What Is ESG?

Endoscopic sleeve gastroplasty, or ESG, is an innovative weight-loss procedure that is performed without surgical incisions. Your physician operates with an endoscope, a long, thin, flexible tube that is inserted into the stomach through the mouth. Attached to the endoscope is a camera and tiny instruments that suture or sew shut about 70 percent of the organ. By reducing stomach size, ESG also reduces appetite and makes it easier for persons with weight-related medical conditions to manage their food consumption. Unlike more invasive procedures, ESG requires less recovery time and is generally reversible.

If you or a loved one is struggling with a weight-related condition but is concerned about the risks of surgery, ESG might be a viable alternative. To learn more, schedule a visit with your Baptist Health provider or a member of our gastroenterology team.

Pros and Cons of ESG Surgery

ESG offers several advantages over surgical weight-loss procedures, including gastric bypass surgery, sleeve gastrectomy, and laparoscopic sleeve gastrectomy. Any surgical procedure, whether open or laparoscopic, requires incisions – cuts in the body – that increase the possibility of infection, bleeding, and other complications. Endoscopic procedures are free of incisions. ESG also reduces post-operative pain and enables quicker recovery times.

Surgical procedures may have an advantage in appetite reduction. A stomach that has been sutured shut rather than surgically altered may stretch out over time, requiring additional procedures to assist the patient in managing his or her weight.

Who Is a Candidate for ESG?

Individuals with a medical diagnosis of obesity are the primary candidates for ESG. The procedure is available to both children and adults. Diagnosis is based on a person’s BMI or body-mass index. BMI is determined by dividing an individual’s weight in kilograms by his or her height in meters squared. (Scientific measurements are stated in metric terms.) ESG is suited for anyone with a BMI of 30 to 40, if lifestyle changes, including improved diet and increased exercise, fail to register weight loss. Persons with a BMI of over 40 may benefit more from a surgical procedure.

Risks and Benefits

ESG has multiple benefits for persons undertaking the procedure:

• Weight loss: ESG has enabled patients to realize weight losses in the range of 15 to 20 percent of pre-operative totals.
• Improved management of weight-related diseases: Obesity is linked to a number of medical conditions, including heart disease, high blood pressure, and type-2 diabetes. Sustainable weight loss leads to reduced incidence of these conditions.
• Shorter operating and recovery times: Endoscopic procedures require less time, both in the operating suite and during the recovery process afterwards.
• Reduced medical complications: ESG is accomplished without incisions, which lessens the possibility of medical complications.

There are, nevertheless, risks associated with an endoscopic weight-loss procedure:

• Gradual diminishment of weight loss: ESG limits the functional area of the stomach without altering its size. This means that the stomach can gradually regain its shape over time, thereby reversing the loss of appetite.
• Discomfort and pain: Like any medical procedure, ESG can result in some post-operative pain and discomfort, including heartburn and nausea.
• Endoscopic injury: Though safer than invasive surgery, ESG can still cause irritation or injury from the endoscope’s presence inside the body.
• Reactions to anesthesia: Like traditional surgery, endoscopic procedures require anesthesia. A reaction risk remains.

Preparing for ESG

If you opt for ESG, your physician will order medical tests to determine your suitability for the procedure. Among these tests will be one for detecting potentially adverse reactions to anesthesia.

You won’t be able to eat or drink anything on the day of the procedure, but ESG does not require bowel clearance beforehand. Your physician may request a temporary halt to your medications.

What Happens During ESG?

ESG is usually performed on an outpatient basis. You’ll be administered a general anesthetic, so you’ll sleep through the procedure.

The endoscope enters your stomach through the mouth and esophagus. Your stomach will be inflated with a harmless gas that enables the endoscopic specialist to watch the procedure on a television screen. He or she will use the suturing device to first mark and then staple the stomach in eight to ten locations. This will decrease the area of the stomach lining, excluding most of it from the digestive process.

An ESG procedure typically takes an hour to an hour and a half. You’ll wake up in a recovery area, where you’ll be monitored for complications. Most patients are able to return home the same day. A family member or friend will need to accompany you, because of the lingering effects of anesthesia.

Recovery from ESG

Full recovery from ESG can take up to 30 days, though for many the period is much shorter. Any post-operative pain or discomfort should diminish quickly. Take care with your diet while recovering. You’ll begin with liquids, gradually shifting to semisolid and then solid foods. Focus on small meals and carefully chewing every mouthful.

Medical procedures are only one part of the weight-loss journey. Permanent weight reduction requires lifestyle changes as well. Exercise and a healthy diet are critical aspects of this process. Baptist Health has resources that can assist you in your transition to a new, healthier way of living.

Take Our Health Assessment

Obesity is often accompanied by serious health issues. If you’re interested in a weight-loss procedure but have misgivings about surgery, non-invasive ESG might be right for you. To evaluate your level of risk for weight-related disease, take our online health risk assessment. To schedule a screening appointment, contact your Baptist Health provider.