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Publications

Journal Article Ahead of print

PubMed: 42474954 DOI: 10.1007/s11695-026-08865-1

Endoscopic Gastric Mega-plication (MEGA) for the Primary Treatment of Obesity: "A European Multicenter Retrospective Cohort Study, 6-month Outcomes".

Obes Surg

Authors: Román Turró Araú, Gherzon Casanova Rimer, Antonio Ortega Sabater, Ivo Boskoski, Milutin Bulajic, Jan Willem Greve, Karl Miller, Sebastian Teschers, Juan Colán-Hernández, Laura García Moldón, Anna Vila Moix, Sandra Andrés Valero, Salvatore Francesco Vadalà di Prampero, Jesús Turró, Yousef Alshamali, Christopher C Thompson, Jorge Carlos Espinós

Affiliations

  • Digestive Endoscopy Unit, Hospital Quirón Teknon, Barcelona, Spain.
  • Digestive Endoscopy Unit, Hospital Quirón Teknon, Barcelona, Spain.
  • Digestive Endoscopy Unit, Hospital Quirón Teknon, Barcelona, Spain.
  • Agostino Gemelli University Polyclinic, Rome, Italy.
  • Digestive Endoscopy Unit, Ospedale Isola Tiberina-Gemelli Isola, Rome, Italy.
  • Metabolic and Bariatric Surgery, Maastricht UMC, Maastricht, Netherlands.
  • Private clinical practice in Salzburg, Salzburg, Austria.
  • New Weight, Private clinical practice, Germany, Germany.
  • Department of Gastroenterology, Jaber Al Ahmed Al Sabah Hospital,, Kuwait City, Kuwait. Digestive Endoscopy Unit, Hospital Quirón Teknon, Barcelona, Spain.
  • Brigham and Women's Hospital, Boston, MA, USA.

Abstract

BACKGROUND

Obesity is a chronic and highly prevalent disease. Although bariatric surgery is the most effective treatment, access remains limited. Endoscopic bariatric therapies have emerged as minimally invasive alternatives. MEGA (Endoscopic Gastric Megaplication) is a modified version of POSE 2.0 that uses two G-LIX devices, a 33-mm G-PROX, and fewer sutures (mean: six) to create double gastric plications, with the goal of streamlining the procedure.

OBJECTIVE

To evaluate the technical reproducibility, clinical efficacy, and safety of the MEGA technique at 6 months in a multicenter cohort of patients with obesity, and to explore inter-center variability and correlations between technical and clinical outcomes.

METHODS

This retrospective multicenter cohort study included 54 patients with BMI (kg/m²) ≥ 27and comorbidities or BMI ≥ 30, treated with MEGA across six European centers experienced in bariatric endoscopy. Procedures were performed by local endoscopists after standardized training by a single instructor. Technical variables (number of sutures, procedure time) and clinical outcomes (%TBWL, %EBWL) were analyzed.

RESULTS

At 6 months, mean %TBWL was 14.75 ± 6.24% (95% CI:13.05-16.45), and mean %EBWL was 56.17 ± 33.75% (95% CI: 46.96-65.39), with no significant differences among centers (p = 0.406). Overall, 81.5% of patients (95% CI: 69.2-89.6) achieved ≥ 10% TBWL. No serious adverse events were reported. No correlation was found between number of sutures and %TBWL.

CONCLUSION

In this preliminary multicenter study with 6-month follow-up, the MEGA technique was associated with clinically meaningful weight loss and no serious adverse events. Larger prospective studies with long-term follow-up are needed.

MeSH

Cohort Studies, Drug-Related Side Effects And Adverse Reactions, Sutures, Obesity, Therapeutics