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Endoscopic Sleeve

An Endoscopic Sleeve Gastroplasty is a minimally invasive procedure. It is a weight loss procedure offered to patients who are not candidates for bariatric surgery. Using an endoscope suturing device, the endoscopist constricts the stomach, resulting in a ‘sleeve.’ – Reem Shariaha MD

The Endoscopic Sleeve Gastroplasty or ESG is a new procedure that reduces the functional volume of the stomach. Little doubt exists that gastric restriction is a critical mechanism in achieving substantial weight loss; purely restrictive bariatric procedures, such as gastric banding and sleeve gastrectomy, have been shown to result in expected weight loss (%EWL) of 65.5% and 76.1%, respectively, at 12 months.*



What is Endoscopic Sleeve Gastroplasty

Endoscopy is the visualization of gastrointestinal tract with a flexible endoscope. Recently a device was created that allows the intestinal wall to be sutured. This has many applications, but one of them is to suture the front wall of the stomach to the back wall. This prevents the stomach from widening and lengthening as the patient eats. During an ESG a channel is preserved along the lesser curve of the stomach similar in size to what is left intact after a laparoscopic (operative) sleeve gastrectomy or LSG. In essence the ESG is an even less invasive version of the minimally-invasive LSG.


Endoscopic Sleeve Gastroplasty Procedure Animated Video

The Advantages of Endoscopic Sleeve Gastroplasty Over Laparoscopic Sleeve Gastrectomy*

The ESG has certain advantages over the LSG. It is not technically surgery, although it does require general anesthesia due to the length of the procedure. There are no incisions, and therefore, little or no pain after the procedure. Recovery time is much less. A typical patient should go home later the same day, and be able to return to work within 24-48 hours. Also, because it is incisionless, the ESG has no lifting or exercise restrictions afterwards, unlike the LSG which limits activity for several weeks. Cosmetically, the ESG has an obvious advantage. Patients who wish to keep the fact they have undergone a weight-loss procedure are also at an advantage. In addition, the overall cost of the ESG is less than LSG.


Can the ESG Procedure be used for bariatric revision surgery?

Yes. The Endoscopic Sleeve Gastroplasty is also being used in weight loss surgery revisions, including the Laparoscopic Sleeve Gastrectomy.



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