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

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.