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POSE (Primary Obesity Surgery Endoscopic) Making stomach smaller without incisions - through the mouth.



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food is affected.

Please watch the videos for a great explanation of this fascinating procedure. This particular tool is cleared by the FDA for other purposes, but it is undergoing testing here in the USA for weight loss. If you live near a testing center, you may qualify to undergo this procedure at no cost. There is a doctor here in the USA who has done many of these procedures. At this time there are no long term negative effects we can present, as the procedure is newer.

Pros:

Outpatient procedure

Inscisionless, no surgical scars or wounds (no infection)

Healing is fast - back to work next day, sounds like.

Fast procedure

Permanent procedure

Secret surgery

Cons:

We don't know long term negative effects

What could they be?

Permanent procedure

Only for people who want to lose 25-60 pounds.

__________

USGI Medical Receives FDA Approval to Launch Head-to-Head Pivotal Study to Determine Safety, Effectiveness of Incisionless, Endoscopic Weight Loss Procedure printButton.png By Marketwired - Medical and Healthcare Wednesday, 09 October 2013 09:27

The company plans to enroll approximately 350 subjects at up to nine centers across the U.S.

"Although published data show significantly superior weight loss results from bariatric surgery than from diet and exercise alone, a major open or laparoscopic operation still poses risks and longer recovery times, and surgery is not right for every patient," said Thomas E. Lavin, MD, FACS, FASMBS, founder of The Surgical Specialists of Louisiana and an investigator in the study, known as the ESSENTIAL™ Trial. "Surgery for weight loss has been studied with positive results, but this will be one of the first major trials to prospectively compare the effectiveness of an endoscopic procedure against a sham procedure plus diet and exercise. Based on preliminary studies conducted in Europe, we believe that this new approach may help patients feel full sooner during meals, improving satiety and reducing hunger cravings so they can control their portions, consume fewer calories and lose weight."

Physicians participating in the study will use USGI Medical's g-Cath EZ™ Suture Anchor Delivery Catheter to place tissue anchors across folds of tissue in strategically-located parts of the stomach to reduce its size and ability to stretch to accommodate a meal. The g-Cath, which is used extensively for general, non-obesity indications, is the first endoscopic suturing technology proven to create a durable, healed fold in the stomach.

The incisionless outpatient procedure has been performed on over 2,000 patients, mostly in Europe, where it is known as "POSE." The procedure is performed entirely through the mouth without any incisions through the abdomen. Many patients have returned to work without any bandages or signs of surgery within two to three days.

"If the data are positive and consistent with smaller trials, it could mean that tens of thousands of patients may have an incredibly compelling option to consider if they've struggled to lose weight with diet and exercise, but aren't prepared to accept the risk of traditional bariatric surgery," Dr. Lavin added.

"The start of the ESSENTIAL Trial represents a significant milestone for USGI Medical and endoscopic approaches to weight loss," said John Cox, Chief Operating Officer of USGI Medical. "Our efforts to support this study underscore our excitement about the potential of our technology and our commitment to patient safety and outcomes. We look forward to working with many of the country's leading bariatric surgeons and advanced endoscopists, both at top academic medical institutions and well-respected private centers, to enroll patients in this study. Based on our experience to date, we believe our new incisionless approach to treating obesity may offer promise to patients who have struggled to lose weight through diet and exercise."

Results of European Studies of POSE Recently Announced

Physicians from Spain reported results of two studies showing the positive outcomes and physiological effects of the POSE procedure at the 18th World Congress of International Federation for the Surgery of Obesity & Metabolic Disorders (IFSO) in Istanbul this past August.

Román Turró, M.D., reported results of his team's POSE experience at the GI Endoscopy Department at the Centro Medico Teknon, Barcelona. Prospective, institutional ethics-approved data collection began in February 2011 and included results from 137 consecutive procedures performed through July 2013. The first 22 patients who had been followed for 12 months post-procedure at the time of the presentation achieved average excess weight loss of 62% and total body weight loss of 19%.

Importantly, initial safety data were favorable for POSE as well. Of the 137 patients, none were hospitalized with a surgical intervention after undergoing POSE. One patient developed an infection that was treated with antibiotics and two patients suffered intra-gastric bleeding, which was treated endoscopically. The average age of patients included in the safety analysis was 42.8 years and the average body mass index (BMI) was 36.9 at the time of the procedure. Females accounted for 74% of the patients.

Endoscopies on a subset of these patients also confirmed that the suture anchors remained in place in the stomach 12 months after the procedure.

Separately at IFSO, Silvia Delgado-Aros, MSc, MD, PhD, a member of the Neuro-Enteric Translational Science (NETS) Research Group at the Institut Hospital del Mar d'Investigacions Mèdiques in Barcelona, presented physiologic findings showing that POSE led to weight loss, a sustained reduction in caloric intake, normalization of blood sugar levels and improved feelings of fullness and satiety triggered by an improved gut peptide response to food. In this controlled study, patients followed for 15 months reported mean excess weight loss of 63.7%.

For additional details about the ESSENTIAL Trial™, please visit ClinicalTrials.gov.

CAUTION: Investigational Device. Limited by United States law to investigational use. The safety and effectiveness of the g-Cath for weight loss has not been established.

About Obesity

On June 18, 2013, the American Medical Association adopted policy that recognizes obesity as a disease requiring a range of medical interventions to advance obesity treatment and prevention. The American Heart Association (AHA) estimates that 78.4 million Americans age 20 and over are obese (with a BMI of 30.0 kg/m2 and higher). If current trends in the growth of obesity continue, total healthcare costs attributable to obesity could reach $861 to $957 billion by 2030, which would account for 16% to 18% of U.S. health expenditures, the AHA predicts.

About USGI Medical

USGI Medical is committed to the development of technologies to enable Incisionless Surgery -- the treatment of diseases through the natural passageways of the body. USGI's Incisionless Operating Platform™ provides surgeons the operating platform and specialized tools they need to perform surgery through a patient's mouth or other natural orifices, reducing the need for external incisions into the abdomen. Importantly, USGI has demonstrated the capability to reliably and durably suture GI tract tissue without an incision. Operating through the body's natural orifices offers promise for less pain, shorter hospital stays, reduced risk of wound infection and no external scars -- and is rapidly becoming an option sought after by patients and healthcare providers. USGI offers surgeons and gastroenterologists the tools they need to offer millions of potential patients a less invasive surgical option. www.usgimedical.com

Read more http://www.marketwired.com/mw/release.do?id=1839575&sourceType=3

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Anyone had this yet? I am very interested in this procedure and would like to find a surgeon in Mexico who is doing it.

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Also interested to hear if anyone has had this POSE procedure and success rates

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Currently that procedure is still very new , within past 2 yrs and there isn't enough data for long term sucess rates yet. I actually posted a similar thread over the weekend about this. My surgeon recently started performing this procedure and currently he has a patient that is 3 months out. This procedure only provides better restriction from stretching of pouch, however as always... diet and exercise will make it successful. Here is an a great link for a neat animation video. If accessing via mobile, animation will be on bottom of page. If by desktop or laptop top right.

I also asked if this was covered under insurance and my surgeon said yes but depends on insurance. In addition, he also said this is a cheaper and less invasive versus revision surgery

http://apolloendo.com/procedures/outlet-pouch-reduction/

Edited by Dream4tc

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There are over 2500 patients who have had this done as of 2014. It is new in USA but they have been doing this procedure in Spain for many years. Id love to know where they all go as I cant seem to find many threads or blogs from people who have had it done. The ones Ive found have had mixed results; however there are others who are delighted with the outcome and are glad they didnt listen to the negative views. I hope Im one of the successful ones as I hear this week about an op date for POSE

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My POSE surgery went without a hitch on Tuesday. I have to say though afterwards my oesophagus and throat were very sore for 2 days but I kept to the instructions for meds and diet to the word. The third day I felt much improved and actually went to work on the 2nd day. Its wasnt easy though, could have done with 3 straight days relaxing. I weighed just over 80 kilos in August and the day of the procedure I was 77. Since then, 4 days my weight has dropped to 74. I started cutting down my food before the surgery date and for 1 week followed doctors diet instructions. You take very little in the first 3 days, just liquids like broth and Protein Shake. Now I can take natural yoghurt, sugar free jelly, broth and Protein shake for the next 10 days. After that slowly the diet increases. All in all im pleased with the weight loss and I couldnt have asked for better care.

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My question would be related to long-term effects.

It looks like they are altering the size of the fundis. But, not removing it entirely as with the sleeve. It seems that over time, the fundis that is still there would stretch as fundis' are designed to do.

Curious.

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Yes inner surfer girl, thats correct. but it is a totally different concept to sleeve or plication. The fundus is reduced in size as this is the part of the stomach that sends the hunger signal to the brain. As this is reduced the signals are less. Also there is another 1 or 2 sutures placed at the bottom for slower emptying.

This procedure is no good for people who eat emotionally or have to be sick before they stop eating or those with high BMI. It is best for people who had Portion Control and have lost it as theyve got older and dont want to get any bigger. It is early days for me but after a few consultations with the surgeon he felt this was best for me. He would not offer it to someone with a BMI of say 40 or above as he feels that the other procedures are more appropriate for them. I do have some control Id just hit a wall and couldnt get my post baby weight /pre menapaus weight under control. Ill let you know how I am in a month or so. I was happy to try this as I just didnt feel I wanted to do anything more invasive. I do have hope though that it will be better and a longer time tool than the gastric balloon which would have been another option.

I could have had plication but again didnt want the invasive surgery. Ill see how it goes. Time will tell. After spending this amount of money its also another good motivator. I have 12 months back up support with the dietician who will hopefully help me change my chip. I am not naive enough to think that the POSE will be solely responsible for the weight loss, I agreed that Id have to make diet and life changes. But believe me that is for the better. If it reduces my hunger while I can make the changes it will be a great help.

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So a little update. Weight loss slowed down as I can pretty much snack normally but larger meals I still have a restriction. I avoid deserts when dining out and try to make decent choices. Although I do accompany my main meal with a glass or two of vino. I'm about 72 kilos. I've changed scales which are a good kilo heavier than the last set so not worrying about that too much. On old scales I'd be 71 kilos but hey.... It's near on 9 kilo loss

So new scale. Been to dietician and feel really peed off. I've only been talked into a laboratory Protein product. I've give it a go and I'm not happy. No social life and it's so restricted I'm cheating and feel bad on every level. So decided before my appointment on the 19th Nov ill continue with the product but if a friend wants to meet me for lunch ill go. But ill order chicken or fish with veg. After the restrictions of the pre op post op and changes I've made since I feel I want to find a balance of mindful eating. I'm cooking for the family and of course I want to reach my goal but I don't need to do it in 4 weeks. But I have to be honest I was told I'd receive less hunger signals to the brain. I'm not 100% sure if that is correct or happening However I'm still losing weight and it is to be expected that weight loss slows down after the initial few weeks. I am in effect dieting and I do still feel hungry. So ill see how I go in the coming weeks as I wasn't sure if I was hungry or if it was stomach acid in the early days. I can safely say though that ths procedure is not for people who eat and pick like a habit. It takes work. I feel it's more the price of the surgery that's keeping me motivated than the actual procedure. Trying to stay in a good state of mind.

Edited by butterflyvan

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So how are you doing now butterflyvan? Please update us. This was the surgery I wanted but could not find anyone to perform it. So I eventually gave up looking and had a plication in Mexico.< /p>

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Ok. I'm down to 71.5 kilos started at 80. The weight loss has stopped now and if I want to lose anymore I'm going to have to stick to a strict diet. Xmas approaching and then a holiday I somehow doubt that's going to be easy. I'm pleased with the weightloss so far and undrstand it's a tool. At times I feel dissapointed with the effort it still.takes to lose weight and if you are a picker at food like me it's not the best option. The only time I feel any effect is if I had a large portion. But I can pretty eat as much as I could before but try not to. I'll have to see where I am with it another 3 months down the line but I'm not that over the moon that I would recommend it at this stage. Would I have lost the weight without it, probably not but I think it's more what I've spent that mentally drives me rather than procedure. If you have a bigger weight loss I'd probably think of another option. That said I have no banding problems or any reflux . I am as I was before. When I get back off holiday ill go back to the dietician and hopefully get the support I need to lose a bit more. Thanks for asking. Good luck and let me know what you decide.

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Ok. I'm down to 71.5 kilos started at 80. The weight loss has stopped now and if I want to lose anymore I'm going to have to stick to a strict diet. Xmas approaching and then a holiday I somehow doubt that's going to be easy. I'm pleased with the weightloss so far and undrstand it's a tool. At times I feel dissapointed with the effort it still.takes to lose weight and if you are a picker at food like me it's not the best option. The only time I feel any effect is if I had a large portion. But I can pretty eat as much as I could before but try not to. I'll have to see where I am with it another 3 months down the line but I'm not that over the moon that I would recommend it at this stage. Would I have lost the weight without it, probably not but I think it's more what I've spent that mentally drives me rather than procedure. If you have a bigger weight loss I'd probably think of another option. That said I have no banding problems or any reflux . I am as I was before. When I get back off holiday ill go back to the dietician and hopefully get the support I need to lose a bit more. Thanks for asking. Good luck and let me know what you decide.

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