A Controlled Study to Evaluate the Efficacy of an Endoluminal-suturing Device (Endomina) as an Aid for Endoscopic Gastric Reduction
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Enrollment
- 72
- Locations
- 4
- Primary Endpoint
- Incidence of all Adverse Device Effects
Study Overview
Brief Summary
The aim of this trial is to evaluate the efficacy of an endoluminal vertical gastroplasty (EVG) using an endoluminal-suturing device. Safety will also be characterized, in particular by the incidence of all Adverse Device Effects (ADEs). A secondary endpoint is to compare a delayed treatment control group (diet alone; crossover at 6 months) with a treatment group (EVG plus diet). Other secondary endpoints include improvements in other obesity measures.
Detailed Description
Surgery is currently the only effective treatment for morbid obesity and can be divided into restrictive surgeries (Lap Band and Sleeve gastrectomy), malabsorptive surgeries (Biliary pancreatic deviation and duodenal switch) or a combination of both (RYGBP).
This latter technique is the most common and most effective surgical procedure performed worldwide and has been processed to be an effective treatment of morbid obesity and its complications, achieving excess weight loss of 65 to 80 %; 1-2 years after surgery.
Vertical gastric plication is a novel surgical approach for reducing the stomach capacity. Anterior surface plication and greater curvature plication are variations of vertical gastric plication that reduce the gastric capacity through infolding of the anterior surface or greater curvature of the stomach, respectively. These approaches have been tested, with positive results.
A transoral or endoluminal approach (i.e. a procedure that requires no incision, because access is granted through the mouth) offers the potential for additional benefit to the patient, because the procedures continue to become more and more minimally invasive.
Advances in endoluminal devices are now allowing clinicians the ability to begin exploring bariatric procedures performed via flexible endoscopy. Although these procedures may not be as effective as their surgical counterparts, these less-invasive options may relieve patients of the significant risks associated with surgery and might become part of the armamentarium of obesity management.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Sequential
- Primary Purpose
- Treatment
- Masking
- None
Eligibility Criteria
- Ages
- 18 Years to 65 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Age between 18-65 years;
- •Class I or class II obesity (i.e. BMI between 30 to 40 kg/m²);
- •Must be able to comply with all study requirements for the duration of the study as outlined in the protocol. This includes complying with the visit schedule as well as study specific procedures such as: clinical assessment, endoscopy, radiography, as well as laboratory investigations;
- •Must be able to understand and be willing to provide written informed consent;
- •Must live within 75 km of the treatment site;
- •Had followed the bariatric multidisciplinary workup (blood analyses, dietician, psychologist and doctor appointments).
Exclusion Criteria
- •Achalasia and any other esophageal motility disorders;
- •Severe esophagitis;
- •Gastro-duodenal ulcer;
- •Heart diseases: unstable angina, myocardial infarction within the past year, or heart disease classified within the New York Heart Association's Class III or IV functional capacity;
- •Hypertension: uncontrolled hypertension during last 3 months;
- •Diabetes: uncontrolled diabetes (on insulin therapy or oral therapy with Hba1c > 10%);
- •TBWL >5% over the last 6 months;
- •Severe renal, hepatic, pulmonary disease or cancer;
- •GI stenosis or obstruction;
- •Pregnancy, breastfeeding or willing to become pregnant in the coming 18 months;
- •Previous bariatric surgery, balloon or other endoscopic obesity-related therapy;
- •Anticoagulant therapy;
- •Impending gastric surgery 60 days post intervention;
- •Currently participating in other study
Outcomes
Primary Outcomes
Incidence of all Adverse Device Effects
Time Frame: one year from procedure
Safety will be characterized by the incidence of all Adverse Device Effects (ADEs), non-serious and serious, possibly related to or related to the procedure and/or device that are experienced by study participants.
Weight loss
Time Frame: one year from procedure
total weight loss and excess weight loss
Secondary Outcomes
- Quality of life(one year from procedure)
- Weight loss at 6 months(at 6 months after the procedure (treatment group))
- More than 15% weight loss(one year from procedure)
- TBWL(one year from procedure)
- Weight and height(one year from procedure)