, Volume 23, Issue 9, pp 1375-1383
Date: 17 Apr 2013

Early Experience with the Incisionless Operating Platform™ (IOP) for the Treatment of Obesity

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We report our initial experience and 6-month outcomes in a single center using the per-oral Incisionless Operating Platform™ (IOP) (USGI Medical) to place transmural plications in the gastric fundus and distal body using specialized suture anchors (the Primary Obesity Surgery Endolumenal [POSE] procedure).


A prospective observational study was undertaken with institutional Ethics Board approval in a private hospital in Barcelona, Spain. Indicated patients were WHO obesity class I–II, or III, where patients refused a surgical approach.


Between February 28, 2011 and March 23, 2012, the POSE procedure was successfully performed in 45 patients: 75.6 % female; mean age 43.4 ± 9.2 SD (range 21.0–64.0). At baseline: mean absolute weight (AW, kg), 100.8 ± 12.9 (75.5–132.5); body mass index (BMI, kg/m2), 36.7 ± 3.8 (28.1–46.6). A mean 8.2 suture-anchor plications were placed in the fundus, 3.0 along the distal body wall. Mean operative time, 69.2 ± 26.6 min (32.0–126.0); patients were discharged in <24 h. Six-month mean AW was 87.0 ± 10.3 (68.0–111.5); BMI decreased 5.8 to 31.3 ± 3.3 (25.1–38.6) (p < 0.001); EWL was 49.4 %; TBWL, 15.5 %. No mortality or operative morbidity. Minor postoperative side effects resolved with treatment by discharge. Patients reported less hunger and earlier satiety post procedure. Liquid intake began 12 h post procedure with full solids by 6 weeks.


At 6-month follow-up of a prospective case series, the POSE procedure appeared to provide safe and effective weight loss without the scarring, pain, and recovery issues of open and laparoscopic bariatric surgery. Long-term follow-up and further study are required.