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Background <p>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.</p> Objective <p>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.</p> Methods <p>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.</p> Results <p>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 (<i>p</i> = 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.</p> Conclusion <p>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.</p>

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

  • 期刊论文

  • 发表日期：

    2026年7月20日

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  • 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

摘要

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.