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Are you suffering from excess weight and have a body mass index of thirty or more?  

Are you unable to reach your desired weight loss target with diet and exercise alone?  

Do you wish for a healthier body without undergoing surgery and bearing the potential risks?  

Are you ready to make changes and adapt to a healthier lifestyle? 

You may be the perfect candidate for Endoscopic Sleeve Gastroplasty (ESG). 

ESG process

What is Endoscopic Sleeve Gastroplasty (ESG)?

ESG is one of the most popular and effective nonsurgical endoscopic weight loss procedures. It is a minimally invasive organ-preserving procedure that uses an endoscopic device to shrink the size and volume of a stomach by about seventy percent. You will therefore feel full and satisfied with less food, take in fewer calories, and consequently lose weight.   

ESG reshapes and shortens the stomach. It also causes delayed gastric emptying, thus helping the stomach empty into the intestines slower. This makes you feel fuller for a longer period of time. 

The whole ESG procedure is performed without any incisions. The endoscopist inserts an endoscope, a tube having a camera, and light through the mouth into the stomach. The endoscope is equipped with a stitching device that sutures the inside of the stomach. It brings the walls together like an accordion to diminish the stomach size. 

The process requires forty-five minutes, followed by a couple of hours in the recovery room for monitoring and hydration. After that, the patient is on the way home. 

Before the process, your physician may ask for some laboratory tests and will discuss some instructions you will need to follow. These can include fasting from midnight the day before the procedure, temporary modifications in your medications before and after the procedure, and a list of foods you can or cannot eat when you recover from ESG during the first few weeks. 

ESG is a very well-tolerated procedure. Some patients may experience nausea, abdominal pain, or discomfort. Those symptoms are frequently mild, do not last long, and typically resolve in a few days.  

Your physician will prescribe medications to alleviate such symptoms. 

Many people confuse Endoscopic Sleeve Gastroplasty and Vertical Sleeve Gastrectomy (also known as Sleeve Gastrectomy, or Laparoscopic Sleeve Gastrectomy) so it is vital to highlight the main differences. 

 

 

Vertical Sleeve Gastrectomy

What is Vertical Sleeve Gastrectomy (VSG)?

A sleeve gastrectomy, also known as a gastric sleeve surgery, is a surgical weight loss procedure. During this surgery, a portion of the stomach is removed, creating a smaller, banana-shaped stomach pouch. A smaller stomach restricts the amount of food a person can eat, leading to reduced calorie intake and weight loss. VSG is a surgical process. The surgeon makes small incisions in the abdomen and uses a laparoscope (a thin, flexible tube with a camera) to guide the surgery. They remove approximately 75-80% of the stomach, leaving behind the smaller sleeve-shaped portion. The remaining stomach is much smaller than the original, which limits the amount of food that can be consumed. This helps patients feel full more quickly and reduces their appetite. The sleeve gastrectomy not only reduces stomach size but also affects hormones that control hunger and metabolism. This can lead to improved appetite control and better weight loss results. Sleeve gastrectomy is a permanent procedure, as the removed portion of the stomach cannot be reattached. Patients typically experience significant weight loss following sleeve gastrectomy. The amount of weight loss varies from person to person but can be substantial. Besides weight loss, this surgery can improve or resolve obesity-related health issues such as type 2 diabetes, high blood pressure, and sleep apnea. Like any surgical procedure, sleeve gastrectomy carries risks, including infection, bleeding, and complications related to anesthesia. Patients need to discuss these risks with their surgeon.

 

 

ESG versus VSG

While both procedures reduce the stomach size, ESG is a much less invasive alternative in comparison with Laparoscopic Sleeve Gastrectomy, as the latter involves cutting and removing part of the stomach. 

Safety

ESG is much safer than Vertical Sleeve Gastrectomy. The most feared complications with Vertical Sleeve Gastrectomy are strictures (when the lumen of the stomach is too narrow and the patient can not eat) and leaks (when there is a hole at the staple line resulting in the leaking of stomach fluid into the abdomen). These are related to the fact that the surgery involves cutting and stapling the stomach. Endoscopic Sleeve Gastroplasty does not involve any cutting of the stomach and the whole procedure is performed from the inside of the stomach lumen. Therefore, the risk of complications is far less than surgery.  

No Incisions, No Scars

When a surgeon performs a Laparoscopic Sleeve Gastrectomy, incisions need to be made in the abdominal wall to introduce the camera and the equipment necessary to perform the surgery. This leaves abdominal scars.  ESG on the other hand, is performed through the mouth. It involves no incisions and leaves no scars.

Faster Recovery

Vertical Sleeve Gastrectomy involves making incisions in the muscles of the abdominal wall. This causes pain and the recovery is long. Patients usually need to be off work for 2-3 weeks. Endoscopic Sleeve Gastroplasty, on the other hand, does not involve cutting any muscles, as it is performed through the mouth, and the patients usually take 2-3 days off only before going back to work and to their routine. 

Outpatient Procedure

It is important to note that ESG is an outpatient procedure. You do not get admitted to the hospital, and it can be performed in an outpatient surgery center. This is in contrast with Laparoscopic Sleeve Gastrectomy which requires admission to the hospital usually for one night. 

Weight Loss

The results?  One year after the procedure, most patients drop between eighteen to twenty percent of their total weight.  Weight loss mostly happens early on and is usually maintained long-term in most patients. One study followed patients who underwent an ESG procedure for five years and the mean weight loss at five years was 15.9%. It is important to understand that weight loss with surgical sleeve gastrectomy is higher than the weight loss with ESG. With Laparoscopic Sleeve Gastrectomy, the expected weight loss usually varies from 25% to 35% of your total body weight. 

No Acid Reflux

Acid reflux is one condition that can be problematic when discussing bariatric surgery options. It is established that sleeve gastrectomy increases acid reflux. This can lead to damage to the esophageal lining resulting in esophagitis (inflammation of the esophagus) or Barrett’s esophagus (changes of the lining of the esophagus that can lead to cancer). One piece of great news is that ESG does not cause any increase in acid reflux. This was verified in clinical studies and it may be related to the preservation of the angle between the stomach and the esophagus as well as the nerves of the stomach (as the stomach is not cut). 

Health Benefits

Moreover, as ESG achieves significant weight loss, it leads to several health benefits such as improving blood pressure, blood sugar levels, obstructive sleep apnea, fatty liver, joint pains, mood, and quality of life. 

Long-Term Commitment

Like other weight-loss procedures, Endoscopic Sleeve Gastroplasty requires a commitment to a healthier lifestyle for sustainable long-term results. Although the procedure is effective, the best results are achieved by those who participate in an integrated support program.  

Endoscopic Sleeve Gastroplasty is a great tool that can help you take back control of your eating habits. It allows you to see actual results when you make the effort and change your lifestyle. Along with diet, exercise, and lifestyle changes, and with the support and nutritional and behavioral guidance provided by your treating team, ESG can help you deliver a new, better, healthier version of yourself. 

If you are ready to change your life, and you think Endoscopic Sleeve Gastroplasty may be a good option for you, do not hesitate to contact us. At The Silhouette Clinic, we are ready to provide you with a personalized weight management program, always toward a better, healthier you. 

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