Weight Loss

Weight-loss procedure makes stomach into 'accordion' without surgery

A new, nonsurgical weight-loss procedure — which involves inserting a tube down a patient's throat and suturing the stomach — is safe and effective, a new study finds.

During the procedure, which is called endoscopic sleeve gastroplasty, doctors insert a long tube down a patient's esophagus to the stomach. Then, they sew "pleats" into the stomach, which makes it resemble an accordion.

The procedure reduces the volume of the stomach, so that patients feel fuller faster and therefore eat less, said lead study author Dr. Reem Sharaiha, an assistant professor at Weill Cornell Medicine in New York City. Sharaiha presented her findings here today (May 6) at Digestive Disease Week, a scientific meeting focused on digestive diseases. 

Because the procedure is "endoscopic," and thus does not involve cutting through the abdomen, the procedure is not considered surgical.

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The new procedure could be a good option for people who are obese, meaning they have a BMI of 30 or higher, who either cannot undergo weight-loss surgery due to medical conditions or do not want to have surgery, Sharaiha said during a news conference in advance of her presentation. The procedure is not intended to replace other weight-loss surgery options, but rather to offer an additional, "safe and reliable, cost-effective" option, she said.

In the study, which has not yet been published in a peer-reviewed journal, Sharaiha and her co-authors compared the endoscopic sleeve gastroplasty to two options for weight loss that do involve surgery: laparoscopic sleeve gastrectomy and laparoscopic banding.

Both of those operations involve making small incisions in a person's abdomen to allow surgeons to reach the stomach. During a laparoscopic sleeve gastrectomy, surgeons cut away a large portion of the stomach, making the organ smaller and sleeve-shaped. During a laparoscopic banding operation, surgeons wrap a band around the upper portion of the stomach (rather than cutting the organ), so that only a smaller section of the stomach is left to carry out its functions.

The new study examined 91 patients who underwent the endoscopic procedure, 120 patients who had laparoscopic sleeve gastrectomy and 67 patients who had a laparoscopic banding operation, Sharaiha said during the press conference.

One year later, the researchers found that the patients who had the endoscopic procedure had lost, on average, nearly 18 percent of their body weight, while laparoscopic sleeve patients lost an average of nearly 30 percent of their body weight and laparoscopic banding patients lost an average of more than 14 percent of their body weight.

The endoscopic sleeve patients lost less weight than the laparoscopic sleeve patients but had a much lower rate of complications : 1 percent compared with 10 percent, Sharaiha said. In addition, endoscopic sleeve patients were able to leave the hospital the same day of the procedure, she said. Laparoscopic sleeve gastrectomy patients in the hospital for about three days, on average, after the operation, and laparoscopic banding patients stayed in the hospital for a day and half, on average, after the operation.

The endoscopic procedure also cost less than the laparoscopic sleeve procedure, according to the study. The endoscopic sleeve gastroplasty cost, on average, $12,000, while the laparoscopic sleeve gastrectomy cost $22,000 on average. The laparoscopic banding operation cost $15,000 on average.

Sharaiha noted that most the patients who underwent the endoscopic procedure had to pay out of pocket, while insurance usually covered the other operations. It's possible that this affected the results, as previous studies have shown that people are more adherent to weight-loss guidelines if the individuals need to pay for the procedures themselves, Sharaiha added.

Originally published on Live Science .