5% at 3, 6, and 9 months, respectively. 50 New data from this trial show %TBWL of 15.7 ± 6.8%.…”

Endobariatrics: well past infancy and maturing rapidly

“…POSE 2 is a variation of the original procedure in which plications are restricted to the gastric body. Lopez-Nava et al [62] reported superior TBWL with Pose 2 (17.8%) compared to the original Pose procedure.…”