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

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 feasib...

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Bibliographic Details
Published in:Obesity surgery 2008-09, Vol.18 (9), p.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: Article
Language:English
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
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Summary: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.
ISSN:0960-8923
1708-0428
DOI:10.1007/s11695-008-9552-5