Why the ESG might be the future of bariatric surgery?

Why the ESG might be the future of bariatric surgery?

ESG stands for endoscopic sleeve gastroplasty. What does endoscopic sleeve gastroplasty mean in plain English?

  1. Reduction of the size of the stomach.
  2. Changing the shape of the stomach into a sleeve-like structure

The steps above are carried out using endoscopy (camera inserted through the mouth) without the need for any incisions.

This is different from sleeve gastrectomy where the stomach size is reduced and its shape is changed using keyhole (laparoscopic) surgical instruments.

The endoscopic sleeve (ESG) has several advantages.

  • The risk of complications is lower than the risk of complications with a surgical sleeve. This is because it does not involve incisions or staple lines that might bleed or leak. The procedure takes a shorter time to complete too.


  • The recovery is faster after the endoscopic sleeve. This is because there are no incisions (cuts) in the tummy wall.


  • There are no restrictions to physical activity (including heavy lifting) after the procedure. Due to the lack of incisions, there is no risk of a hernia.


  • The operation is reversible. Some patients might change their minds after having the procedure or they might not be happy with the restriction. The option of reversing the operation is something that some patients might appreciate.


  • The procedure is revisable. If the stomach is so very tight that the patient feels sick or vomits a lot, some of the sutures can be cut. If the weight loss is little or the patient regained weight, it might be possible to tighten the stomach further.


  • You do not burn any bridges by having this procedure. You can have a surgical sleeve or other operations after the endoscopic sleeve.


  • The risk of reflux or worsening reflux is significantly less.


  • It is ideal for patients with mild to moderate obesity as they do not need to lose a large amount of weight.


  • The technique is constantly refined to achieve more weight loss and fewer complications.


In an ideal world, patients who appreciate the above advantages of the ESG should have it. If it were a success for them, that is perfect; they had a low-risk procedure that achieved their objectives. If it did not achieve its objectives, no problem! They can still have other procedures. If there are no-cost constraints, this procedure can easily become the most widely used bariatric procedure.


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