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Endoscopic Sleeve Gastroplasty


Endoscopic sleeve gastroplasty (ESG) is a procedure designed to help individuals lose weight. The surgeon uses an endoscopic camera fitted with a suturing device to reshape the stomach into a sleeve and reduce the patient’s ability to eat large quantities of food. The internal suture pattern will collapse 70-80% of the patient’s stomach, but will not remove or cut the stomach.

ESG is permanent but may be reversed, if necessary. Patients who undergo ESG may lose 30-60% of excess weight and even experience improvement or remission of diseases like hypertension, type 2 diabetes, and other obesity-related comorbidity diseases. The ESG may also be referred to as the Endosleeve or the Accordion procedure.

What is Gastroplasty?

Gastroplasty means “stomach molding”. The Latin term “gastro-” means stomach, and “-plasty” means to mold.


The term “endoscopic” means the procedure involves the use of an endoscope. The term “sleeve” refers to the shape of the stomach that is created during the procedure.

Who is a Candidate for ESG?

To determine whether a patient could benefit from ESG, the physician will consider BMI, body composition, and the presence of diseases like hypertension, obstructive sleep apnea, hypertriglyceridemia, polycystic ovarian syndrome (PCOS), type 2 diabetes, and fatty liver disease.

Patients with one of the following conditions may qualify for endoscopic sleeve gastroplasty:

  • Difficulty maintaining weight loss despite diet and exercise
  • BMI greater than 30
  • Body fat percentage greater than 35%
  • Metabolic diseases such as type 2 diabetes, polycystic ovarian syndrome (PCOS), hypertriglyceridemia, hypertension, obstructive sleep apnea, and fatty liver disease.

What Happens During The Procedure?

Unlike traditional bariatric surgery, which requires incisions to alter or remove parts of the patient’s body, endoscopic sleeve gastroplasty doesn’t require any cuts and won’t leave any visible scars.

During the procedure, the surgeon inserts a flexible tube called an endoscope fitted with a mechanical suturing device through the patient’s mouth, down the esophagus, and into the stomach.

Once in the stomach, the suturing device will sew three rows of stitches. The stitches will then be pulled to constrict the pouch-like stomach into the shape of a sleeve.

Potential Risks of ESG

Compared to other bariatric procedures like gastric balloon, gastric sleeve, lap band, and gastric bypass, ESG has a much lower complication rate. Serious complications are very rare, but may include perigastric fluid collection, pneumothorax, gastric leak, and pulmonary embolism. It is extremely rare for treatment of these complications to involve additional procedures or surgery.

Benefits of ESG

ESG offers undeniable benefits that attract patients; these include:

  • Minimally invasive: no incisions and no scarring
  • Doesn’t require an overnight hospital stay
  • Less expensive than gastric sleeve surgery
  • Doesn’t alter the natural digestion process
  • May reduce feelings of hunger

Why Choose the Weight Loss Surgery Institute

We have a team of experienced medical professionals trained to perform weight loss surgery, including endoscopic sleeve gastroplasty. Using state-of-the-art equipment and advanced techniques, our team delivers the highest quality of treatment to ensure outstanding results. Call our office today to schedule a consultation and learn more about ESG.

I saw results fairly quickly after the surgery. Within the first month I was down 30 lbs. The surgery has changed my life for the better for so many reasons. *

- Ashley

Dr. Naim made me feel very comfortable and motivated. I would definitely do the procedure again, in a heartbeat. *

- Lavina

This is by far one of the best decisions I’ve ever made. Without a doubt, I would do it all over again. *

- Nikesha

"After seeing my results, I would definitely come back and do it again. I don’t know what took me so long!" *

- Donna