Learning About Endoscopic Sleeve Gastroplasty

Endoscopic sleeve gastroplasty (ESG) is surgery to make your stomach smaller. It can help you reach and stay at a weight that is healthy for you if other strategies—like healthy eating, physical activity, or weight loss medicines—didn't work well enough. Doctors may recommend ESG for adults with a body mass index (BMI) of 30 to 50.

During ESG, the doctor uses stitches to close off a portion of your stomach and shapes it into a narrow form that looks like a sleeve.

ESG lowers the size of your stomach to about one third of its current size. A smaller stomach means you can't eat as much in one sitting. The narrow, tube-like shape also means it’ll take longer for food to go through your stomach. You’ll feel full for longer after eating.

The doctor will give you medicine (general anesthesia) to make you fall asleep before the surgery. You won’t feel any pain. To do the surgery, the doctor slides a thin tube with a camera (called an endoscope) down your throat and into your stomach. Then the doctor uses surgical tools attached to the endoscope to make the stitches and close off a portion of your stomach.

ESG has some important benefits. It can help you lose about 15% to 20% of your body weight within a year or two. Getting to a weight that’s healthy for you lowers your risk of health problems like heart disease and type 2 diabetes.

ESG is a minimally invasive procedure. That means the doctor can do it without having to make cuts to your belly. This can help you recover faster. It also lowers the risk of problems during and after the surgery. Unlike other weight loss procedures that remove a part of your stomach, ESG can be reversed. It’s also possible to repeat the surgery after a few years if your stomach has stretched out.

Like every surgery, ESG has possible risks. Some risks include bleeding, blood clots, infections, and problems from the anesthesia.

There’s also a small chance that the stitches can break right after the surgery or over time. Talk with your doctor about any concerns you have before the surgery.

After the surgery, you might be able to go home the same day. Or you might stay at the hospital overnight. You might have stomach pain or nausea for a few days. Talk with your doctor about medicines that can help.

You’ll have to follow a special diet until your stomach is healed and your body gets used to eating smaller portions. Here's what that might look like:

• About 8 hours after the surgery, you can start with a liquid diet.
• After about 2 weeks, you can eat soft foods.
• After about 6 weeks, your stomach is healed enough that you can eat a regular diet.

Talk with your doctor about what a healthy eating plan looks like for you after ESG. For example, it's a good idea to avoid foods that are high in sugar or fat because they can upset your stomach.

Keep in mind that ESG or other weight loss procedures are only one piece of your obesity treatment plan. It’s also important to follow any other weight loss strategies you and your doctor agreed on, like eating healthy foods and being active.