BariClip delivers significant reductions in BMI, %TWL and %EWL at six months

Laparoscopic vertical clip gastroplasty (LBCG) using the nonadjustable BariClip is a safe and effective bariatric procedure in the short term, with significant reductions in BMI, %TWL and %EWL observed over a six-month period, according to a retrospective observational study by researchers from Jordan.

Figure 1:  Schematic illustration of laparoscopic vertical clip gastroplasty using the nonadjustable BariClip system, showing the placement of the clip along the stomach to create a restrictive effect while preserving the continuity of the gastrointestinal tract.

In addition to weight loss, the investigators said the procedure has a low incidence of postoperative complications, absence of opioid use and rapid recovery highlighting the potential advantages of this minimally invasive and reversible technique.

Bariclip is designed to restrict gastric capacity while preserving anatomical integrity. Unlike traditional sleeve gastrectomy, Bariclip implantation does not involve gastric resection, potentially minimising surgical risk and allowing reversibility. However, data on its early efficacy and safety remain limited.

Therefore, the study team evaluated short-term surgical outcomes, weight loss metrics, and comorbidity resolution among patients undergoing Bariclip implantation. This retrospective observational study included 82 patients who underwent Bariclip placement at Istiklal Hospital, Amman, Jordan. Outcomes assessed included total weight loss (TWL%) and excess weight loss (EWL%) at 2 weeks, 1, 2, 3 and 6 months postoperatively. Additional variables included operative time, hospital stay, early postoperative complications (within 30 days), reintervention rates and changes in obesity-related comorbidities.

Outcomes

The 82 patients had a mean age of 37.6 years (SD 9.9; range 18–60) and the majority were female (76.8%) and Jordanian nationals (95.1%). 45.1% had at least one comorbidity, most commonly diabetes or insulin resistance (54.1% of those with comorbidities). Most patients underwent Bariclip surgery for obesity (91.5%), with the remainder for overweight management (8.5%). The mean baseline BMI was 36.6 kg/m² (SD 4.7; range 27.2–48.5). All procedures were performed laparoscopically, with a mean operative time of 60.4 minutes (SD 2.15; range 58–65 minutes). No intraoperative complications were observed.

No patients required opioid analgesia during their hospital stay (0%). The mean postoperative pain score was 5.2 (SD 3.7; range 0–10). Mean scores for nausea and abdominal distention were 3.4 (SD 3.6; range 0–10) and 6.1 (SD 3.4; range 0–10), respectively. No patients experienced vomiting postoperatively (0%). Over half of the patients (54.9%) required mild analgesics (paracetamol) during admission, while the remainder (45.1%) did not require additional pain medication. The majority of patients ambulated within 1–2 hours after surgery (62.2%), with a smaller proportion mobilizing after 3–4 hours. Hospital stay was either 1 day (52.4%) or 2 days (47.6%) for all patients.

Out of 82 patients, three (3.7%) developed early procedure-related complications before the 6-month follow-up, all of which required readmission and surgical intervention. Two patients (2.4%) experienced clip slippage - one at 3 weeks and the other at 2 months postoperatively - identified through follow-up imaging prompted by suboptimal weight loss and persistent vomiting. Both were successfully managed with laparoscopic clip repositioning. One patient (1.2%) developed gastric erosion at approximately 4 months postoperatively, diagnosed via endoscopy after presenting with epigastric pain and anaemia. The clip was removed laparoscopically, and the patient recovered without further complications. No postoperative complications were observed at 6-month follow-up.

There was a statistically significant effect of time on BMI following Bariclip surgery (p<0.001) with mean BMI decreased significantly from baseline (Mean = 36.6, SD = 4.7) to all subsequent time points (2 weeks, 1 month, 2 months, 3 months, and 6 months; all p<0.001). A clear downward trend was observed, with mean BMI reaching 29.2 (SD = 3.9) at 6 months postoperatively (Figure 2).

Figure 2: Mean BMI trend across six time points after Bariclip surgery.

There was a progressive reduction in weight, %TWL, and %EWL across all timepoints. At 6 months postoperatively, the mean %TWL reached 20.04% ± 5.39%, while the mean %EWL was 74.32% ± 40.75%, indicating substantial weight reduction and improvement relative to excess body weight. The most significant drop occurred within the first three months, with continued but slower weight loss up to the six-month mark (Figure 3).

Figure 3: Mean %TWL and %EWL across six time points after Bariclip surgery.

The researchers said the findings suggest that BariClip may offer advantages in operative efficiency, early recovery, and perioperative safety, although their dataset was limited to weight loss and perioperative outcomes. Systematic data on comorbidity resolution, GERD incidence, and quality-of-life measures were not available in this retrospective cohort, which represents a limitation of their study.

“With its favourable risk profile and potential for reversibility, Bariclip may represent an appealing option for patients who are not ideal candidates for permanent anatomical alteration. It may serve as a reversible, anatomy-preserving alternative to Lap-BAND, a minimally invasive competitor to ESG, or a bridge procedure for selected patients who are not candidates for permanent anatomical alterations,” the authors conclude. “Future prospective and randomized studies comparing Bariclip to LSG, endoscopic sleeve gastroplasty, or pharmacologic interventions are needed to confirm its place in the bariatric surgery spectrum. Moreover, assessment of comorbidity resolution, quality of life, and patient satisfaction will provide a more comprehensive evaluation of its clinical utility.”

The findings were reported in the paper, ‘Retrospective analysis of the BariClip procedure: Clinical outcomes and complication profile’, PLOS One. To access this paper, please click here

Image:

Figure 1:  Schematic illustration of laparoscopic vertical clip gastroplasty using the nonadjustable BariClip system, showing the placement of the clip along the stomach to create a restrictive effect while preserving the continuity of the gastrointestinal tract.