Endoscopic Sleeve Gastroplasty (ESG)

Endoscopic Sleeve Gastroplasty is non-surgical method to lose weight and treat obesity related co-morbidities such as diabetes, hypertension, high cholesterol, reflux, obstructive sleep apnea etc.


It is an incisionless transoral endoscopic procedure that uses a full-thickness endoscopic suturing system to reduce stomach volume into a tubular gastric cavity.


How Is Endoscopic Sleeve Gastropasty Performed?

This procedure does not require any incisions or cuts. Endoscopy sleeve gastroplasty is performed via a Gastroscopy using special suturing technique. We usually perform this procedure under General Anesthesia. The stomach is inspected first, and then an endoscope fitted with a suturing device is introduced orally. Using the device and accessories, multiple full-thickness sutures are placed inside the gastric wall to make it smaller, like a tube, and reduce its distensibility.

How Does Endoscopic Sleeve Gastroplasty Help To Lose Weight?

ESG leads to significant weight loss by enabling patients to feel full quickly after a meal and thus limiting their meal volume. Additionally, it may also delay gastric emptying causing early satiety.


What Are The Indications For Endocopic Sleeve Gastroplasty?

  • Patients with obesity (BMI ≥27.5 kg/m2)

  • Patients who are unsuccessful in achieving or maintaining weight loss after diet and lifestyle modification or medications alone

  • Patients who do not qualify for bariatric surgery or who are unsuitable or decline bariatric surgery

What Are The Advantages Of Endoscopic Sleeve Gastroplasty?

It is a non-surgical procedure that requires only an endoscopy. It has a quick recovery and is less risky and reversible with no long term side effects.


ESG is a relatively safe procedure which can result in an average of 15-20% excess body weight loss. Some studies have even reported higher excess body weight loss.


It has lower side effects compared to other endoscopic procedures such as Intra Gastric Balloons as well as bariatric procedures such as Banding, laparoscopic sleeve gastrectomy and Roux en Y Gastric bypass.


The procedure can reduce or eliminate other medical conditions related to obesity such as:

  1. Diabetes

  2. High blood pressure

  3. High cholesterol

  4. Reflux

  5. Sleep apnea

  6. Cardiovascular issues



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