How Endoscopic Sleeve Gastroplasty Works
ESG is a minimally invasive procedure, done under sedation, that reduces stomach volume. It changes the stomach’s original bean-like shape to a narrow tubular “sleeve” to help promote weight loss.
Under general anesthesia, your physician creates the surgical sleeve gastrectomy’s anatomy by inserting an endoscope into your mouth and using a suturing tool. This creates restriction and alters hunger hormones to encourage weight loss.
What is ESG?
Endoscopic sleeve gastroplasty (ESG) is an incision-less bariatric procedure that reduces stomach size without removing organs. An endoscope, a tiny camera, and surgical tools are inserted by your doctor via your mouth, down your esophagus, and finally into your stomach during the roughly hour-long surgery. The endoscope is connected to a mechanical suturing device that places three rows of stitches in the area of your stomach holding food and shrinks it into a smaller “sleeve” shape.
This lessens the amount of food you can eat at any given time, which helps you lose weight. It also slows the speed at which food passes from your stomach to the intestines, so you feel full more quickly.
In addition to weight loss, patients who undergo this type of bariatric surgery often experience reduced symptoms. This often leads to better quality of life and higher self-esteem.
While studies of bariatric surgery have shown promising results, it is essential to understand that sleeve gastrectomy, like all weight loss procedures, may not be the be-all and end-all solution for long-term, sustainable weight loss. To manage excess weight, patients should consider ESG only after exploring other lifestyle and medical interventions, including diet and exercise.
How Does ESG Work?
A gastroenterologist inserts An endoscope into your mouth and stomach during an endoscopic sublingual sagittal gastroscopy (ESG). They employ it to make the sutures that transform your stomach’s shape from a bean-like to a sleeve-like tubular form. This restricts your food intake and makes you feel full after eating a smaller portion. ESG has been shown to help patients lose weight and improve their overall health.
In a recent meta-analysis, researchers found that ESG has comparable efficacy to surgical options like gastric sleeve surgery and Laparoscopic Banding (LSG). However, it has the added benefit of being a nonsurgical procedure. As such, it can be performed on patients who may not qualify for or would prefer not to undergo surgery.
ESG is reversible, meaning your stomach can return to its original shape. It is also a much safer procedure than LSG, with a lower risk of complications and shorter hospital stays.
However, it’s important to note that ESG is not a cure for obesity or its comorbidities. Diet, activity, and other factors can still significantly impact your ability to lose and keep weight off. To help you improve your health, a gastroenterologist can recommend working with a dietitian and other specialists. They can teach you strategies for sustainable weight loss so you can keep your weight off for years to come.
Who is a Good Candidate for ESG?
For many people, achieving and maintaining weight loss is difficult. But a recent study reported that weight loss surgery helps people achieve more sustainable and long-term weight loss — and reduces the risk of health complications like heart disease, diabetes, and sleep apnea.
However, bariatric surgery isn’t suitable for everyone. It’s also expensive and only sometimes covered by insurance. In addition, some patients may have health conditions that prevent them from undergoing gastric sleeve surgery. Endoscopic sleeve gastroplasty (ESG) is a minimally invasive alternative to surgical gastric sleeve gastrectomy (LSG) for these individuals.
In ESG, a doctor inserts an endoscope into the mouth to alter the stomach’s shape in a nonsurgical procedure similar to LSG. The process involves suturing the stomach into a narrow tube-like shape, creating restriction, which slows down how quickly food leaves the stomach and changes satiety-inducing hormones.
The ESG procedure is less invasive than LSG because there are no cuts or permanent changes to the stomach’s anatomy. It takes about an hour, and patients are fully sedated. Compared to other types of weight loss surgery, ESG results in more sustained and stable weight loss. It is also an excellent option for people with acid reflux or GERD, who could experience worsening symptoms after a surgical sleeve gastrectomy. However, more research is needed to understand how the procedure works and its hormonal effects.
What are the Benefits of ESG?
With ESG, you can lose significant weight and improve your health. You can’t eat as much after the surgery because, according to research, it slows down digestion, which makes you feel fuller sooner. You also absorb fewer calories from food, contributing to long-term weight loss.
You can expect to lose 20 percent of your body weight with this surgery, in combination with dietary and lifestyle changes. This is almost double the average weight loss from diet and exercise alone. You may also experience improved health conditions associated with obesity, including diabetes, hypertension, gout, high cholesterol, and liver disease.
The surgeon uses a narrow tube called an endoscope with a light and a camera to enter your stomach. The doctor then stitches your stomach to make it smaller, forming a narrow “sleeve” shape. This reduces your stomach’s volume by 70%, which limits how much you can eat and makes you feel full faster.
This procedure is relatively safe. It has a low rate of complications, and most minor side effects, such as pain, nausea, and vomiting, resolve within a few days.