Skip to main content
Top
Published in: Obesity Surgery 5/2020

01-05-2020 | Obesity | Original Contributions

Safety and Feasibility of a Novel Endoscopic Suturing Device (EndoZip TM) for Treatment of Obesity: First-in-Human Study

Authors: Gontrand Lopez-Nava, Ravishankar Asokkumar, Angel Rull, Fernandez-Corbelle, Inmaculada Bautista, Barham Abu Dayyeh

Published in: Obesity Surgery | Issue 5/2020

Login to get access

Abstract

Introduction

Endoscopic gastroplasty and gastric volume reduction techniques have been shown to achieve significant weight loss and improvement in comorbid conditions. The objective of this study is to assess the feasibility and safety of a novel fully automated, operator-independent endoscopic suturing system (EndoZip™) for minimally invasive treatment of obesity.

Design

Single-center pilot feasibility study.

Patients

Eleven patients with a body mass index (BMI) of 30 to 40 kg/m2 with or without obesity-associated comorbidity.

Interventions

Gastric volume reduction with EndoZip™ system.

Main Outcome Measurements

Primary outcome was to assess the technical feasibility and safety. The secondary outcome was to determine %total body weight loss (TBWL) and %excess weight loss (EWL) at 6 months.

Results

The mean ± SD age was 42.7 ± 5.6 years, and the mean ± SD BMI was 36.9 ± 2.8 kg/m2. A majority (64%) were men. The procedure was technically successful (100%) in all patients. A median of 3 (range, 2–4) full-thickness sutures were placed, and the mean procedure time was 54.6 ± 23.9 (23–100) min. No immediate complications occurred, and all were discharged in 24 h. One patient developed respiratory infection 3 days after the procedure and required hospitalization. The infection was mild and resolved with antibiotic treatment. At 6-month follow-up, the mean ± SD TBWL, %TBWL, and %EWL were 17.8 ± 6.7 kg, 16.2 ± 6.0%, and 54.3 ± 28.4%, respectively (p < 0.001).

Limitations

Limited number of patients.

Conclusion

Our first-in-human study showed that the Endozip™ device could be safely used for the treatment of obesity. The early weight loss results are promising. An extended feasibility study on a larger sample size is being planned (Clinicaltrials.​gov. NCT03472196).
Literature
1.
go back to reference Abu Dayyeh BK, Rajan E, Gostout CJ. Endoscopic sleeve gastroplasty: a potential endoscopic alternative to surgical sleeve gastrectomy for treatment of obesity. Gastrointest Endosc. 2013;78:530–5.CrossRef Abu Dayyeh BK, Rajan E, Gostout CJ. Endoscopic sleeve gastroplasty: a potential endoscopic alternative to surgical sleeve gastrectomy for treatment of obesity. Gastrointest Endosc. 2013;78:530–5.CrossRef
2.
go back to reference Wallstabe I, Oberaender N, Weimann A, et al. Endoscopic sleeve gastroplasty using the novel Endomina device for morbidly obese patients. Endoscopy. 2018;50:E327–8. Wallstabe I, Oberaender N, Weimann A, et al. Endoscopic sleeve gastroplasty using the novel Endomina device for morbidly obese patients. Endoscopy. 2018;50:E327–8.
3.
go back to reference Lopez-Nava G, Galvão MP, da Bautista-Castaño I, et al. Endoscopic sleeve gastroplasty for the treatment of obesity. Endoscopy. 2015;47:449–52.CrossRef Lopez-Nava G, Galvão MP, da Bautista-Castaño I, et al. Endoscopic sleeve gastroplasty for the treatment of obesity. Endoscopy. 2015;47:449–52.CrossRef
4.
go back to reference 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;27:2649–55.CrossRef 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;27:2649–55.CrossRef
5.
go back to reference Alqahtani A, Al-Darwish A, Mahmoud AE, et al. Short-term outcomes of endoscopic sleeve gastroplasty in 1000 consecutive patients. Gastrointest Endosc. 2019;89:1132–8.CrossRef Alqahtani A, Al-Darwish A, Mahmoud AE, et al. Short-term outcomes of endoscopic sleeve gastroplasty in 1000 consecutive patients. Gastrointest Endosc. 2019;89:1132–8.CrossRef
8.
go back to reference Fayad L, Cheskin LJ, Adam A, et al. Endoscopic sleeve gastroplasty versus intragastric balloon insertion: efficacy, durability, and safety. Endoscopy. 2019;51:532–9.CrossRef Fayad L, Cheskin LJ, Adam A, et al. Endoscopic sleeve gastroplasty versus intragastric balloon insertion: efficacy, durability, and safety. Endoscopy. 2019;51:532–9.CrossRef
9.
go back to reference Sharaiha RZ, Kumta NA, Saumoy M, et al. Endoscopic sleeve gastroplasty significantly reduces body mass index and metabolic complications in obese patients. Clin Gastroenterol Hepatol. 2017;15:504–10.CrossRef Sharaiha RZ, Kumta NA, Saumoy M, et al. Endoscopic sleeve gastroplasty significantly reduces body mass index and metabolic complications in obese patients. Clin Gastroenterol Hepatol. 2017;15:504–10.CrossRef
10.
go back to reference Abu Dayyeh BK, Acosta A, Camilleri M, et al. Endoscopic sleeve gastroplasty alters gastric physiology and induces loss of body weight in obese individuals. Clin Gastroenterol Hepatol. 2017;15:37–43.e1.CrossRef Abu Dayyeh BK, Acosta A, Camilleri M, et al. Endoscopic sleeve gastroplasty alters gastric physiology and induces loss of body weight in obese individuals. Clin Gastroenterol Hepatol. 2017;15:37–43.e1.CrossRef
11.
go back to reference Saumoy M, Schneider Y, Zhou XK, et al. A single-operator learning curve analysis for the endoscopic sleeve gastroplasty. Gastrointest Endosc. 2018;87:442–7.CrossRef Saumoy M, Schneider Y, Zhou XK, et al. A single-operator learning curve analysis for the endoscopic sleeve gastroplasty. Gastrointest Endosc. 2018;87:442–7.CrossRef
12.
go back to reference Hill C, El Zein M, Agnihotri A, et al. Endoscopic sleeve gastroplasty: the learning curve. Endosc Int Open. 2017;5:E900–4.CrossRef Hill C, El Zein M, Agnihotri A, et al. Endoscopic sleeve gastroplasty: the learning curve. Endosc Int Open. 2017;5:E900–4.CrossRef
13.
go back to reference Shahnazarian V, Ramai D, Sarkar A. Endoscopic bariatric therapies for treating obesity: a learning curve for gastroenterologists. Transl Gastroenterol Hepatol. 2019;18(4):16.CrossRef Shahnazarian V, Ramai D, Sarkar A. Endoscopic bariatric therapies for treating obesity: a learning curve for gastroenterologists. Transl Gastroenterol Hepatol. 2019;18(4):16.CrossRef
14.
go back to reference Movitz BR, Lutfi RE. Endoscopic sleeve gastroplasty: are we burning bridges? Surg Obes Relat Dis. 2017;13:2056–8.CrossRef Movitz BR, Lutfi RE. Endoscopic sleeve gastroplasty: are we burning bridges? Surg Obes Relat Dis. 2017;13:2056–8.CrossRef
15.
go back to reference Jirapinyo P, Thompson CC. Training in bariatric and metabolic endoscopic therapies. Clin Endosc. 2018;51:430–8.CrossRef Jirapinyo P, Thompson CC. Training in bariatric and metabolic endoscopic therapies. Clin Endosc. 2018;51:430–8.CrossRef
16.
go back to reference Turkeltaub JA, Edmundowicz SA. Endoscopic bariatric therapies: intragastric balloons, tissue apposition, and aspiration therapy. Curr Treat Options Gastroenterol. 2019;17:187–201.CrossRef Turkeltaub JA, Edmundowicz SA. Endoscopic bariatric therapies: intragastric balloons, tissue apposition, and aspiration therapy. Curr Treat Options Gastroenterol. 2019;17:187–201.CrossRef
17.
go back to reference Goyal D, Singh VK, Amateau SK, et al. Evolution of endoscopic bariatric devices: from development to practice. Am J Gastroenterol. 2019;114:679–83.CrossRef Goyal D, Singh VK, Amateau SK, et al. Evolution of endoscopic bariatric devices: from development to practice. Am J Gastroenterol. 2019;114:679–83.CrossRef
18.
go back to reference Sullivan S, Edmundowicz SA, Thompson CC. Endoscopic bariatric and metabolic therapies: new and emerging technologies. Gastroenterology. 2017;152:1791–801.CrossRef Sullivan S, Edmundowicz SA, Thompson CC. Endoscopic bariatric and metabolic therapies: new and emerging technologies. Gastroenterology. 2017;152:1791–801.CrossRef
19.
go back to reference Machytka E, Bužga M, Zonca P, et al. Partial jejunal diversion using an incisionless magnetic anastomosis system: 1-year interim results in patients with obesity and diabetes. Gastrointest Endosc. 2017;86:904–12.CrossRef Machytka E, Bužga M, Zonca P, et al. Partial jejunal diversion using an incisionless magnetic anastomosis system: 1-year interim results in patients with obesity and diabetes. Gastrointest Endosc. 2017;86:904–12.CrossRef
20.
go back to reference Grupo Colaborativo de la Sociedad Española de Nutrición Comunitaria (SENC, Aranceta Bartrina J, Arija Val V et al. Dietary guidelines for the Spanish population (SENC, December 2016); the new graphic icon of healthy nutrition. Nutr Hosp. 2016; 33: 1–48. Grupo Colaborativo de la Sociedad Española de Nutrición Comunitaria (SENC, Aranceta Bartrina J, Arija Val V et al. Dietary guidelines for the Spanish population (SENC, December 2016); the new graphic icon of healthy nutrition. Nutr Hosp. 2016; 33: 1–48.
21.
go back to reference 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;82:425–38.e5.CrossRef 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;82:425–38.e5.CrossRef
22.
go back to reference Aurora A, Khaitan L, Saber A. Sleeve gastrectomy and the risk of leak: a systematic analysis of 4,888 patients. Surg Endosc. 2012;26:1509–15.CrossRef Aurora A, Khaitan L, Saber A. Sleeve gastrectomy and the risk of leak: a systematic analysis of 4,888 patients. Surg Endosc. 2012;26:1509–15.CrossRef
23.
go back to reference Elms L, Moon R, Varnadore S, et al. Causes of small bowel obstruction after roux-en-Y gastric bypass: a review of 2,395 cases at a single institution. Surg Endosc. 2014;28:1624–8.CrossRef Elms L, Moon R, Varnadore S, et al. Causes of small bowel obstruction after roux-en-Y gastric bypass: a review of 2,395 cases at a single institution. Surg Endosc. 2014;28:1624–8.CrossRef
24.
go back to reference Jirapinyo P, Thompson CC. Endoscopic bariatric and metabolic therapies: surgical analogues and mechanisms of action. Clin Gastroenterol Hepatol. 2017;15:619–30.CrossRef Jirapinyo P, Thompson CC. Endoscopic bariatric and metabolic therapies: surgical analogues and mechanisms of action. Clin Gastroenterol Hepatol. 2017;15:619–30.CrossRef
25.
go back to reference Hajifathalian K et al. Long-term follow up and outcomes after endoscopic sleeve gastroplasty for treatment of obesity (5 year data). Gastrointest Endosc. 89(6):–AB58. Hajifathalian K et al. Long-term follow up and outcomes after endoscopic sleeve gastroplasty for treatment of obesity (5 year data). Gastrointest Endosc. 89(6):–AB58.
26.
go back to reference Alqahtani AR, Elahmedi M, Alqahtani YA, et al. Laparoscopic sleeve gastrectomy after endoscopic sleeve gastroplasty: technical aspects and short-term outcomes. Obes Surg. 2019. Obes Surg. 2019;29:3547–52.CrossRef Alqahtani AR, Elahmedi M, Alqahtani YA, et al. Laparoscopic sleeve gastrectomy after endoscopic sleeve gastroplasty: technical aspects and short-term outcomes. Obes Surg. 2019. Obes Surg. 2019;29:3547–52.CrossRef
27.
go back to reference Sullivan S, Swain JM, Woodman G. 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.CrossRef Sullivan S, Swain JM, Woodman G. 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.CrossRef
Metadata
Title
Safety and Feasibility of a Novel Endoscopic Suturing Device (EndoZip TM) for Treatment of Obesity: First-in-Human Study
Authors
Gontrand Lopez-Nava
Ravishankar Asokkumar
Angel Rull
Fernandez-Corbelle
Inmaculada Bautista
Barham Abu Dayyeh
Publication date
01-05-2020
Publisher
Springer US
Published in
Obesity Surgery / Issue 5/2020
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-019-04370-w

Other articles of this Issue 5/2020

Obesity Surgery 5/2020 Go to the issue