Endoscopic Sleeve Gastroplasty (ESG)
Also known as a non-surgical sleeve or “endosleeve,” endoscopic sleeve gastroplasty is a newer type of weight-loss procedure. Endoscopic sleeve gastroplasty reduces the size of your stomach using an endoscopic suturing device without surgery. This procedure may be an option if you’re significantly overweight — a body mass index of 30 or more — and diet and exercise haven’t worked for you.
Endoscopic sleeve gastroplasty leads to significant weight loss. It helps you lose weight by limiting how much you can eat. And the procedure is minimally invasive, reducing the risk of operative complications. Like other options for weight loss surgery, endoscopic sleeve gastroplasty requires that you commit to a healthier lifestyle. You need to make permanent changes to your diet and get regular exercise to help ensure the long-term success of endoscopic sleeve gastroplasty.
What is ESG?
The ESG is a weight loss procedure that uses an endoscopic suturing device to reduce the size of the stomach by 70 to 80 percent. With reduced stomach size, patients will feel full sooner, and the stomach will not be able to secrete as many hunger-inducing hormones. The highlight of this procedure is that it is NON-SURGICAL. The fact that it is non-surgical translates to no incisions, no scars, and little or no pain after the procedure, which usually lasts under two hours. In essence, the ESG is an even less invasive version of the minimally-invasive laparoscopic sleeve gastrectomy (LSG).
Who is a candidate?
The endoscopic sleeve gastroplasty (ESG) is an excellent option for patients who are obese (BMI over 30) and are not ideal candidates or do want to avoid undergoing bariatric surgery. The procedure can help obese patients with (or help prevent) diabetes, high blood pressure, high cholesterol or triglycerides, obstructive sleep apnea, and heart disease or stroke. Endoscopic sleeve gastroplasty could be an option for people who aren’t candidates for other bariatric surgeries. The procedure is available to people whose body mass index (BMI) is above 30 who haven’t been successful in maintaining weight loss with other methods.
Is ESG the right treatment for me?
Endoscopic sleeve gastroplasty isn’t for everyone who is overweight. A screening process assists our physicians to determine if the procedure might be beneficial for you. You must be willing to commit to healthy lifestyle changes, regular medical follow-up, and participate in behavioral therapy.
Endoscopic sleeve gastroplasty isn’t appropriate for anyone who has gastrointestinal bleeding, a hiatal hernia larger than three centimeters, or who has had a prior bariatric surgical procedure.
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How is ESG done?
Endoscopic sleeve gastroplasty is performed in the surgery center as an outpatient procedure. General anesthesia is used for the procedure, so it does not involve any pain.
The procedure is done using an endoscope, a flexible tube with a camera and an endoscopic suturing device attached. The endoscope is inserted down your throat into the stomach. The tiny camera allows our specialist to see and perform the operation within your stomach without making incisions in the abdomen.
Using the endoscope, the doctor places approximately 12 sutures in the stomach. The sutures placed will alter the structure of your stomach, leaving it in a tube shape. The reshaped stomach then restricts the number of calories your body can absorb.
The procedure takes about 90 minutes. After the endoscopic sleeve gastroplasty, you’ll awaken in a recovery room, where medical staff monitors you for any complications. The majority of people return home the same day, after recovering from sedation. Some people might require a short admission to the hospital for one day or less for observation after the procedure.
Are there any risks associated with ESG?
Overall the ESG is a very safe procedure. The only risks involved include being under general anesthesia, bleeding (less than 1 percent), leakage (less than 1 percent), obstruction, and injury to the esophagus. These complications are very rare. The only discomfort you may have after the procedure is a sore throat, due to having the endoscope placed inside of your esophagus during the procedure. Because the procedure is still new, and not in extensive use, questions remain about its long-term effectiveness and risks.
How do I prepare?
If you qualify for a bariatric surgery sleeve, your health care team will give you specific instructions on how to prepare for your procedure. You will need to have various lab tests and exams before your weight loss surgery. You may have restrictions on eating, drinking, and which medications you can take. You also may be required to start a physical activity program.
It’s helpful to plan for your recovery after the procedure. For instance, arrange for help at home if you think you’ll need it. Recovery from endoscopic sleeve gastroplasty generally only takes a day or two.
What to expect after ESG
After the procedure, you won’t be allowed to eat for about eight hours. Then, you’ll be allowed to start a liquid diet, which you need to continue for at least two weeks. Over four weeks, you’ll move on to semi-solid foods, and then to a regular healthy diet.
You’ll also have medical checkups and meet with a nutritionist and psychologist frequently after your procedure.
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Endoscopic sleeve gastroplasty can lead to significant weight loss. The amount of weight you lose also depends on how much you can change your lifestyle habits. Studies of this advanced weight loss treatment reveal promising results.
A recent study of patients with an average BMI of around 38 found that endoscopic sleeve gastroplasty led to an average weight loss of 39 pounds (17.8 kilograms) after six months. After 12 months, weight loss was 42 pounds (19 kilograms).
In a study of people with an average BMI of about 45, the procedure resulted in an average weight loss of about 73 pounds (33 kilograms) during the first six months.
When weight-loss surgery doesn’t work
It’s possible not to lose enough weight or to regain weight after any weight-loss procedure, even if the procedure was performed correctly. This weight gain can happen if you don’t follow the recommended lifestyle changes. To help avoid regaining weight, you must make permanent healthy changes in your diet and get regular physical activity and exercise. Need more information? Call us today and ask about our bariatric surgery sleeve.
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