Endoscopic Sleeve Gastroplasty: Should You Do It? 

The ESG procedure is a minimally invasive alternative to surgical sleeve gastrectomy. It is less invasive because it doesn’t involve cutting into your abdomen and does not require stomach removal.

Patients with a BMI of 30 or greater can benefit from ESG by losing weight and treating obesity-related health issues such as high blood pressure, sleep apnea, and high cholesterol. ESG is performed while you are asleep under general anesthesia.

What is Sleeve Gastroplasty?

ESG, or endoscopic sleeve gastroplasty, is a minimally invasive bariatric procedure. It changes the shape of your stomach from a bean-like form into a tubular “sleeve.” It limits your food intake, which helps you lose weight. It also reduces the production of hunger hormones.

In ESG, doctors use an endoscope with a suturing device to enter your mouth and stomach. They double-stitch the wider part of your stomach, which makes it smaller and resembles a tube-like sleeve. It reduces your stomach’s volume without removing any stomach tissue and leaves no scars.

Like all weight loss surgery or procedures, it is best for people who struggle with obesity and cannot achieve their desired results through diet and exercise alone. It’s crucial to realize that ESG is not a cure-all; you must adopt healthy lifestyle adjustments to maintain weight loss and avoid issues. 

How Does Sleeve Gastroplasty Work?

Endoscopic sleeve gastroplasty cost varies from $8,100 to $27,300. The sleeve gastroplasty procedure is performed in the endoscopic suite under general anesthesia. The doctor puts an endoscope—a flexible tube with a camera—through the mouth, neck, and stomach. The endoscope releases gas into the stomach to expand it, allowing the surgeon to view it on a monitor.

The endoscope is fitted with a suturing device so the surgeon can use it to change the stomach tissue. In this reversible procedure, the surgeon places a series of sutures that connect folds of stomach tissue, forming a sleeve-like shape.

You will feel fuller more quickly because it decreases stomach volume and lowers the rate at which food travels to the colon. The procedure lasts about 90 minutes and is an outpatient option.

After the surgery, you’ll be on a liquid diet for several hours. Then, you’ll gradually move on to soft foods, then solids, until you can eat your regular healthy diet again.

As with all bariatric surgeries, sleeve gastroplasty can help you achieve substantial long-term weight loss—usually about 15%-20% of your total body weight in the first year.

What Can I Expect from Sleeve Gastroplasty?

ESG is a useful tool for people with trouble losing weight through diet and exercise. For some people, even a small weight loss can drastically lower their chance of developing obesity-related health problems. In many cases, excess weight loss may eliminate the need for medications to manage these conditions.

During the outpatient procedure, you will be under general anesthesia as the gastroenterologist passes the endoscope through your mouth and throat to stitch your stomach into a slimmer tube or “sleeve.” Because this is an incision-less operation, there are no surgical incisions or scarring. This small stomach sleeve limits the amount of food you can eat and changes the hormones that make you hungry.

To guarantee sufficient recovery and to get the most out of the treatment, you will start with a clear liquid diet before gradually transitioning to semi-solids and then a regular meal. Regular follow-up appointments and support from your behavior coach, dietitian, and medical team will help you achieve long-term success with this reversible, nonpermanent weight loss surgery.

Your gastroenterologist will inquire about your medical history and discuss your weight loss objectives during the appointment to determine whether you are a good candidate for this safe and effective procedure. Your healthcare team will also provide specific pre-procedure instructions and guidelines, dietary restrictions and recommendations to prepare for your surgery.

Is Sleeve Gastroplasty Right for Me?

Your stomach’s size and form can be altered through a minimally invasive surgical technique called a sleeve gastroplasty, or ESG. During the outpatient endoscopic procedure, your doctor uses a camera connected to an FDA-approved suturing device to apply four to six stitches.

These sutures fold your stomach into a narrow, “sleeve-like shape that holds less food. It helps you feel full more quickly and leads to sustainable weight loss. ESG is ideal for adults with a BMI over 30 who have tried to lose weight through diet and exercise but aren’t ready for traditional bariatric surgery.

Thanks to a general anesthetic, you will be put to sleep during the surgery. A gastroenterologist trained in endoscopic procedures will insert the endoscope into your mouth, into your esophagus, and then into your stomach. A camera on the endoscope shows your stomach’s contents on a monitor.

You will start with a liquid diet, then move to semi-solid foods for two weeks, followed by a nutrient-dense, regular diet as directed by your dietitian. Like any other weight loss procedure, long-term success with ESG requires a commitment to permanent healthy lifestyle changes.

Before the procedure, you will meet with a specialist who is a board-certified doctor in obesity medicine and a registered dietitian. Then, you’ll have a comprehensive medical evaluation, including pre-operative blood work and an upper endoscopy.