The POSE-2 Procedure for People with Obesity: A Safe and Effective Treatment Option.

PURPOSE: Besides lifestyle interventions, medication, and surgery, endoscopic options are becoming part of the current treatment landscape for people with obesity. With the POSE (Primary Obesity Surgery Endoscopic) procedure, endoluminal folds are created in the stomach with full-thickness sutures. Recently, the modified version, POSE-2, was introduced in clinical practice. This study aims to evaluate the safety and effectiveness of the POSE-2 procedure after one year in patients with obesity. MATERIALS AND METHODS: All patients treated with the POSE-2 procedure between March 2019 and November 2022 in the Zuyderland Medical Center and the Dutch Obesity Clinic were included in this retrospective data study. Inclusion criteria are as follows: age between 18 and 65 years and a BMI > 30 kg/m2. All patients with contraindications for the POSE-2 procedure were excluded. RESULTS: Forty-nine patients were included of which 86% were female, with a mean age of 46 years and mean BMI of 34.6 kg/m2. Total weight loss was evaluated at 3, 6, and 12 months and was 11.5%, 13.2%, and 14.8%, respectively. A median of 14 anchor sutures was used in a median procedure time of 50 min. All patients except one had same day discharge. Postprocedural complaints were mild and consisted of nausea and vomiting (36.7%) and pain (54.2%). No complications were recorded in this group. One week postprocedure, most patients (95.9%) reported feeling satisfied between meals. CONCLUSION: The POSE-2 procedure can be applied as a safe and effective treatment for people with obesity. This study presents a positive effect on weight reduction and no complications after 1 year of follow-up.

Perforation of stomach lining 1 year after POSE procedure.

The primary obesity surgery endoscopic, or POSE, is an endoscopic procedure where sutures are placed in the stomach to reduce its size and achieve weight loss. This procedure is regarded as a safe procedure with little minor or major adverse events. We describe the case of a woman who presented with a perforation of the stomach lining 1 year after a POSE procedure at the site of a snowshoe anchor. This has not been described previously as a late complication. The perforation was treated surgically by removing the anchor and closing the defect. Later analysis revealed an active Helicobacter pylori infection.

A flickering cutaneous lesion occurring after an insect bite.

Many exaggerated skin reactions after insect bites have been described and due to global warming the incidence of these cases will increase. This clinical video promotes its recognition by showing an unusual cutaneous phenomenon after an insect bite.