Evaluation of EndoZip System in Obese Patients Who Failed to Reduce Weight With Non-surgical Weight-loss Methods

A multicenter, prospective, single-arm, open-label, controlled clinical trial aimed to evaluate the safety and effectiveness of the EndoZip system procedure, coupled with lifestyle modifications, for weight reduction in obese patients with BMI of 30-40 kg/m2.

Study Overview

• Status: Completed
• Conditions: Obesity
• Intervention / Treatment: Device: EndoZip System

Detailed Description

study will include up to 45 (10-20 patients per site), ages of 21 -70 of obese patients who failed to reduce weight with non-surgical weight-loss methods.

The duration for each participant will be 12 months and will include the following follow up visits and procedures:

• Office visits: screening, 1 week, and 1, 2, 4, 6, 8, 10, and 12 month(s)
• Remote follow up (by Phone): 3, 5, 7, 9, and 11 month(s)
• Endoscopy procedure: baseline, 2 and 6 months post EndoZip procedure
• Motility evaluation by Gastric Emptying Breath Test (GEBT): baseline, 6 months
• Physical examination, vital signs, waist circumference and BMI: baseline, 1 week, 1, 2, 4, 6, 8, 10 and 12 months
• Blood tests: baseline,2, 6 and 12 months
• IWQOL-Lite: baseline, 2, 6 and 12 months
• Psychological health questionnaire-9 (PHQ-9) :baseline
• Sleep Apnea (only for the relevant population): baseline 2, 6 and 12 months

The patient will required to follow a specific diet and to have a physical activity during the study period ( 12 month).

• Study Type: Interventional
• Enrollment (Actual): 48
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Spain
  • Madrid, Spain, 28050
    • Hospital Universitario HM Sanchinarro

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 17 years to 66 years (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

1. Age 21-70
2. BMI ≥ 30 and ≤40 kg/m².
3. Willingness to comply with the substantial behavioral modifications program as required by the procedure.
4. Patients with history of failure with non-surgical weight-loss methods.
5. Willingness to follow protocol requirements, including signed informed consent, routine follow-up schedule, completing laboratory tests, completing IWQOL questionnaire and completing the medically supervised diet and behavior modification program.
6. Residing within a reasonable distance from the investigator's office and able to travel to the investigator to complete all routine follow- up visits.
7. Ability to give informed consent.
8. Women of childbearing potential (i.e., not post-menopausal or surgically sterilized) must agree to use adequate birth control methods.

Exclusion Criteria:

1. Prior surgery of any kind on the gastrointestinal tract (except uncomplicated cholecystectomy or appendectomy).
2. Patients with history of small bowel or colonic obstruction, and/or adhesive peritonitis and/or abdominal adhesions.
3. Patients with any inflammatory disease
4. Patients with history of cancer in the gastrointestinal tract.
5. Potential upper gastrointestinal bleeding conditions such as a history of angioectasias.
6. A known gastric mass or gastric polyps > 1 cm in size.
7. Patients with TG >500 or LDL >190
8. A known hiatal hernia > 4cm of axial displacement of the z-line above the diaphragm or severe or intractable gastro-esophageal reflux symptoms while on maximal medical therapy.
9. A structural abnormality in the esophagus or pharynx such as a stricture or diverticulum that could impede passage of the endoscope.
10. Patient with motility disorders of the GI tract or intractable constipation
11. Patients with known coagulation disorder (INR >1.5) or on anticoagulation therapy.
12. Type 1 diabetes or Type 2 diabetes with a HgbA1c >8 in 6 weeks prior the procedure or use of any medication for diabetes other than metformin. Patients with any serious health condition unrelated to their weight that would increase the risk of endoscopy
13. Patients with chronic abdominal pain
14. Patients with hepatic insufficiency or cirrhosis
15. Patients that used an intragastric device for weight loss within 2 years prior to this study.
16. Patients with psychological health questionnaire-9 (PHQ-9) score of 10 or higher.
17. Patients receiving daily prescribed treatment with high dose aspirin (> 100mg daily), anti-inflammatory agents, anticoagulants or other gastric irritants.
18. Patients with history or current abuse of drugs or alcohol
19. Patients who are unable or unwilling to take prescribed proton pump inhibitor medication
20. egg, milk, or wheat allergy (unable to go through the GEBT)
21. Patients who are pregnant or breast-feeding.
22. Patients who are taking medications that cause weight loss
23. Patients with Severe cardiopulmonary disease or other serious organic disease which might include known history of coronary artery disease, Myocardial infarction within the past 12 months, poorly-controlled hypertension, required use of NSAIDs
24. Patients taking medications on specified hourly intervals that may be affected by changes to gastric emptying, such as anti-seizure or anti-arrhythmic medications
25. Patients who are taking corticosteroids, immunosuppressants, and narcotics
26. Symptomatic congestive heart failure, cardiac arrhythmia or unstable coronary artery disease.
27. Pre-existing respiratory disease such as chronic obstructive pulmonary disease (severe COPD), pneumonia or cancer.
28. Diagnosis of autoimmune connective tissue disorder (e.g. lupus, HIV, erythematous, scleroderma) or immunocompromised.
29. Specific diagnosed genetic disorder such as Prader Willi syndrome (motility disorder)
30. Eating disorders including night eating syndrome (NES), bulimia, binge eating disorder, or compulsive overeating
31. Known history of endocrine disorders affecting weight such as uncontrolled hypothyroidism.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: EndoZip System; The Nitinotes EndoZip system is designed to allow for the creation of multiple internal gastric segmentation (4-8) in the stomach by using an endoscopic approach. The system allows the forming of wall-to-wall longitudinal attachments of the anterior and posterior stomach walls, creating multiple strictures within. Creation of this segmentation may significantly reduce gastric volume, may affect gastric motility and consequently, reduce weight.

Device: EndoZip System; The Nitinotes EndoZip system is designed to allow for the creation of multiple internal gastric segmentation (4-8) in the stomach by using an endoscopic approach. The system allows the forming of wall-to-wall longitudinal attachments of the anterior and posterior stomach walls, creating multiple strictures within. Creation of this segmentation may significantly reduce gastric volume, may affect gastric motility and consequently, reduce weight.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Body Total Body Weight Loss (kg) From Baseline to12 Months	Change in body total body weight loss (kg) from baseline to 12 months post EndoZip procedure	12 month
Percentage of Patients With a Reduction in %TBWL of at Least 5% From Baseline to 12 Months.	Percentage of patients with a reduction in %TBWL of at least 5% from baseline to 12 months.	12 month

Collaborators and Investigators

• Sponsor: Nitinotes Surgical Ltd.
• Investigators: Study Director: Ravit Peled, NiTiNotes Ltd

Study record dates

Study Major Dates

• Study Start (Actual): June 30, 2021
• Primary Completion (Actual): February 10, 2023
• Study Completion (Actual): July 3, 2023

Study Registration Dates

• First Submitted: February 21, 2021
• First Submitted That Met QC Criteria: February 24, 2021
• First Posted (Actual): February 26, 2021

Study Record Updates

• Last Update Posted (Actual): August 13, 2025
• Last Update Submitted That Met QC Criteria: August 12, 2025
• Last Verified: August 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Body Weight; Body Weight Changes; Weight Loss
• Other Study ID Numbers: CL00003

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No