In November, the prestigious Cleveland Clinic hailed a "scar-less" weight-loss surgery as one of the top 10 medical innovations expected this year. Developed by a company aptly called Satiety Inc., the procedure shrinks the stomach by using a stapler inserted through the mouth, rather than by cutting open a person's belly. But when the results of a clinical trial came in, the procedure resulted in the shedding of far fewer pounds for patients than the company had hoped. Venture capitalists who had invested $86 million in Satiety over a decade shut the company down. The failure of the procedure, called transoral gastroplasty, pushes back the availability of any incision-less procedure to millions of obese Americans for several years, a disappointment to companies trying to find the next best thing to major surgery. The setback also further restricts options for those who are overweight, because it is occurring on top of federal rejections of a new generation of diet pills.