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'Sewing machine' surgery cuts pounds, not skin

A promising new weight-loss procedure may be a safe and effective way to help people who want to lose 40 pounds or more.
/ Source: TODAY

A promising new weight-loss procedure may be a safe and effective way to help people who want to lose 40 pounds or more, but want to avoid drastic obesity surgery.

The innovative, surgery-free method helped patients drop close to 18 percent of their body weight, researchers reported last month.

“It's like a glorified sewing machine,” says gastroenterologist Dr. Reem Sharaiha of New York Presbyterian Hospital/Weill Cornell Medical Center, who led the study.

“There are a series of sutures going from one part of the stomach to the bottom of the stomach all the way to the top. No scars, no cuts. You are asleep, like going to the dentist to pull your teeth out.”

Her team found that the accordion procedure helped patients, on average, lose 17.6 percent of their weight and nearly 27 inches from around their waists. The BMIs of the 91 patients who underwent the procedure between 2013 and 2016 decreased from 40.7 — considered morbidly obese — to a BMI of 32. The results were published in the May Journal of Clinical Gastroenterology and Hepatology.

The minimally invasive, non-surgery procedure involves using an endoscopic tube with a camera attached that goes down the mouth into the esophagus and lets a gastroenterologist see inside the stomach.

The doctors sews stitches in the stomach to pull it tight and make it smaller without making any cuts. Over time a patient's weight loss can plateau, but doctors can go back and re-tighten the stomach, leading to more pounds shed. After the procedure, post-op recovery involves a liquid diet for two weeks.

New York resident Jaheidi Fonseca, 31, was having trouble losing weight after having three children. Two-years ago Fonseca tipped the scale at 219 pounds, trying everything from diet pills to protein shakes to shed the weight — without success.

“It was incremental, after I had my first child I gained weight that never came off, having two other children I just kept gaining and harder for me to lose,” Fonseca, a medical technician, told NBC News. “I wasn't on the right track to start losing weight."

After seeing her fellow colleagues lose weight, Fonseca met with a gastroenterologist who recommended the endoscopic sleeve gastroplasty (ESG), also called the accordian procedure.

Obesity, defined as a body mass index (BMI) over 30, affects 78.6 million Americans — more than one-third of U.S. adults, according to the National Institutes of Health.

This procedure is meant for people with type 2 diabetes, sleep apnea, unhealthy cholesterol and a BMI of less than 40.

The study's early results show that the accordion procedure is safe, effective and less expensive than surgery for people who have been unable to lose weight through lifestyle changes, said Dr. Stacy Bethauer, president of the American Society of Metabolic and Bariatric Surgery, who was not involved in the study.

"While it may not be as effective as surgery, it has fewer complications and may be the ideal treatment for patients with less severe obesity," said Brethaur. "Like any weight loss treatment, endoscopic procedures should be done as part of a multidisciplinary weight management program that can help each patient determine the best option for them."

Dr. Scott Kahan, a weight loss expert at the Obesity Society and George Washington University Medical Center, sees promise in the procedure since it can be offered to a wider group of people. “This procedure includes patients with BMI over 30, whereas traditional bariatric surgery is usually only offered to people with a BMI of at least 35,” Kahan, who was also not involved in the study, told NBC News.

Currently, the procedure costs between $10,000-$15,000 and insurance coverage is limited. However, with more studies coming in, the accordion procedure could be covered. One limiting factor is accessibility, since approximately 25 centers in the U.S. currently perform this procedure, Sharaiha said.

After the 40-minute procedure, Fonseca went home the same day and the pounds came off and continued to drop. She lost nearly 60 pounds and found the stamina to start exercising and eating better.

“You see the weight loss right away,” Fonseca said. “Three days later you start feeling different and you start seeing changes little by little, day by day. You just lose more and that's the best thing the best feeling ever. I wanted to make a change for me.”