Endoscopic Sleeve Gastroplasty
What’s Endoscopic Sleeve Gastroplasty?
Endoscopic Sleeve Gastroplasty (ESG) is a minimally invasive, outpatient, non-surgical, incision-less weight loss procedure. The endoscopist sutures the stomach from the inside to reduce its size, which results in long-lasting weight loss. The procedure is very well tolerated. The patients are not admitted to the hospital, and they return to their normal routine after a few days.
Who is ESG for?
ESG is most suited for patients who were unable to achieve the desired weight loss with diet and lifestyle changes. It is also suited for patients who do not want to undergo surgery or who do not meet the criteria for traditional bariatric surgery.
The perfect candidate for ESG is a patient with a BMI between 30 and 40 who is committed to the weight loss program and willing to adapt to a healthier lifestyle.
How is ESG performed?
The procedure is done endoscopically, so no incisions are needed. The endoscopist advances an endoscope (a tube with a camera and a light on its tip) through the mouth to the stomach. The scope is equipped with a suturing device that allows us to suture the stomach from inside. This way, we can decrease the size of the stomach by about 70-80%. The stomach can accommodate smaller meals; but also the rate by which the food empties from the stomach is decreased, so a smaller meal lasts for a much longer period of time. The patient can follow a low caloric diet without feeling hungry all the time.
How much weight would you lose?
Most people lose around 18 to 20 percent of their total body weight at 1 year after the procedure. Most of the weight loss occurs early on but it is maintained. Five years after the procedure, people have maintained a 15% total body weight loss. The key is to adopt a healthier lifestyle in the long run.
Other health benefits of ESG
In addition to weight loss patients who undergo an ESG see an improvement in their blood sugar, blood pressure as well as mood and obstructive sleep apnea.
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What is ESG?
Endoscopic Sleeve Gastroplasty (ESG) is a minimally invasive, outpatient, non-surgical, incision-less weight loss procedure. The endoscopist sutures the stomach from the inside and invaginates it on itself to reduce its size, which results in long-lasting weight loss.
How is ESG different than laparoscopic sleeve gastrectomy?
ESG is NOT surgery. It is performed endoscopically through the mouth, so there are no incisions and no scars. While surgical sleeve gastrectomy requires admission to the hospital for 1-3 days, ESG is an outpatient procedure. You are monitored in recovery for a couple of hours then you go home the same day. We do not cut or remove any part of the stomach so it is a much safer option than surgery.
Is ESG reversible?
No. ESG is a permanent procedure, which is a good thing. Once the stomach heals, it remains in the same shape long term. This is key to long term maintained weight loss.
Do the sutures need to be removed?
No. Initially, the sutures hold the stomach in a sleeve shape. When the stomach heals, it will remain in the new shape and size long term and the sutures are no longer needed. However, we do not remove the sutures. The sutures are very small and thin and they remain within the wall of the stomach and you will not feel that they are there.
What are the most common side effects?
Most people experience nausea and some abdominal pain or discomfort after the procedure. These symptoms are usually mild and can be controlled with medications. The symptoms usually resolve in a few days.
Am I a candidate for ESG?
ESG is most suited for patients who were unable to achieve the desired weight loss with diet and lifestyle changes.
While there is no strict BMI requirement for the procedure, the perfect candidate for ESG is a patient with a BMI between 30 and 40 who are committed to the weight loss program and willing to adapt to a healthier lifestyle.
ESG is also suited for patients with higher BMIs who do not want to undergo surgery.
Are there any contraindications for the procedure?
Previous stomach surgeries and current gastric ulcers are contraindications for the procedure. Major medical problems such as advanced liver disease can also be contraindications.
How long does the procedure take?
The procedure itself takes around 60-90 minutes. You will be asked to present to the endoscopy suite an hour before the procedure. After the procedure, we will watch you in the recovery area for a couple of hours. We will give you additional IV fluids and any necessary pain or nausea medications, then you will be discharged home.
When can I return to work?
You will recover at home for 2-3 days then you can go back to work and resume your normal routine.
How much weight can I lose with ESG?
Most people lose around 18 to 20 percent of their total body weight at 1 year after the procedure. The weight loss is maintained and at 5 years after the procedure people have maintained a 15% total body weight loss. Weight loss can vary depending on the patient’s motivation and adherence to the dietary recommendations. The key is to adopt a healthier lifestyle in the long run.
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