Endoscopic sleeve gastroplasty (ESG) is a new, non-surgical, minimally invasive bariatric procedure that can lead to significant weight loss with lowered risks of complications. Endoscopic Sleeve procedure also offers reduced downtime.
A Non-Surgical Gastric Sleeve?
You read that correctly. The ESG procedure represents the latest advancements in gastric science. By opting for the procedure, you can begin losing excess weight right away without having to resort to external incisions, sutures, or stitches, and the lengthy downtime associated with traditional bariatric surgeries.
Endoscopic sleeve gastroplasty lets you get back to living life on your terms while getting a headstart on your weight loss journey.
Like other bariatric procedures, you must be committed to living a healthier lifestyle. That commitment, combined with your choice of an experienced bariatric surgeon, can lead to long-term success and a drastically improved quality of life.
What is Endoscopic Sleeve Gastroplasty (ESG)?
Endoscopic sleeve gastroplasty is unlike most bariatric procedures in that there are no incisions required. With traditional techniques like gastric sleeve surgery and Roux-en-Y gastric bypass surgery, much of the downtime you face is spent recovering from the trauma to your skin. That is not the case with ESG.
Another difference is that ESG is considered a low BMI bariatric procedure. That means that you can qualify for the weight loss technique even if you have a body mass index as low as 30. Meanwhile, gastric sleeve surgery and gastric bypass surgery CA CC require you to have BMIs of 35 to 40 and above.
The similarity to other bariatric procedures is that ESG can lead to long-term weight loss. Another similarity with a majority of bariatric surgeries is that ESG requires patients to commit to a year of physician’s advice, which includes healthy eating and a regular exercise routine.
ESG is performed by a board-certified bariatric surgeon or gastroenterologist. The procedure involves an endoscope, which is a camera attached to a flexible tube that is inserted through the mouth and down into the stomach. During the procedure, the stomach is diminished in size, which forces you to eat less, leading to long-term weight loss.
What is the Difference Between Endoscopic Sleeve Gastroplasty and Traditional Gastric Sleeve Surgery?
When the disease of obesity has taken hold and diet and exercise fail to move the numbers on the scale, patients have a variety of weight loss procedures to choose from. One of those is sleeve gastrectomy, otherwise known as gastric sleeve surgery, which is currently the most commonly prescribed weight loss surgery worldwide.
How Gastric Sleeve Surgery is Performed
During gastric sleeve surgery, several small incisions are made around the abdominal region. These cuts function as entry points for a laparoscope, a camera attached to a long tube. Surgical tools are inserted into the other incisions for the purpose of changing the digestive system.
Once these tools are inserted, 75-80% of the stomach is removed. The portion of the stomach extracted is responsible for the release of ghrelin, the hunger hormone. By removing the stomach tissue, your body produces less ghrelin, making you feel less hungry overall.
The remaining stomach tissue is converted into a banana-shaped tube or sleeve. The reduced stomach size limits food intake and creates a caloric deficit in the body. Not only do you feel less hungry, but you also end up eating less. These stomach changes make it possible to lose a majority of your excess weight quickly.
How Endoscopic Sleeve Gastroplasty is Different
ESG works in a similar fashion to gastric sleeve surgery minus incisions. Instead of going through the abdomen, a suturing device is inserted into the throat and finally the stomach. Once inserted, the surgical tool is used to make the stomach smaller. It will shape the remaining tissue into the resulting sleeve. Both procedures take around 60 to 90 minutes to complete.
As you can see, both gastric sleeve and endoscopic sleeve gastrectomy involve the same mechanisms. The main difference is that ESG does not involve trauma to the outside of the body.
How Does the Surgeon Perform Endoscopic Sleeve Gastroplasty?
The ESG procedure is considered an outpatient operation that is done under general anesthesia, which means you will be unconscious during the non-surgical session.
The bariatric surgeon uses a flexible tube affixed with a camera and endoscopic suturing device, which is better known by the term endoscope.
The camera allows the operating surgeon to view the internal workings of your stomach by way of a monitor in the operating room. The surgeon performs the surgery inside your abdomen, which prevents the need for any external incisions. Because of this factor, there is a lowered risk to your health and almost no downtime following the completion of the operation.
The surgeon uses the endoscope to place sutures in the stomach, which converts the stomach into a much smaller tube or sleeve. As a result, you are restricted by how much food you can eat.
A normal stomach holds around 3 pints of food while the newly converted stomach holds around a half-cup of food. The procedure teaches you to eat smaller portions. You also feel fuller faster during meals.
Watch this ESG Demonstration Video by Johns Hopkins Medicine
Who is a Suitable Candidate for Endoscopic Sleeve Gastroplasty?
This innovative weight loss procedure is suitable for those with elevated body mass index (BMI) scores of 30 or higher. In many cases, those with high BMIs also suffer from one or more obesity-related ailments like type 2 diabetes, high blood pressure, obstructive sleep apnea, and nonalcoholic fatty liver disease.
Endoscopic sleeve gastroplasty is an effective treatment for these obesity comorbidities. The bottom line is that anyone who wants to lose significant weight and live a healthier, longer life, can be an excellent candidate for this bariatric procedure.
Procedures like endoscopic sleeve gastroplasty are traditionally performed after you have tried and failed to lose weight by changing your diet and exercise habits. ESG is recommended for those who do not qualify for traditional bariatric surgery or wish to enact weight loss without resorting to surgical treatments such as gastric bypass surgery or gastric sleeve surgery.
To determine if you are an ideal candidate for ESG, your bariatric surgeon will perform a screening test. This test will determine if the procedure may be beneficial for you. In addition to surgery, your bariatric surgeon will want to ensure you are ready to commit to a healthy lifestyle. He will arrange regular follow-ups that include visits with behavioral therapy specialists, a dietician, physical fitness experts, and others. These experts will become known as your bariatric healthcare team.
Who is Not a Suitable Candidate for Endoscopic Sleeve Gastroplasty?
You are not recommended for this surgery if you have a large hiatal hernia or a condition associated with gastrointestinal bleeding, such as a peptic ulcer or gastritis.
How Much Does Endoscopic Sleeve Gastroplasty Cost?
The average cost of endoscopic sleeve gastroplasty ranges from $12,000, making it less expensive than many traditional bariatric surgery options.
Does Insurance Cover Endoscopic Sleeve Gastroplasty?
Health insurance companies have historically viewed bariatric procedures as cosmetic in nature rather than as life-saving surgeries. Times have changed. Many procedures today recognize the life-quality benefits of bariatric techniques such as gastric bypass and gastric sleeve. However, since endoscopic sleeve gastroplasty is a new type of procedure, your policy may not cover the fees associated with the non-surgical weight loss technique. Check with your policyholder for details.
While insurance is unlikely to cover ESG, there are ways to afford the weight loss procedure. If you cannot pay the full amount outright, medical financing is available. Companies like Care Credit can be used to cover the costs of surgery. This will allow you to worry about payment fulfillment later. Other ideas include getting a personal loan, or a credit union loan, and borrowing the fees necessary from family or friends.
Are There Risks to This Minimally Invasive Bariatric Surgery?
One of the benefits of opting for endoscopic sleeve gastroplasty is that the operation greatly lowers the risks to your health. You may experience pain and nausea for several days, which is typical of any digestive-system-altering technique. These side effects can be managed with pain and nausea medications. You should feel better after a few days.
If weight loss stalls or is not as significant as you would have hoped, you can opt for another bariatric surgery such as gastric bypass surgery.
How Much Weight Can You Lose with Endoscopic Gastroplasty?
If you can manage to alter your lifestyle, which means eating healthily and getting regular exercise, you have the potential to lose between 15% and 20% of your total body weight within a span of 12 to 24 months. That means a person weighing 300 pounds stands to lose between 45 and 60 pounds, respectively.
After the initial weight loss, your bariatric specialist will give you tools to prevent the weight from being regained. To be successful with weight loss procedures and prevent weight regain, all patients are required to make lifestyle changes. Eating healthily and taking part in regular exercise can help you keep the excess weight at bay.
Your bariatric specialist will also give you advice for keeping the weight off, such as working closely with a dietician or nutritionist, using a personal trainer, taking part in online or in-person support groups, keeping a food journal, maintaining motivation, and having the support of family and friends.
What Health Conditions Can Improve After ESG?
Studies have shown that endoscopic sleeve gastroplasty can improve or resolve the symptoms of:
- Type 2 diabetes
- Hypertension (high blood pressure)
- Osteoarthritis (joint pain)
- Obstructive sleep apnea
- Mood disorders (anxiety and depression)
- And many more!
The procedure can also lower the risk of stroke, heart attacks, and several types of cancer.
How Do You Prepare for Endoscopic Sleeve Gastroplasty?
If your bariatric surgeon during the initial consultation deems you a suitable candidate for endoscopic sleeve gastroplasty, your health team will give you specific instructions on how to adequately prepare. They may perform various lab tests and examinations prior to surgery to ensure the state of your health.
The health team will advise you to refrain from eating and drinking in the hours prior to the procedure. They will also advise you on which medications you can and cannot take. They might require you to begin a physical fitness program as a part of your bariatric treatment plan.
What is Recovery Like After Endoscopic Sleeve Gastroplasty?
With popular bariatric surgeries like sleeve gastrectomy and Roux-en-Y gastric bypass, there is a recovery period of several weeks to a month. This time span allows the body to heal from the effects of anesthesia and surgical trauma done to the body as the digestive system is altered.
With ESG, since the procedure is technically non-surgical, recovery is typically fast. Most patients are released from the hospital on the same day. You can also usually return to work within 24 to 48 hours following the procedure.
Furthermore, you will not face any exercise or lifting restrictions upon returning home. Your body should be fully recovered. This will allow you to almost immediately return to your everyday activities.
We recommend that you plan ahead for the recovery phase of the procedure. That includes arranging for a friend or family member to drive you from the surgical center to your home.
After the procedure, you will awaken in the recovery area of the bariatric surgical center. Medical staff will monitor your health and vital signs during this time to check for signs of complications. Once you have fully recovered from sedation, you will be sent home.
It should be noted that most people are released from the surgical center. They are allowed to return home on the same day of the procedure. Others require a short admission to the hospital for a day or two for observation following surgery.
The surgeon will recommend that you refrain from eating for a few hours after endoscopic sleeve gastroplasty. You will then be placed on a liquid diet, which will last for at least two weeks. From that point onward you will move gradually to semi-solid foods before moving to a regular healthy diet.
Ready to Change Your Life with This Low-Risk Bariatric Procedure?
When you have tried diet and exercise, but nothing has succeeded in helping you achieve a healthy weight, endoscopic sleeve gastroplasty might be right for you.
Southern California residents are encouraged to call Healthy Life Bariatrics to schedule a consultation with Dr. Babak Moeinolmolki, one of the world’s leading bariatric surgeons.
Dr. Moein (for short) is a dual-board-certified bariatric surgeon who also specializes in post-bariatric body contouring surgery. That means you can achieve improved health and a toned appearance all under the same roof and by the same medical professional.