Endoscopic Cervical Bariatric Surgery: Follow-up Study in a Porcine Model

• Published in: Obesity surgery Vol. 18; no. 9; pp. 1188 - 1191
• Main Authors: del Genio, Gianmattia, Gagner, Michel, Nocca, David, Cuenca-Abente, Federico, Biertho, Laurent, Waage, Anne, Faife, Barbara, del Genio, Federica, Boza, Camilo, Aggarwal, Rajesh, del Genio, Alberto
• Format: Journal Article
• Language: English
• Published: New York Springer-Verlag 01.09.2008; Springer Nature B.V
• Subjects: Animals; Endoscopy; Esophagus; Esophagus - pathology; Esophagus - surgery; Feasibility Studies; Female; Gastroplasty - methods; Hogs; Letter to the Editor; Medicine; Medicine & Public Health; Mucous Membrane - pathology; Neck; Surgery; Surgical techniques; Swine; Weight control; Weight Loss; Laparoscopy; Morbid obesity; Neck; Notes; Bariatric surgery
• ISSN: 0960-8923; 1708-0428
• DOI: 10.1007/s11695-008-9552-5

Background The realisation of bariatric surgery has to date modified the digestive process solely through procedures within the abdominal cavity. However, endocrine surgeons have recently demonstrated the feasibility of a minimally invasive approach to the neck. In this study, we explored the feasibility, safety and weight progression of a bariatric procedure performed at the neck. Methods Eleven 40–50 kg Yorkshire pigs underwent endoscopic placement of an adjustable band to the cervical esophagus (ECB). Weight was monitored at postoperative days 15, 30, and after 7 weeks; weight progression was compared with an identical group of pigs who underwent a sham procedure. At autopsy, the surgical site was evaluated in a microscopic and macroscopic manner. Results Mean operating time was 66 ± 5.76 min. All pigs tolerated the procedure well, except one subject that experienced food intolerance. The ECB group experienced significantly slower weight gain than the sham group ( P  = 0.005). Proper location of the band and absence of microscopic lesions at the esophageal wall were confirmed at autopsy and pathological examination. Conclusion Bariatric surgery at the neck is feasible and produces effects on weight reduction. Further refinements and longer observation periods are required to propose this procedure as safe and effective alternative in humans.