Gastric restriction is an important principle of both roux-en-Y gastric bypass and laparoscopic adjustable gastric banding. The FDA cleared OverStitch Endoscopic Suturing System (Apollo Endosurgery, Austin, TX) offers the physician the ability to restrict gastric size by approximating tissue endoluminally via an incisionless/per-oral approach. The use of this system has the potential to reduce the complications associated with current surgical approaches while effecting the desired gastric restriction. The primary objective is to collect data on the use of the OverStitch Endoscopic Suturing System (Apollo Endosurgery, Inc. Austin, Texas) for gastric tissue approximation during primary gastric restrictive procedures.
The primary objective is to collect data on the use of the OverStitch Endoscopic Suturing System (Apollo Endosurgery, Inc. Austin, Texas) for gastric tissue approximation during primary gastric restrictive procedures. The primary endpoint of this study is evaluation of safety and feasibility of the procedure. All subjects for whom the plication procedure is initiated (defined as placement of the overtube) will be included in the safety analysis. The primary safety analysis will assess the occurrence of adverse events through 12 months after the plication procedure. Technical success will be defined as minimum placement of 8 sutures upon initial endoscopic intervention. Safety will be determined as no adverse events directly related to the procedure at 12 months. Secondary Endpoints: 1. Efficacy: Data for the following effectiveness outcome measures (variables) will be collected and analyzed relative to baseline: * Percent excess weight loss (%EWL) * Total weight lost (kg) and percent weight lost * Change in (BMI) and percent change in BMI * Change in waist circumference * Improvement in co-morbid disease(s) including, but not limited to, improvement in vital signs and/or laboratory values * Changes in quality of life measures as reported on Quality of Life questionnaire(s) (evaluated relative to baseline) * Changes in feelings of satiety measures as reported on the TFEQ-R18 (relative to baseline) 2. Durability: Data will be collected on the durability of the plications by evaluating the remaining plications at the 12 month endoscopy, compared to the number of plications placed at the time of procedure.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
20
Endoluminal gastric tissue approximation using an incisionless/per-oral endoscopic suturing device for primary gastric restrictive procedures
Jackson Health System
Miami, Florida, United States
Brigham and Women's Hospital
Boston, Massachusetts, United States
St. Joseph's Regional Medical Center at New Jersey
Paterson, New Jersey, United States
University of Texas at Houston
Bellaire, Texas, United States
Number of Participants With Adverse Events
Perioperative adverse events were defined as those occurring during the procedure or the post-procedure observation period. Postoperative adverse events were defined as occurring during the first three days after the procedure. Delayed adverse events were defined as occurring on the fourth post-procedure day or afterwards.
Time frame: 12 months
Evaluation of Technical Feasibility of the Procedure
Technical success was defined by placement of at least 8 running sutures and 4 interrupted sutures in the gastric body with exclusion of the lateral stomach.
Time frame: Day 0 - Procedure Day
Percent Excess Weight Loss
Data for the following effectiveness outcome measures (variables) will be collected and analyzed relative to baseline: Percent excess weight loss
Time frame: 12 Months
Durability
Data will be collected on the durability of the plications by evaluating the remaining plications at the 12 month endoscopy, compared to the number of plications placed at the time of procedure.
Time frame: 12 months
Percentage of Total Body Weight Loss
Data for the following effectiveness outcome measures (variables) will be collected and analyzed relative to baseline: Percentage of Total body weight loss
Time frame: 12 Months
BMI Loss (kg/m^2)
Data for the following effectiveness outcome measures (variables) will be collected and analyzed relative to baseline: BMI Loss (kg/m\^2)
Time frame: 12 Months
Waist Circumference Loss (cm)
Data for the following effectiveness outcome measures (variables) will be collected and analyzed relative to baseline: Waist Circumference Loss (cm)
Time frame: 12 Months
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