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Endoscopic gastroplasty: an effective solution in a high-risk patient with morbid obesity

Abstract

A 61-year-old man was referred to the bariatric endoscopy unit for the management of morbid obesity (BMI 47 kg/m2). He had multiple obesity-related medical comorbidities. His weight gain started 8 years after suffering smoke inhalation syndrome following an industrial accident. He sustained permanent lung parenchymal injury resulting in impaired pulmonary function. His mobility was restricted to a wheelchair and was dependent on long term oxygen therapy. He tried diet and lifestyle intervention but could not achieve significant weight loss. He was referred for bariatric surgery but was declined because of substantial comorbidities, poor pulmonary function, anesthetic risk (ASA Class 4), and risk of complications. After depleting all of his options, he sought us for endoscopic therapy. Following a successful collaboration with the anesthetist, endocrinologist, and nutritionist, we performed an endoscopic gastroplasty using the modified primary obesity surgery endoluminal procedure (POSE-2) and reduced the gastric volume. He recovered immediately without complications and achieved significant weight loss at 10 months (41 kg). He is now able to walk, the oxygen requirements have decreased, and the comorbidities have significantly improved.

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Correspondence to Janese Laster.

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Conflict of interest

Dr.Gontrand Lopez-Nava is a consultant for Nitinotes Surgical, Apollo Endosurgery, and USGI Medical. All other authors have no disclosure.

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All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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Informed consent was obtained from all patients for being included in the study.

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Lopez-Nava, G., Laster, J., Negi, A. et al. Endoscopic gastroplasty: an effective solution in a high-risk patient with morbid obesity. Clin J Gastroenterol 14, 489–493 (2021). https://doi.org/10.1007/s12328-020-01322-1

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Keywords

  • Endoscopic sleeve gastroplasty
  • POSE
  • BMI
  • Morbid obesity
  • Bariatric endoscopy