Endoscopic sleeve gastroplasty is a minimally invasive, endoscopic weight-loss procedure that reduces stomach volume by placing full-thickness sutures along the greater curvature, creating a narrow “sleeve.”

Why Do I Need ESG?

Indicated if you have:

  • BMI 30–40 without or with mild obesity-related comorbidities
  • Failed diet, exercise, or medical therapy
  • Desire for a less invasive alternative to surgical sleeve gastrectomy

How Should I Prepare?

  • Evaluation: Nutritional, psychological, and metabolic assessment.
  • Fasting: Nothing by mouth for at least 8 hours pre-procedure.
  • Medications: Adjust anticoagulants per protocol; start proton-pump inhibitor.
  • Consent: Review risks, benefits, and post-procedure diet plan.

What Happens During the Procedure?

  • Under deep sedation, an endoscopic suturing device is advanced into the stomach.
  • Multiple rows of sutures are placed from the antrum to the fundus, reducing lumen size by ~70%.
  • Procedure time: 60–90 minutes.

What Can I Expect Afterwards?

  • Recovery: 1–2 hours in recovery until sedation wears off.
  • Diet:
    1. Clear liquids for 3 days
    2. Pureed foods days 4–14
    3. Soft solids weeks 3–4
    4. Transition to regular healthy diet by week 6
  • Activity: Light activity immediately; avoid heavy lifting for 1 week.

Risks & Possible Complications

  • Abdominal pain or nausea (10–20%)
  • Suture line leak (1–2%)
  • Gastrointestinal bleeding (<1%)
  • Rare need for conversion to surgery

Seek care for severe abdominal pain, persistent vomiting, fever, or bleeding.

Follow-Up

  • Clinic visits and nutrition counseling every month for 6 months.
  • Endoscopic check at 6 months if indicated.
  • Long-term lifestyle and behavioral support for sustained weight loss.