Endoscopic Sleeve Gastroplasty

Endoscopic sleeve Gastroplasty (ESG) is an incisionless surgical procedure that uses an endoscope (a tube with a camera attached which is inserted via the mouth down a patient’s oesophagus and then stomach).

The aim of the procedure is to reduce the volume of the stomach by up to 50 – 60%, as well as change the way that it functions. The name Endoscopic Sleeve Gastroplasty (ESG) is unfortunate, as it suggests that the ESG is similar to the surgical Sleeve Gastrectomy, which it is not. ESG has a similar risk profile to Sleeve Gastrectomy, however ESG avoids removing or stapling the stomach, the procedure takes less time to perform and works to aid weight loss in a different way.

The ESG works not just by reducing stomach size but by partitioning the stomach into a slowly emptying upper part, and a normally functioning lower part. The ‘upper part’ (distensible fundus) of the ESG stomach ‘traps’ food, which then descends slowly down the main stomach channel, whereas liquids move more quickly through the main channel and also in between folds of stomach created by the sutures.

Current studies have shown that the ESG is effective at causing weight loss. The magnitude of weight loss is less than some surgical procedures, but it is certainly sufficient for many patients who may not otherwise consider themselves as candidates for a more permanent option.

Because it is a relatively new procedure, little information is available on its long-term effectiveness (more than two years) in causing weight loss, or on the long-term consequences of the procedure.

Every surgical procedure carries a degree of risk, and the Endoscopic Sleeve Gastroplasty is no different. The procedure is performed under general anaesthetic which itself carries its own risks. In addition to this other risks can include complications such as abdominal pain, difficulty drinking, although more serious complications occur less frequently.