Clinical experience of transoral suturing for an endoluminal vertical gastroplasty: 1-year follow-up in 64 patients

Roberto Fogel, Juana De Fogel, Ydaly Bonilla, Rafael De La Fuente

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Background: Bariatric surgery for severe obesity has demonstrated significant health benefits, but it is not without complications. Transoral approaches to weight loss offer a minimally invasive option. Objective: To evaluate the safety and feasibility of a transoral suturing procedure for weight loss. Design: Single-center, uncontrolled study with a 1-year follow-up. Setting: Hospital de Clinicas, Caracas, Venezuela. Patients: Sixty-four patients (mean age [SD] 31.5 ± 10.1 years, range 16-62 years; mean (SD) preoperative body mass index [BMI] 39.9 ± 5.1 kg/m2, range 28.0-60.2 kg/m2) were enrolled between 2003 and 2005. Intervention: Endoluminal vertical gastroplasty by using a continuous suture pattern to treat obesity. Main Outcome Measurements: Short-term complication monitoring and patient weight before the procedure and at 1, 3, and 12 months after the procedure. Results: The outpatient procedures were performed in approximately 45 minutes. Patients had a significant reduction in BMI at 12 months (mean [SD] BMI 39.9 ± 5.1 kg/m2 vs 30.6 ± 4.7 kg/m2; P < .001) and a percentage of excess weight loss (%EWL) (SD) of 21.1 ± 6.2, 39.6 ± 11.3, and 58.1 ± 19.9 at 1, 3, and 12 months, respectively. By comparing the study's subpopulations, group I (baseline BMI ≥40 kg/m2, n = 33), group II (baseline BMI 35-40 kg/m2, n = 19), and group III (baseline BMI <35 kg/m2, n = 12) demonstrated a %EWL (SD) of 48.9 ± 10.7, 56.5 ± 13.9, and 85.1 ± 24.0, respectively, at 12 months after the procedure (P = .037 when comparing group I vs II; P < .001 when comparing group II vs III and group I vs III). No patients experienced any serious adverse events. Limitations: This study represents a single center's clinical experience, with no sham control. Conclusions: Endoluminal vertical gastroplasty by using a continuous suture pattern is associated with significant weight loss. Additional studies are needed to demonstrate the procedure's long-term safety and efficacy.

Original languageEnglish (US)
Pages (from-to)51-58
Number of pages8
JournalGastrointestinal endoscopy
Issue number1
StatePublished - Jul 1 2008
Externally publishedYes


ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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