First commercial EndoZip ESG cases performed in France

The first commercial EndoZip Automated Suturing System for Endoscopic Sleeve Gastroplasty (ESG) cases have been performed in France. The cases were performed at the Institute of Image-Guided Surgery (IHU Strasbourg) in Strasbourg, France, under the leadership of Professor Silvana Perretta, Chief of Foregut Surgery and Advanced Gastrointestinal Endoscopy. This milestone represents another important step in Nitinotes' European commercial expansion following recent introductions in Italy and Spain.

Perretta's adoption of EndoZip highlights growing interest in ESG among physicians with expertise spanning advanced endoscopy, bariatric surgery, and foregut surgery, reinforcing the potential for automation to expand access to minimally invasive obesity treatment. A recognised international leader in surgical innovation, therapeutic endoscopy and minimally invasive gastrointestinal procedures, Perretta has been at the forefront of advancing integrated approaches to obesity and foregut disease treatment.

Silvana Perretta

"Obesity remains one of the most significant healthcare challenges worldwide, and expanding access to minimally invasive treatment options is increasingly important," said Perretta. "Technologies that simplify procedural execution and reduce technical complexity have the potential to support broader adoption of ESG across different physician specialties. My initial experience with EndoZip was promising, and I look forward to further evaluating its role in clinical practice."

Endoscopic Sleeve Gastroplasty has emerged as a minimally invasive option for patients seeking meaningful weight loss without surgery. However, adoption has historically been concentrated among a relatively small number of highly experienced endoscopists due to the technical complexity associated with conventional endoscopic suturing systems.

EndoZip is an automated endoluminal suturing system designed to simplify tissue approximation during endoscopic procedures for the treatment of obesity. By automating key suturing steps, the system is intended to reduce technical complexity and support a more standardized approach to ESG.

"One of our core beliefs has always been that automation can help unlock the full potential of ESG by making the procedure more accessible to a broader range of physicians," said Lloyd Diamond, CEO of Nitinotes. "The first cases in France, performed under Prof. Perretta's leadership at IHU Strasbourg, are particularly meaningful because they demonstrate interest not only among advanced endoscopists, but also among leading bariatric and foregut surgeons, supporting our belief that automation can help expand ESG adoption across a broader physician base."

The first commercial cases in France follow recent EndoZip procedures in Italy and Spain, reflecting continued commercial momentum and growing physician adoption following CE Mark approval.

EndoZip is CE marked in Europe and is currently limited to investigational use in the US.