Endoscopic Sleeve Gastroplasty Procedure
Overview
Endoscopic sleeve gastroplasty (ESG) is a type of bariatric endoscopy that helps people manage obesity without the need for surgery. This procedure uses an endoscope—a flexible tube equipped with a camera and a suturing device—guided through the mouth to the stomach. Using this tool, the doctor stitches the stomach to reduce its size.
Key Facts About ESG:
- No external incisions
- Reduces stomach volume
- Short recovery time
People with a body mass index (BMI) of 30 or higher who have not seen results from diet and exercise may be candidates for ESG. The smaller stomach can help limit how much food a person eats, supporting weight loss. ESG often allows for a faster return to normal activities compared to traditional surgery. Success with ESG depends on making long-term diet and activity changes.
Reasons for Choosing This Procedure
Endoscopic sleeve gastroplasty targets people who have not reached their weight loss targets with lifestyle changes alone. Candidates usually have a body mass index (BMI) above 30. This procedure offers an option for those wanting to lose weight without undergoing traditional bariatric surgery like a Roux-en-Y gastric bypass or surgical sleeve gastrectomy.
Many people choose this treatment if they do not qualify for, or prefer to avoid, more invasive methods such as laparoscopic sleeve gastrectomy. It may also help those at risk for severe health conditions linked to obesity, such as:
- Heart disease and stroke
- Type 2 diabetes
- High blood pressure
- High cholesterol
- Joint concerns from osteoarthritis
- Sleep apnea
- Nonalcoholic fatty liver disease or NASH
A detailed health screening determines eligibility before starting the process. Some people, including those with large hiatal hernias or certain stomach conditions, may not be able to have the procedure. Willingness to commit to healthy habits, behavioral support, and medical follow-up is essential for anyone considering this weight loss option.
Note: Endoscopic sleeve gastroplasty might not be covered by all health insurance plans.
Possible Problems and Complications
Endoscopic sleeve gastroplasty generally poses few risks, but some remain. Common issues include pain, nausea, and vomiting for several days after the procedure. Medication usually relieves these problems. Less frequent but more serious complications include:
- Bleeding
- Abdominal infection
- Perforation (a hole in the stomach)
- Blood clots
All medical procedures have some level of risk. Patients should talk with their doctor about symptoms such as ongoing pain, fever, or signs of infection.
Getting Ready for Your Procedure
Preparation for endoscopic sleeve gastroplasty often includes several important steps:
- Lab Tests and Blood Work: Doctors may order these before surgery to check general health.
- Food and Drink Rules: Patients receive instructions on when to stop eating and drinking.
- Medicine Guidelines: Some medications must be stopped or changed before anesthesia.
- Physical Activity: Doctors may recommend starting with gentle exercise.
- At-Home Help: Arranging support at home helps with recovery.
What to Expect
What Happens While the Procedure Is Being Done
A gastroenterologist performs this minimally invasive weight loss procedure in an endoscopy unit. Patients receive general anesthesia, making them sleep and unaware during the process. The doctor does not make any cuts in the skin. A flexible endoscope with a camera and stitching tool goes through the mouth into the stomach.
This lets the doctor see clearly inside the body and place sutures without open surgery. The doctor reshapes the stomach into a narrow tube, which helps limit food intake by causing fullness sooner. The entire process usually takes between one and two and a half hours.
Key Points
- Outpatient setting
- No surgical incisions
- Performed by a gastroenterologist
- General anesthesia used
What Recovery and Care Look Like Right After
Once the procedure ends, patients go to a recovery area where medical staff monitor for problems. Most people leave the same day, but a short hospital stay may be needed if special care is required. To protect the stomach, patients cannot eat for several hours.
Patients begin a liquid diet, which lasts for about two weeks. The diet then moves to semisolid foods followed by a regular healthy diet. Recovery time is usually quick, thanks to the minimally invasive approach.
Post-Procedure Steps Table
| Timeframe | Diet Progression |
|---|---|
| Immediate hours | No food or drink |
| Days 1–14 | Liquid diet only |
| Weeks 3–4 | Semisolid foods allowed |
| After 4 weeks | Regular healthy foods |
Outcomes
Some individuals may not lose as much weight as expected or may gain weight back after weight-loss procedures. This can happen even when the treatment is performed correctly.
The main factors often include not sticking to changes in eating habits, physical activity, or self-care routines. People who stay dedicated to lifestyle changes usually see better outcomes, including:
- Weight loss of about 10% to 15% in the first year
- Improvement in type 2 diabetes
- Better blood pressure control
- Lower risk for heart disease and stroke
- Reduced joint pain
- Enhanced metabolic health
| Health Area | Possible Benefit |
|---|---|
| Hypertension | Lower blood pressure |
| Diabetes | Blood sugar improvement |
| Sleep Apnea | Fewer breathing problems |
| Metabolic Diseases | Improved overall health |
