The Endoscopic Mega Plication Procedure (EMPP). Prospective Study of the Primary Obesity Surgery Endoluminal (POSE) with Double G-Lix Procedure for treatment of Obesity. Safety and effectiveness at three-month follow-up

Aims The Endoscopic Mega Plication procedure ( EMPP ) involves a novel pattern of full-thickness gastric body plications to shorten and narrow the stomach using the IOP platform ( POSE ) with 33 mm G-Prox and durable snowshoe anchor pairs and two G-lix simultaneously to achieve larger folds and reduce the number of plications per procedure. Our prospective trial examined the safety and durability of EMPP in adults with obesity.

Methods Adults with obesity grade I and II underwent EMPP in our center. Primary outcomes were safety, durability of plications at 3, 12 and 24 month follow-up and the cost effectiveness of the technique. Safety will be determined by the incidence of any serious adverse events reported either by the subject or observed by the investigator, relating to the procedure either peri- procedurally or in the follow-up period. All adverse events will be documented.

Secondary outcomes were percent total body weight loss (%TBWL) and proportion of patients achieving >5% TBWL at 12 months.

Results 10 patients (60% female; mean age, 45 ± 9.7 years; mean body mass index, 37 ± 2.1 kg/m2) were enrolled. This procedure used an average of 10±2 suture anchor pairs, with a mean duration of 20 ± 7 minutes, and was technically successful in all subjects. 3-month follow-up: no serious adverse events occurred [1] [2].

Conclusions The follow-up of these first three months seems to show that the EMPP ( POSE technique with double G-Lix ) is ​​safe, durable and cost-effective, but it is necessary to complete the long-term follow-up and carry out studies with a larger sample.

Conflicts of interest

Authors do not have any conflict of interest to disclose.

• 1 JirapinyoMD MPH, Christopher C, Thompson MD. Comparison of distal primary obesity surgery endolumenal techniques for the treatment of obesity. Gastrointestinal EndoscopyVolume 96, Issue 3, September 2022; Pages 479-486
• 2 Nava GLopez, Arau RT, Asokkumar R, Maselli DB, Rapaka B, Matar R, Bautista I, Espinos Perez JC, Bilbao AM, Jaruvongvanich V, Vargas EJ, Storm AC, Neto MG, Abu Dayyeh BK.. Prospective Multicenter Study of the Primary Obesity Surgery Endoluminal (POSE 2.0) Procedure for Treatment of Obesity. Clin Gastroenterol Hepatol. 2022

Publication History

Article published online:
14 April 2023