title: Early experience with the Incisionless Operating Platform™ (IOP) for the treatment of obesity : the Primary Obesity Surgery Endolumenal (POSE) procedure.
abstract: BACKGROUND
  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).
  
  
  METHODS
  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.
  
  
  RESULTS
  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/m(2)), 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Unidad de Endoscopia, Centro Médico Teknon, Vilana, 12, 08022 Barcelona, Spain. jcespinos@gmail.com
authors.forename: J C
authors.initials: JC
authors.lastname: Espinós
authors.forename: R
authors.initials: R
authors.lastname: Turró
authors.forename: A
authors.initials: A
authors.lastname: Mata
authors.forename: M
authors.initials: M
authors.lastname: Cruz
authors.forename: M
authors.initials: M
authors.lastname: da Costa
authors.forename: V
authors.initials: V
authors.lastname: Villa
authors.forename: J N
authors.initials: JN
authors.lastname: Buchwald
authors.forename: J
authors.initials: J
authors.lastname: Turró
mesh_terms: D000328:Adult; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D057605:Natural Orifice Endoscopic Surgery; D009767:Obesity, Morbid / Q000453:epidemiology / Q000628:therapy*; D061646:Operative Time; D056888:Patient Positioning; D011182:Postoperative Care; D011446:Prospective Studies; D012527:Satiation; D013030:Spain / Q000453:epidemiology; D016896:Treatment Outcome; D015431:Weight Loss