Endoscopic Gastric Mega-plication (MEGA) for the Primary Treatment of Obesity: European Multicenter Retrospective Cohort, 6 Month Outcomes

Endoscopic Gastric Mega-plication (MEGA) for the Primary Treatment of Obesity: European Multicenter Retrospective Cohort, 6 Month Outcomes | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Endoscopic Gastric Mega-plication (MEGA) for the Primary Treatment of Obesity: European Multicenter Retrospective Cohort, 6 Month Outcomes Román Turró Araú, Gherzon Casanova Rimer, Antonio Ortega Sabater, and 13 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9534363/v1 This work is licensed under a CC BY 4.0 License Status: Under Revision Version 1 posted 12 You are reading this latest preprint version Abstract Introduction: Obesity is a chronic and highly prevalent disease. Although bariatric surgery is the most effective treatment, access remains limited. Endoscopic bariatric therapies have emerged as minimally invasive alternatives. MEGA (Endoscopic Gastric Megaplication) is a modified version of POSE 2.0 that uses two G-LIX, a 33 mm G-PROX, and fewer sutures (mean: six) to create double gastric plications, aiming to improve procedural efficiency and sustainability. Objective: To evaluate the technical reproducibility, clinical efficacy, and safety of the MEGA technique at 6 months in a multicenter cohort of patients with obesity, and to explore inter-center variability and correlations between technical and clinical outcomes. Methods: This retrospective multicenter cohort study included 54 patients with BMI >27 and comorbidities or BMI >30, treated with MEGA across six European centers experienced in bariatric endoscopy. Procedures were performed by local endoscopists after standardized training by a single instructor. Technical variables (number of sutures, procedure time) and clinical outcomes (%TBWL, %EBWL) were analyzed. Results: At 6 months, mean %TBWL was 14.75 ± 6.24 and mean %EBWL was 56.17 ± 14.91, with no significant differences among centers (p = 0.406). Overall, 81.48% of patients achieved >10% TBWL. No adverse events were reported. Mean procedure time was 31.4 ± 11.3 minutes, with a mean of 6.36 ± 0.76 sutures. No correlation was found between number of sutures and %TBWL. Conclusion: MEGA appears to be an effective, safe, and reproducible endoscopic technique, with consistent multicenter results supporting its use as a sustainable option for obesity treatment. Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Revision Version 1 posted Editorial decision: Revision requested 12 May, 2026 Reviews received at journal 11 May, 2026 Reviewers agreed at journal 03 May, 2026 Reviews received at journal 02 May, 2026 Reviews received at journal 02 May, 2026 Reviewers agreed at journal 01 May, 2026 Reviewers agreed at journal 01 May, 2026 Reviewers agreed at journal 01 May, 2026 Reviewers invited by journal 30 Apr, 2026 Editor assigned by journal 30 Apr, 2026 Submission checks completed at journal 29 Apr, 2026 First submitted to journal 26 Apr, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9534363","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":633627477,"identity":"afab93dd-209a-495e-bad2-b8ae26bef26d","order_by":0,"name":"Román Turró 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Surgery](https://link.springer.com/journal/11695)","snPcode":"11695","submissionUrl":"https://submission.springernature.com/new-submission/11695/3","title":"Obesity Surgery","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-9534363/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9534363/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eIntroduction:\u003c/strong\u003e\u003cbr\u003e\nObesity is a chronic and highly prevalent disease. Although bariatric surgery is the most effective treatment, access remains limited. Endoscopic bariatric therapies have emerged as minimally invasive alternatives. MEGA (Endoscopic Gastric Megaplication) is a modified version of POSE 2.0 that uses two G-LIX, a 33 mm G-PROX, and fewer sutures (mean: six) to create double gastric plications, aiming to improve procedural efficiency and sustainability.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eObjective:\u003c/strong\u003e\u003cbr\u003e\nTo evaluate the technical reproducibility, clinical efficacy, and safety of the MEGA technique at 6 months in a multicenter cohort of patients with obesity, and to explore inter-center variability and correlations between technical and clinical outcomes.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e\u003cbr\u003e\nThis retrospective multicenter cohort study included 54 patients with BMI \u0026gt;27 and comorbidities or BMI \u0026gt;30, treated with MEGA across six European centers experienced in bariatric endoscopy. Procedures were performed by local endoscopists after standardized training by a single instructor. Technical variables (number of sutures, procedure time) and clinical outcomes (%TBWL, %EBWL) were analyzed.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e\u003cbr\u003e\nAt 6 months, mean %TBWL was 14.75 ± 6.24 and mean %EBWL was 56.17 ± 14.91, with no significant differences among centers (p = 0.406). Overall, 81.48% of patients achieved \u0026gt;10% TBWL. No adverse events were reported. Mean procedure time was 31.4 ± 11.3 minutes, with a mean of 6.36 ± 0.76 sutures. No correlation was found between number of sutures and %TBWL.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e\u003cbr\u003e\nMEGA appears to be an effective, safe, and reproducible endoscopic technique, with consistent multicenter results supporting its use as a sustainable option for obesity treatment.\u003c/p\u003e","manuscriptTitle":"Endoscopic Gastric Mega-plication (MEGA) for the Primary Treatment of Obesity: European Multicenter Retrospective Cohort, 6 Month Outcomes","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-05-08 16:45:05","doi":"10.21203/rs.3.rs-9534363/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-05-12T23:35:21+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-11T23:29:56+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"28023044766419813054399917146199109553","date":"2026-05-03T13:39:02+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-02T17:55:28+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-02T08:15:26+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"335111885488676458331368483378664465008","date":"2026-05-01T17:17:16+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"11015849553067772606844730808147664531","date":"2026-05-01T11:39:56+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"309322553635776087843374673410653369544","date":"2026-05-01T07:29:02+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-04-30T21:48:12+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-04-30T19:33:16+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-04-29T22:26:25+00:00","index":"","fulltext":""},{"type":"submitted","content":"Obesity Surgery","date":"2026-04-26T20:16:40+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"obesity-surgery","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"obsu","sideBox":"Learn more about [Obesity Surgery](https://link.springer.com/journal/11695)","snPcode":"11695","submissionUrl":"https://submission.springernature.com/new-submission/11695/3","title":"Obesity Surgery","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"418b44e6-9857-4991-aaaf-1dbf1f5340b7","owner":[],"postedDate":"May 8th, 2026","published":true,"recentEditorialEvents":[{"type":"decision","content":"Revision requested","date":"2026-05-12T23:35:21+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-11T23:29:56+00:00","index":18,"fulltext":""},{"type":"reviewerAgreed","content":"28023044766419813054399917146199109553","date":"2026-05-03T13:39:02+00:00","index":17,"fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-02T17:55:28+00:00","index":16,"fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-02T08:15:26+00:00","index":15,"fulltext":""},{"type":"reviewerAgreed","content":"335111885488676458331368483378664465008","date":"2026-05-01T17:17:16+00:00","index":14,"fulltext":""},{"type":"reviewerAgreed","content":"11015849553067772606844730808147664531","date":"2026-05-01T11:39:56+00:00","index":13,"fulltext":""},{"type":"reviewerAgreed","content":"309322553635776087843374673410653369544","date":"2026-05-01T07:29:02+00:00","index":12,"fulltext":""},{"type":"reviewersInvited","content":"5","date":"2026-04-30T21:48:12+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-04-30T19:33:16+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-04-29T22:26:25+00:00","index":"","fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"in-revision","subjectAreas":[],"tags":[],"updatedAt":"2026-05-12T23:39:08+00:00","versionOfRecord":[],"versionCreatedAt":"2026-05-08 16:45:05","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9534363","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9534363","identity":"rs-9534363","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}