Endoscopic Sleeve Gastroplasty

What is endoscopic sleeve gastroplasty?

Endoscopic sleeve gastroplasty (ESG) is a weight loss procedure that reduces the size of your stomach. It’s a treatment for children and adults with obesity (typically a BMI of 30 or higher). ESG is a minimally invasive alternative to sleeve gastrectomy surgery and other bariatric surgery procedures.

ESG lets your surgeon change your stomach without making any cuts into your belly. They do this by sliding an endoscope (a long, thin tube with a small camera) down your throat and into your stomach. They use stitches to close off a portion of your stomach. This reduces your stomach to a tubelike sleeve, which is about 30% of its original size. The smaller size limits how much you can eat. The narrow shape makes it take longer for your stomach to empty, so you feel fuller longer.

It may be an option for you if weight loss methods like exercise and changes to your diet were unsuccessful. Your healthcare provider can let you know if ESG could work well to help you lose weight.

What happens during the procedure?

Here is what you can expect:

1. You’ll be asleep for the procedure under general anesthesia.
2. A gastroenterologist or an endoscopic surgeon passes the endoscope through your mouth, down your esophagus and into your stomach.
3. The endoscope puts gas into your stomach to expand it.
4. The camera on the endoscope shows the inside of your stomach on a screen.
5. Your provider uses special tools on the endoscope to work inside your stomach.
6. Using a suturing device, they place about 10 stitches between the two walls of your stomach and draw them together.
7. When the walls are pulled together and closed with stitches, your stomach ends up shaped like a narrow tube.

The procedure itself takes 60 to 90 minutes. You may be able to go home later that day, but most people stay overnight so they can be monitored.

What are the side effects of ESG?

Most people have mild pain as their stomach heals. Some have more pronounced pain and nausea for a few days afterward. These side effects are often manageable with over-the-counter (OTC) medications.

What are the potential benefits and risks of ESG?

Benefits include:

• Weight loss of about 15% to 20% within 12 to 24 months
• Improvement of obesity-related illnesses like high blood pressure, Type 2 diabetes and high cholesterol
• Reversible (the stitches can be removed if necessary)

Risks include:

• Temporary pain, nausea and heartburn
• Weight regain or not losing as much weight as you thought
• Minimal risk of bleeding or injury from the endoscope
• Minimal risk of reaction to anesthesia

What is the recovery time from ESG?

Side effects from the procedure often go away within the first week. Most people can return to work at this time. It takes about a month before your stomach is healed enough to eat normally. You’ll have to eat carefully during this time. You’ll start on a liquid diet, then move to a soft diet. Finally, you’ll eat solid foods.

What results can I expect from endoscopic sleeve gastroplasty?

Most people lose 15% to 20% of their total weight within the first year. Weight regain is possible. But eating nutritious foods and exercising regularly can help you maintain your results.

When should I call my healthcare provider?

Call your healthcare provider if you have any of the following after ESG:

• Fever
• Severe belly pain
• Nausea or vomiting
• Blood in your poop or vomit
• Chest pain or shortness of breath
• Difficulty swallowing