Adjustable totally Implantable intragastric prosthesis (ATIIP) -: Endogast® for treatment of morbid obesity:: One-year follow-up of a multicenter prospective clinical survey

Background: The Adjustable Totally Implantable Intragastric Prosthesis (ATIIP) - Endogast (R) is a new mini-invasive technique for the treatment of morbid obesity. The ATIIP is conducted using a surgical and endoscopic procedure. The permanent presence of an air-inflated prosthesis inside the gastric corpus-fundus area and the fixation of the stomach to the abdominal wall are the two main principles in the technique. The prosthesis is connected to a subcutaneous totally implantable system. The aim of the ATIIP is to induce early satiety and reduction of meal intake. This study presents the preliminary results of 1-year follow-up of a multicenter prospective clinical survey. Methods: From November 2004 to March 2007, 57 patients underwent ATIIP: 28 males (49%) and 29 females (51%), with mean age 43.6 years (18-69) and mean BMI 48.9 (33.7-81.2). Follow-up was 1-28 months. Results: Feasibility was 100%, reproducibility 100%, and acceptability found no vomitting. Mean volume of the prosthesis was 210 ml of air (first 3 months, 40 patients). Mean %EWL was 22.3% (3 mos, 40 pts), 28.7% (6 mos, 38 pts), and 39.2% (12 mos, 20 pts). Early postoperative complication was local subcutaneous infection in 7 pts (12.2%). In 16 pts who had a subcutaneous drain and empirical antibiotic therapy until the 4th postoperative day, local infection occurred in 1 patient (6.2%). Late postoperative complications occurred in 3 pts (5.2%) who developed port erosion. Conclusions: Preliminary results indicate that the ATIIP is feasible, reproducible, safe with low risk of complications and has encouraging results in weight loss. Morbidly obese patients > 60 years old and the super-obese (BMI > 50) are specific indications.