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Endoscopic Sleeve Gastroplasty

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Endoscopic sleeve gastroplasty (ESG) is a procedure that utilizes a suturing device to reduce the size of the patient’s stomach and promote weight loss. The patient’s entire stomach is left intact, meaning the organ is not cut or removed. ESG is also referred to as the “scarless sleeve,” “accordion procedure,” or “Apollo Method.”

How Endoscopic Sleeve Gastroplasty Delivers Results

To begin the procedure, the physician will insert an endoscope equipped with a suturing device into the patient’s stomach through the mouth. Then, the doctor will place sutures in a specialized pattern to decrease stomach size. The goals of endoscopic sleeve gastroplasty are to:

  • Reduce stomach size by around 70% to reduce its capacity to hold food
  • Shorten the length of the stomach between 30% and 50%

The Benefits of Endoscopic Sleeve Gastroplasty

After the procedure, patients may experience improvements in diabetes, hyperlipidemia, hypertension, GERD, and osteoarticular disorders.

Though the procedure has not been shown to directly cause improvements in the following conditions, the weight loss that results from ESG may improve:

  • Asthma
  • Acid reflux (GERD)
  • Mood disorders (anxiety, depression)
  • Cognition
  • Sleep apnea
  • Orthopedic problems
  • COPD
  • Cardiovascular disease
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Who is a Candidate for ESG?

To qualify for endoscopic sleeve gastroplasty, patients should:

  • Have a BMI above 30
  • Have no previous weight loss surgery
  • Not have an eating disorder
  • Have no history of ulcers in the stomach or small intestines
  • Have blood sugar levels under control, if they’re diabetic
  • Not be diagnosed with inflammatory bowel disease
  • Have attempted to lose weight through diet and exercise without success

How to Prepare For The Procedure

Before ESG, the patient will need to consume a diet high in protein and low in carbohydrate. They will also need to drink plenty of fluids. Patients will need to stop drinking fluids and consuming food the night before the procedure.

After The Procedure

To support healing of the sutures, patients will need to avoid all carbonated beverages and solid food for the first month. Damage to the sutures may impair weight loss, lead to premature reversal of the procedure, or cause unintended side effects.

About four hours after the procedure patients can begin drinking low-sugar liquids such as water, broth, or iced tea. Patients will need to consume a low-sugar liquid diet for one to two weeks.

At the two week mark, patients can add semi-solid foods into their diet. These foods may include eggs, yogurt, cottage cheese, Jello, canned fruit, and soft fish.

Patients should ask their doctor if they can consume meats, protein powder, potatoes, beans and legumes, fruits, and vegetables.

Foods to avoid include cereals, candy, fibrous vegetables (carrots, peppers, etc), apples, pasta, and bread. Patients should also avoid foods that cause heartburn.

The semi-solid food phase will last for approximately two weeks. Patients should speak to their physician to find out when they can start consuming solid foods.

The Recovery Process

The procedure doesn’t require an extensive recovery period. Patients will be free to go home the same day and may return to work within 24-48 hours after the procedure. Exercising or lifting heavy objects isn’t restricted, either.

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