Endoscopic Sleeve Gastroplasty (ESG)

This procedure uses an endoscope (a flexible tube with a light and camera attached to it) to reduce the volume of the stomach from the inside using a technique called endoscopic suturing. This procedure is performed entirely with the use of an endoscope without any surgical skin incisions or cuts into the stomach itself. While the patient is under general anesthesia, an endoscope with specially designed suturing capabilities is inserted through the mouth and into the stomach, a muscular organ shaped somewhat lie a flask. From inside the stomach, endoscopic suturing is performed to fold the greater curvature of the stomach wall thus reducing the overall volume of the stomach. The goal is to change the stomach from the shape of a large flask into a shape that resembles a skinny banana, similar to the size and shape of a surgically performed sleeve gastrectomy.

ESG can reduce the volume of the stomach by 50 to 70 percent. Because the stomach is smaller and slower to expel food, patients will feel a sense of fullness earlier and eat fewer calories. ESG is not reversible; the remodeling process of the stomach wall is permanent. Therefore, it is crucial that the patient engage in a 12-month behavioral, exercise, dietary lifestyle program to maximize that amount of weight loss and maintain it in the future.

Most patients will lose around 15 to 20 percent of their total body weight with the first year.