Post written by Maria Valeria Matteo, MD, from Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.

This study is a prospective multicenter investigation aimed at assessing the safety, efficacy, and usability of the EndoZip suturing device (Nitinotes Ltd, Cesarea, Israel) for automatic endoscopic gastroplasty in the treatment of class 1 and class 2 obesity.

Obesity rates are rising globally, creating a need for effective treatments. Traditional bariatric surgeries are effective but performed on only a few eligible patients because of risks and resource limitations. Endoscopic gastroplasty offers a less-invasive alternative, but it has a steep learning curve that limits its use to advanced endoscopists. The EndoZip device is a fully automatic endoscopic suturing tool designed for easy use, allowing for creation of gastric segmentations. This operator-friendly system enables an endoluminal gastroplasty that restricts stomach capacity and impairs gastric motility.

This study demonstrates that automatic endoscopic gastroplasty using EndoZip is a safe and effective treatment for obesity. In 43 patients, the mean percentage of total body weight loss at 12 months was 13.21%, with 76.6% achieving a reduction of more than 5%.

Significant improvements were noted in waist circumference, glycated hemoglobin, and alanine aminotransferase levels (P < .001), along with a rise in quality-of-life scores from 35.8 to 51.28 (P < .001). Serious adverse events occurred in 4.4% of patients. The user-friendly design of EndoZip permits quick familiarity for endoscopists, who reported its effectiveness in gastric segmentation and volume reduction.

Advancements in endoscopic techniques are crucial for bridging the gap left by current obesity treatment options. Automatic endoscopic gastroplasty with the EndoZip suturing device marks a significant step forward by simplifying the gastroplasty procedure and reducing operator dependency in suturing. The results observed thus far are encouraging.

Moving forward, further studies with larger sample sizes are needed to assess the long-term durability of the procedure, its impact on comorbidity resolution, and underlying physiological mechanisms of weight loss.

The EndoZip device and its parts.

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