Obesity
Conditions
Keywords
Using POSE as a treatment for Obesity
Brief summary
The purpose of this study is to evaluate the impact of minor variations in Incisionless Operating Platform (IOP)procedural techniques on gastric emptying, hormone levels, satiety, and weight loss in the treatment of primary obesity. It will confirm, in an open prospective study, the action mechanisms for the POSE endoscopic treatment technique for obesity, and it will help determine if they are maintained at least 6 months following the procedure. Durability of weight loss will be tracked through post-POSE visits up to 18 months following the procedure.
Interventions
DEVICEUsing The IOP system from USGI to place suture anchors
Sutures are placed in the distal body in one of three randomized techniques: A = reduction in ring opening to antrum using plications B = continuous horizontal row, running from distal body into proximal antrum C = Control. Current V shape as Control
Sponsors
USGI Medical
Study design
Allocation
RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
21 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
1. Has a BMI of \>30 and \<40 2. Male or female ≥21 yrs. of age and \< 60 yrs. of age at time of enrollment 3. Patient has had no significant weight change (+/- 5% of total body weight) in last 6 months but has been able to lose significant weight in the past with diet and exercise. 4. Is a reasonable candidate for general anesthesia 5. Agrees not to have any additional weight loss interventional procedures or liposuction for at least 18 months following study enrollment and agrees not to take any prescription or over the counter weight loss medications for at least 1 year. 6. Physically and mentally able to comply with the visit schedule, ancillary testing, and behavior modification (diet and exercise) required for the study and agrees to study commitment requirements 7. Had successful completion of the pre-screening, nutritional and educational programs and psychological assessment supporting that the subject is an appropriate bariatric surgical candidate
Exclusion criteria
1. History of (or intra-operative evidence of) bariatric, gastric or esophageal surgery 2. Esophageal stricture or other anatomy and/or condition that could preclude passage of endoluminal instruments 3. Moderate to severe Gastro-esophageal reflux disease (GERD) 4. Known hiatal hernia \>3cm by history or as determined by UGI exam or endoscopy 5. Known GI motility disorder or pancreatic insufficiency/disease 6. Intra-operative Exclusion: Active peptic ulcer or hiatal hernia \>3cm 7. Pregnancy. 8. Present Corticosteroid Use 9. History of inflammatory disease of GI tract 10. Severe coagulopathies, hepatic insufficiency or cirrhosis 11. History or present use of insulin or insulin derivatives for treatment of diabetes 12. Had Type II Diabetes Mellitus (as defined by HgbA1c \>6.0) for greater than 2 years at the time of enrollment 13. Uncontrolled Type II DM (HgbA1c \>7.0 at screening) 14. Patient has quit smoking within last 6 months at time of enrollment or plans to quit smoking in the next year 15. Patient has a history of drug or alcohol abuse or actively abusing either 16. Patient is presently being treated with medication for depression, psychosis, or other mood or eating disorder 17. Non-ambulatory or has significant impairment of mobility 18. Works for, or is first degree relative of investigator, study institution, or support staff involved in the study. 19. Known hormonal or genetic cause for obesity 20. Participating in another clinical study 21. Patient is on medications known to impact GI motility or gut hormones that cannot be discontinued prior to nuclear testing 22. Have work hours, family obligations or transportation issues that could interfere with patient returning for all scheduled evaluations, tests and nutritional counseling. 23. Lives \>60 kilometers from investigator site. 24. Patient is not able to provide written informed consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Weight Loss | Monthly post procedure out to 18 months | Each patient's weight will be measured and recorded on a monthly basis out to 18 months post procedure |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Fasting/Post-prandial Peptides | pre-procedure & 8 weeks post procedure | 1. Samples to be collected when fasting and 30, 60, 90, and 120 minutes after a standard meal (a meal consisting of 400 calories), The meal must be consumed within 10 minutes.. Serum collection tubes will be centrifuged immediately at 4°C for 10 minutes at 3600rpm and stored at -20°C 2. Samples to be collected by ELISA are: C-peptide, serum insulin, glucose, PYY, GLP-1 (active), leptin, and GIP. Total ghrelin level to be analyzed by RIA. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Gastric Emptying | Pre-procedure & 2 & 6 months post procedure | This test consists of determining the duration of a radioactive marker in a stomach, which is non-absorbable, and free of any food components. |
| Satiety Testing | Pre-procedure & 2 & 6 months post procedure | The subjects ingest a nutritional drink (Ensure) at a constant rate of 30 mL per minute, constantly filling the glass with a perfusion pump (Gemini PC-2, IMED, San Diego, CA). (The subjects are not conscious of the volume being ingested.) The subjects are instructed to maintain consumption at the fill rate. Participants take note of their sensation of satiety with a graphical classification scale, which combines verbal descriptors on a scale of 0 to 5 (0 = no symptoms, 1 = first sensation of fullness \[threshold\]; 2 = light, 3 = moderate, 4 = severe, and 5 = maximum fullness or unbearable). The participants are told to stop taking the food product when a score of 5 is obtained. The maximum consumption of volume of the nutritional drink is recorded. |
Countries
Spain
Outcome results
None listed