While under general anesthesia, we can go through your mouth with a large endoscopic instrument and tighten the greater curvature and fundus of your stomach, much in a similar fashion to a "sleeve" gastrectomy of greater curvature plication which drastically decreases your hunger and may greatly assist in your weight loss journey. This special procedure involves tightening your stomach without traditional surgical incisions. Advances in the use of mechanical endoscopic instrumentation has made this technique possible. We use the IOP or Transport from USGI Medical to access the stomach through the mouth and visualize the inner stomach and place the durable suture anchors to complete the procedure. This device was first utilized in the U.S. to work on revisional patients as a platform to tighten dilated stomach pouches or dilated connections between the stomach and small intestine after prior weight loss surgery. It was developed to be a safer alternative to the Open or Laparoscopic Gastric Bypass Revisional surgeries. At present in the U.S. and worldwide there is no reported deaths or serious complications from this procedure (lower mortality rate, fewer problems with nutritional deficiencies and a decreased risk of complications and infection than traditional procedures).

Advantages of P.O.S.E.:
  • Body anatomy is left intact.
  • No significant malnutrition since the body is absorbing the vitamins and minerals.
  • No dumping syndrome.
  • The procedure is reversible; tissue anchors could be removed without invasive surgery if desired.
  • No incisions.
  • Little recovery (minimal sore throat).
  • Privacy - no one will ever know you had this done (no scars!), unless you tell them!!
  • No bridges are burned; as a more invasive procedure could always be done at a later time if desired.
  • No staple lines.
  • Great early weight loss data from single US center presented at IFOS (9-2011) showed 38% EWL at 12 months [which is better than that found with the Realize C band 12 month weight loss recently published by Dr. Ponce).

Disadvantages/Risks of P.O.S.E.:
  • Requires the patient’s strict compliance to lifestyle changes including proper diet & exercise in order to succeed.
  • Vomiting can occur if food is not properly chewed or is being eaten too quickly.
  • This is a CASH or self pay procedure, as insurance does not cover this at this time.
  • Staple lines, if compromised, can leak stomach fluid causing serious infection.
  • Overeating could cause the stomach pouch to begin to dilate over time.
  • There is no long term data at present. See Dr. Lavin data presented at IFSO (9-2011).

Please feel free to discuss the potential for risks and benefits of this procedure further with Dr. Balder at a seminar or at the comfort of an individualized & personalized office visit.

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