What is Endoscopic Sleeve Gastrectomy?
Endoscopic Sleeve Gastrectomy (ESG), also known as Endoscopic Sleeve Gastroplasty, is a minimally invasive, incisionless weight loss procedure. It is performed using an endoscope inserted through the mouth into the stomach. Special suturing tools are used to reduce the size of the stomach by up to 70%, creating a narrow “sleeve” shape. This limits food intake, slows gastric emptying, and supports long-term weight loss without the need for traditional surgery.
When is Endoscopic Sleeve Gastrectomy Recommended?
ESG may be recommended for individuals who:
- Have a body mass index (BMI) of 30 or higher and have not achieved weight loss with diet and exercise
- Are not suitable candidates for surgical weight loss procedures due to health risks or personal preference
- Wish to avoid the scars and longer recovery associated with traditional bariatric surgery
- Require a less invasive weight loss option before undergoing another medical procedure to reduce surgical risk
- Are seeking an alternative to permanent surgical changes to the stomach
How is Endoscopic Sleeve Gastrectomy Performed?
The procedure is carried out under sedation or general anesthesia. An endoscope fitted with a suturing device is passed through the mouth into the stomach. The surgeon then places a series of stitches inside the stomach wall, folding it inwards to reduce its volume and create a tubular shape. No external incisions are made. ESG typically takes 60–90 minutes, and most patients go home the same day or after an overnight stay.
What to Expect during Recovery after Endoscopic Sleeve Gastrectomy?
Recovery is generally quicker than surgical weight loss procedures. Patients usually resume light activities within a few days. A phased diet plan is followed — starting with liquids, then progressing to soft foods, and eventually to a balanced solid diet over several weeks. Regular follow-up appointments are scheduled to monitor progress and provide nutritional guidance.
What are the Risks of Endoscopic Sleeve Gastrectomy?
While ESG is considered safe, potential risks include:
- Nausea or vomiting in the initial days after the procedure
- Abdominal pain or cramping
- Bleeding from the stomach wall
- Rare risk of stomach leak or perforation
- Blood clots (very uncommon)
What are the Benefits of Endoscopic Sleeve Gastrectomy?
Key advantages of ESG include:
- No abdominal incisions or visible scars
- Reduced recovery time compared to surgical options
- Significant weight loss potential
- May improve obesity-related health conditions such as type 2 diabetes and high blood pressure
- Adjustable or reversible if required
