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A Modified POSE 2.0 Double Helix Megaplication Endoscopic Gastroplasty Pattern for Obesity: Initial One-Year Outcomes
1Tokyo Takahashi clinic Nerima, Tokyo, Japan. kodaiyy@hotmail.co.jp.
Introduction:
Endoscopic bariatric and metabolic therapies are increasingly used for obesity. Megaplication Endoscopic Gastroplasty (MEGA) denotes a modified macro-plication pattern within the POSE 2.0 Double Helix platform. Our modification offsets the plication trajectory approximately 45 degrees to the gastric long axis, aiming to reduce gastric volume and shorten the fundus-to-incisura distance.
Methods:
This single-center retrospective observational study included 50 patients who underwent MEGA between March 2025 and April 2026. Primary endpoints were %TWL at 3, 6, and 12 months and perioperative adverse events. Secondary endpoints were comorbidity improvement and 1-year suture retention. Missing follow-up data were not imputed.
Results:
Mean age was 45.9 ± 10.9 years, and mean preoperative body mass index was 34.5 ± 4.2 kg/m². Technical success was achieved in all patients, mean procedure time was 20.9 ± 9.6 min, and no serious adverse events occurred. Follow-up completion was 45/45 (100.0%), 34/38 (89.4%), and 13/15 (86.7%) at 3, 6, and 12 months, respectively. %TWL was 9.1 ± 4.4% (95% confidence interval [CI], 7.7%-10.5%), 12.3 ± 4.5% (95% CI, 10.7%-13.9%), and 18.3 ± 6.5% (95% CI, 14.3%-22.2%), respectively, increasing over time (P < 0.001). Six patients underwent 1-year endoscopy, and suture retention was 100.0% (6/6; exact 95% CI, 54.1%-100.0%).
Conclusion:
This initial Japanese series suggests that modified MEGA within the POSE 2.0 Double Helix platform achieved favorable 1-year weight loss, acceptable safety, and complete suture retention among evaluated patients. Prospective multicenter validation is warranted.