**4.1 POSE™**

Primary obesity surgery endoluminal (POSE) uses the incisionless operating platform (IOP; USGI Medical, San Clemente, CA, USA) to create full-thickness plications in the gastric fundus to reduce gastric volume. The Pose procedure targeted the gastric fundal accommodation. In 2020 López-Navada presented the POSE 2 procedure. Using the same devices, the POSE-2 procedure attempts to impair the gastric motility and restrict the gastric volume [26].

Results: Lopez-Navada et al. reported 2015 about 147 patients who underwent POSE procedure and were followed for one year [9]. Mean EWL was 44.9%. In a meta-analysis of Khan et al. with 7 included studies about POSE procedure Mean pooled EWL after 12 months was 44.91% [27].

Complications: Lopez-Navada reported that short-term adverse events included minor bleeding at the suture site, which was managed without incidence. Sullivan et al. [28], one of the included studies of the meta-analysis of Khan et al., reported that 45% of patients had post-procedure abdominal pain requiring pharmacotherapy, and 40% reported nausea and vomiting. For POSE 2 procedure no AEs were reported.
