Endoscopic Sleeve Gastroplasty (ESG)
Book your place for FREE info event
Endoscopic Sleeve Gastroplasty is often shortened to ESG. The ESG is a non invasive operation as it is completed using endoscopy. The ESG procedure decreases the size of the stomach and changes the shape of the patient’s stomach into a sleeve like structure. The operation is carried out without removing any part of the stomach or creating incisions in the abdominal wall. The ESG uses an endoscopic technique where a camera and surgical instruments are used and access the stomach via the mouth and gullet.
Operation technique
An Endoscopic Sleeve Gastroplasty is carried out using gastroscopy (camera through the mouth) and advanced instruments that are attached to the gastroscope.
Part of the stomach is then sutured (stitched) from the inside of the stomach. The suturing is done in a way that reduces the width and the length of the stomach and subsequently reduces its volume.
Watch the short video to show the Gastric Sleeve technique:
How does the Endoscopic Sleeve Gastroplasty work?
The Endoscopic Sleeve Gastroplasty works by lessening the size of the stomach. That means that the ability of the stomach to receive food is significantly reduced. After the operation the patient will be able to eat less food than what they used to eat before the operation. As the ESG is a relatively new procedure we still do not know fully how the ESG works and there might be other mechanisms of actions for the ESG which aid weight loss.
Also see, Why the ESG might be the future of bariatric surgery… ESG blog post
Benefits of the ESG
- A lower risk procedure: The risk of complications is lower than the risk of complications with surgical operations like sleeve gastrectomy or gastric bypass. This is because the Endoscopic Sleeve Gastroplasty does not involve incisions or staple lines that might bleed or leak. The procedure takes a shorter time to complete too, and this contributes to the reduction in risks.
- Fast recovery: The recovery is faster after the endoscopic sleeve. This is because there are no incisions (cuts) in the tummy wall.
- A reversible procedure: The operation is completely reversible. Some patients might change their mind after having the procedure or they might not be happy with the restriction associated with the procedure. The option of reversing the operation is something that some patients might appreciate.
A revisable procedure: The procedure is completely revisable. If the stomach is too tight that the patient feels sick or vomits a lot, some of the sutures can be cut to adjust this. 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.
- Less occurrence of reflux: The risk of reflux or worsening reflux is significantly less than sleeve gastrectomy.
- An evolving procedure: The Endoscopic Sleeve Gastroplasty technique is constantly refined to achieve more weight loss and less complications.
Endoscopic Sleeve Gastroplasty Results
Ideal for treating mild to moderate obesity: The ESG is ideal for those patients with mild to moderate obesity with a lower BMI of 30 or above as they do not need to lose a significant amount of weight to achieve a healthy weight.
Average weight loss: The average weight loss with the ESG is 18% (this is what is reported in the literature. However, there are several surgeons who report higher weight loss).
Health benefits: Weight loss can control, improve, cure, or prevent health conditions that are caused by obesity such as Type 2 diabetes, high cholesterol, high blood pressure, risk of stroke reflux, polycystic ovaries and sleep apnoea. It can also improve the patient’s quality of life and might prolong patients’ lives.
Preparation for ESG
Initial Consultation with Mr Toumi: During this appointment you will discuss with Mr Toumi your current health, medical history, and past attempts to lose weight. You will also explore your suitability for the surgery, potential options and potential benefits and risks.
Dietitian Appointment: You will have an appointment with our Bariatric Dietitian where your diet will be accessed, a post-op diet plan will be provided for your weeks following surgery.
Psychologist Appointment: You will be seen by our specialist Psychologist who will further assess whether surgery is right for you.
Pre-Operative Assessment: You will also need to have a Pre-Op assessment which may include: An electrocardiogram (ECG) and Blood tests.
Operation and Recovery time
The procedure takes around one hour to complete.
The procedure can either be done as a day case procedure (meaning you can return home the same day) or in some cases might require an overnight stay.
One of the great advantages of the ESG is there are no restrictions to physical activity (including heavy lifting) after the procedure. Due to the lack of incisions, there is no risk of hernia following the ESG.
Recovery after Endoscopic Sleeve Gastroplasty
Healing time: The technique of the Endoscopic Sleeve Gastroplasty means there are no incisions, therefore the recovery is quick.
Pain relief: After discharge, most patients only need paracetamol for pain relief.
Bathing after surgery: Unlike standard bariatric surgical operations where you are unable to bathe or swim for two weeks. It is immediately permitted to bath or swim when you feel ready after the procedure.
Driving after surgery: Patients can return to driving as soon as they recover from anaesthesia if you are able to look over your shoulder and perform an emergency stop without pain.
Returning to work: Most patients can return to work within few days after their operation.
Endoscopic Sleeve Gastroplasty Aftercare
Dietitian appointment: Following an ESG with Mr Toumi you are seen by our Bariatric Dietitian who will provide you with post Bypass diet plans for the short and long term.
Regular follow up appointments: Further to this you will receive regular follow up appointments with Mr Toumi over 2 years following surgery to give you all the support that you need.
Interested private ESG surgery in North East England? Book an appointment below.
What is the difference between Gastroplasty & Gastrectomy?
Gastroplasty and gastrectomy are both surgical procedures related to the stomach, but they serve different purposes:
Gastroplasty: This refers to a surgical procedure aimed at altering the size or shape of the stomach to aid in weight loss. The common gastroplasty procedure is called Endoscopic Sleeve Gastroplasty. It reduces the size of the stomach by stitching it from the inside to make it shorter and narrower.
Gastrectomy: This refers to the surgical removal of all or part of the stomach. Gastrectomy may be necessary in cases of stomach cancer, severe peptic ulcers, or other conditions where removing a portion of the stomach is deemed necessary to improve health or treat the underlying condition. There are different types of gastrectomy procedures, such as partial gastrectomy (removal of part of the stomach) or total gastrectomy (removal of the entire stomach). People affected by obesity benefit from partial removal of the stomach as that reduces the level of the hunger hormone in the blood. This procedure is called Sleeve Gastrectomy.
In summary, gastroplasty is a procedure to alter the stomach’s functional size for weight loss, while gastrectomy involves the removal of all or part of the stomach for different reasons including obesity.