Endoscopic Sleeve Gastroplasty (ESG)

Endoscopic sleeve gastroplasty (ESG) is a minimally invasive, non-surgical procedure used for weight loss in obese individuals. It involves the use of an endoscope, a flexible tube with a camera and instruments on the end, to reduce the size of the stomach.

Procedure Overview

The ESG procedure typically takes 1-2 hours to complete and is performed under general anesthesia or conscious sedation. The endoscope is inserted through the mouth and guided into the stomach. A series of sutures are then placed in the stomach using a specialized device, which reduces the stomach's volume by approximately 70-80%.

Technique

The technique used for ESG involves:

• Insertion of the endoscope into the stomach
• Identification of the stomach's anatomy and marking of the suture sites
• Placement of sutures in a specific pattern to reduce stomach volume
• Tightening of the sutures to create a sleeve-like shape

Benefits

The benefits of ESG include:

• Significant weight loss, with average losses ranging from 15-20% of initial body weight
• Improvement in obesity-related comorbidities, such as type 2 diabetes and hypertension
• Reduced risk of complications associated with traditional bariatric surgery
• Minimally invasive procedure with reduced recovery time

Risks and Complications

Possible risks and complications of ESG include:

• Bleeding or perforation of the stomach
• Infection or abscess formation
• Adverse reactions to anesthesia or sedation
• Nausea, vomiting, or abdominal pain

Candidate Selection

ESG is typically recommended for individuals with a body mass index (BMI) of 30-40 kg/m² who have failed to achieve significant weight loss through diet and exercise alone. Candidates should also meet certain medical criteria, including:

• Age 18-65 years
• No history of prior bariatric surgery
• No significant gastrointestinal disease or bleeding disorders

Post-Procedural Care

After the procedure, patients typically follow a liquid diet for 1-2 weeks, followed by a gradual transition to solid foods. Regular follow-up appointments with a healthcare provider are necessary to monitor weight loss progress and address any potential complications.

Long-Term Outcomes

Studies have shown that ESG can result in significant and sustained weight loss over 1-2 years, with some patients achieving weight losses of up to 25% of initial body weight. However, long-term data is still limited, and further research is needed to fully understand the procedure's efficacy and safety.

Frequently Asked Questions (FAQs)

What is Endoscopic sleeve gastroplasty?
A minimally invasive procedure that reduces stomach size using an endoscope.

Is Endoscopic sleeve gastroplasty a surgical procedure?
It is considered a non-surgical procedure, but performed by a trained physician.

What are the indications for Endoscopic sleeve gastroplasty?
Typically used to treat obesity in individuals with a BMI of 30-40.

How long does the Endoscopic sleeve gastroplasty procedure take?
Usually around 1-2 hours, depending on individual circumstances.

Is Endoscopic sleeve gastroplasty reversible?
Possibly reversible, but may require additional procedures.

What are the potential benefits of Endoscopic sleeve gastroplasty?
May lead to significant weight loss and improvement in obesity-related conditions.

Are there risks associated with Endoscopic sleeve gastroplasty?
Potential risks include bleeding, infection, and adverse reactions to anesthesia.

How much weight can a person expect to lose after Endoscopic sleeve gastroplasty?
Weight loss varies, but typically ranges from 15-20% of initial body weight.

Is Endoscopic sleeve gastroplasty covered by insurance?
Coverage may vary depending on individual policies and medical necessity.

What is the typical recovery time after Endoscopic sleeve gastroplasty?
Usually a few days to a week, with some patients resuming normal activities sooner.