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.