Endoscopic Sleeve Gastroplasty (ESG)
Endoscopic Sleeve Gastroplasty (ESG) is a minimally invasive, outpatient, non-surgical, incision-less weight loss procedure. The endoscopist sutures the stomach from the inside to reduce its size, which results in long-lasting weight loss. The procedure is very well tolerated. The patients are not admitted to the hospital, and they return to their normal routine after a few days.
ESG is most suited for patients who were unable to achieve the desired weight loss with diet and lifestyle changes. It is also suited for patients who do not want to undergo surgery or who do not meet the criteria for traditional bariatric surgery.
The perfect candidate for ESG is a patient with a BMI between 30 and 40 who is committed to the weight loss program and willing to adapt to a healthier lifestyle.
The procedure is done endoscopically, so no incisions are needed. The endoscopist advances an endoscope (a tube with a camera and a light on its tip) through the mouth to the stomach. The scope is equipped with a suturing device that allows us to suture the stomach from inside. This way, we can decrease the size of the stomach by about 70-80%. The stomach can accommodate smaller meals; but also the rate by which the food empties from the stomach is decreased, so a smaller meal lasts for a much longer period of time. The patient can follow a low caloric diet without feeling hungry all the time.
Most people lose around 18 to 20 percent of their total body weight at 1 year after the procedure. Most of the weight loss occurs early on but it is maintained. Five years after the procedure, people have maintained a 15% total body weight loss. The key is to adopt a healthier lifestyle in the long run.
In addition to weight loss patients who undergo an ESG see an improvement in their blood sugar, blood pressure as well as mood and obstructive sleep apnea.