Bariatric surgery has performed wonders for many thousands of patients fighting obesity, but potentially serious side-effects and high costs have spurred a search for alternatives. Now, my colleagues and I at Laval University in Quebec, Canada, have found that a far less intrusive option offers the promise of a highly safe, effective method of achieving significant weight loss, along with improved health and quality of life.

We are very encouraged by the results of our two-year preliminary study of an investigational endoscopic stapler—inserted into the stomach through the mouth—that can create substantial folds or plications, reducing stomach volume, diminishing appetite, and leading to major weight loss.

Investigational Articulated Circular Endoscopic (ACE) stapler
Investigational Articulated Circular Endoscopic (ACE) stapler


Study findings

Our promising findings, from a six-center study conducted in four countries, were presented this week in San Diego at Digestive Disease Week 2016, the largest international gathering of physicians, researchers, and academics in the fields of gastroenterology, hepatology, endoscopy, and gastrointestinal surgery.

We studied 69 patients in Canada, Israel, Argentina, and the Netherlands in whom we collectively created 600 folds using an investigational Articulated Circular Endoscopic (ACE) stapler. You can learn more about our study design here. The ACE process created no serious side-effects and only minimal discomfort, and it reduced stomach capacity by approximately 25%. In one year, patients lost an average of 30% of excess body weight; in the second year, with some regaining, the loss was about 20%.

Conventional bariatric surgery is performed under full anesthesia with substantial cutting of the abdominal wall, risking bleeding, leakage, and other complications. Hospitalization and post-operative care contribute to substantial costs. By contrast, the ACE stapler is used without any trauma to the abdominal wall and the most common side-effects are mild abdominal discomfort and sore throat from insertion of the gastroscope. Ninety-six percent of patients were discharged within 24 hours; most actually could have had same-day discharge, but they were kept overnight as a precautionary protocol.

These results may be particularly good news for the estimated one-third of the population who are obese or morbidly obese, do not respond well to diet or medication, and are not candidates for surgery. Until now, we had virtually no good treatment to offer them.

Beyond weight loss, we also observed significant improvement in obesity-related health problems, including diabetes, hypertension, and hyperlipidemia, but will need further study to reach conclusions. We also can report that obese patients who underwent the ACE treatment reported a wide range of improvements in their eating habits and in their overall quality of life. We are hoping that this will be a catalyst for lasting change for people struggling with obesity.


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