Endoscopic pyloric suturing to facilitate weight loss: a canine model.

Abstract

BACKGROUND: More than 66% of adults in United States are overweight or obese. OBJECTIVE: To decrease gastric emptying and cause early and prolonged satiety by endoscopically narrowing the gastric pylorus. DESIGN: Thirteen dogs were randomized into 3 groups (suture, sham, and control). SETTING: Animal facility. INTERVENTIONS: Sutures were placed across the pylorus in the 7 dogs in the suture group by using an endoscopic suturing device. Three sham dogs had endoscopy without suturing, and 3 control dogs did not have any intervention. MAIN OUTCOME MEASUREMENTS: Gastric emptying studies were conducted on all of the dogs by using 13C-octanoic acid breath tests. All dogs were monitored for daily food intake and weight gain/loss. RESULTS: The suture dogs decreased their food consumption by 48% (P < .02), whereas the sham and control dogs showed 9.5% increase (P = .16). The suture dogs lost 12.7% (P = .001) of their initial body weight, whereas the sham and control dogs gained 13.4% (P = .03). There was a delay in gastric emptying between the presuturing baseline and last postsuturing measurement by 30.75% (P = .005) in the suture dogs. In the sham plus control dogs, there was a delay in gastric emptying during the same period by only 6.75% (P = .55). LIMITATIONS: Long-term efficacy of the sutures was not evaluated. CONCLUSIONS: There was a significant weight loss and decreased food consumption along with a significant prolongation of gastric emptying in the suture dogs compared with the sham and control dogs.