Endoscopic Sleeve Gastroplasty (ESG): Procedure, Results, Recovery

Embarking on a weight loss journey can feel overwhelming, especially when traditional methods haven’t yielded the lasting results you desire. For many, bariatric surgery offers a powerful tool for significant and sustainable weight loss. However, the idea of traditional surgery can be daunting. What if there was a less invasive, yet highly effective, option? Enter Endoscopic Sleeve Gastroplasty (ESG), a revolutionary procedure offering a new path to a healthier you.

At Be Better Bariatrics, we understand the complexities of weight management and are dedicated to providing cutting-edge solutions. This deep dive will explore everything you need to know about endoscopic sleeve gastroplasty, from who is an ideal candidate to the detailed procedure, expected outcomes, and what your ESG recovery will look like. If you’re considering a transformative step towards better health, read on to discover if ESG is the right choice for you.

Who is a Candidate for Endoscopic Sleeve Gastroplasty (ESG)?

ESG is an innovative, minimally invasive procedure designed for individuals who need to lose a significant amount of weight but may not qualify for or prefer to avoid traditional bariatric surgery. It’s a fantastic option for those who have struggled with weight loss despite efforts through diet and exercise.

Typically, ideal candidates for endoscopic sleeve gastroplasty include:

• Individuals with a Body Mass Index (BMI) between 30 and 40: While traditional bariatric surgery often requires a BMI of 35-40 with co-morbidities or a BMI over 40, ESG can be an excellent option for those in the lower obesity ranges.
• Those with obesity-related health conditions: If you have conditions like type 2 diabetes, high blood pressure, sleep apnea, or high cholesterol that are exacerbated by your weight, ESG can help improve these conditions.
• Individuals committed to lifestyle changes: ESG is a tool, not a magic bullet. Successful outcomes depend heavily on your commitment to dietary modifications, regular physical activity, and behavioral changes post-procedure.
• People who have not achieved sustainable weight loss through diet and exercise alone: If you’ve tried various weight loss programs without long-term success, ESG can provide the necessary metabolic and physical changes to kickstart your journey.
• Those seeking a less invasive option: ESG does not involve external incisions, making it an attractive alternative for individuals wary of traditional surgery.

It’s crucial to have a thorough discussion with our specialists at Be Better Bariatrics to determine if ESG aligns with your health profile and weight loss goals.

The Pre-Procedure Evaluation: Preparing for Your Transformation

Before undergoing endoscopic sleeve gastroplasty, a comprehensive evaluation is essential to ensure your safety and optimize your results. This multi-faceted assessment helps us understand your overall health, identify any potential risks, and prepare you for the journey ahead.

Your pre-procedure evaluation will typically include:

• Medical History Review: A detailed discussion about your past and current health conditions, medications, and previous weight loss attempts.
• Physical Examination: A thorough check-up to assess your general health.
• Blood Tests: To evaluate your organ function, nutritional status, and screen for conditions like diabetes.
• Endoscopy: An upper endoscopy may be performed to examine your esophagus, stomach, and duodenum for any abnormalities that might affect the procedure.
• Psychological Evaluation: To ensure you are mentally prepared for the lifestyle changes required after ESG and to address any underlying emotional factors related to eating habits.
• Nutritional Counseling: You’ll meet with a registered dietitian to begin understanding the dietary changes necessary for success, both before and after the procedure.
• Consultations with Specialists: Depending on your health profile, you may consult with cardiologists, pulmonologists, or other specialists to ensure you are a suitable candidate.

This thorough preparation is a cornerstone of our approach at Be Better Bariatrics, ensuring you are fully ready for your ESG journey.

Step-by-Step: The Endoscopic Sleeve Gastroplasty Procedure

One of the most appealing aspects of endoscopic sleeve gastroplasty is its minimally invasive nature. Unlike traditional bariatric surgeries that involve external incisions, ESG is performed entirely through the mouth, using an endoscope.

Here’s a step-by-step look at what happens during the procedure:

1. Anesthesia: You will be given general anesthesia, meaning you’ll be asleep and comfortable throughout the entire procedure.
2. Endoscope Insertion: A thin, flexible tube called an endoscope, equipped with a camera and a suturing device, is gently guided down your esophagus into your stomach. There are no external cuts or incisions.
3. Stomach Reduction: Using the suturing device attached to the endoscope, the surgeon places a series of sutures (stitches) in your stomach. These sutures are strategically placed to fold and reshape your stomach, reducing its size and capacity. Imagine cinching a large bag into a smaller, banana-shaped pouch.
4. Creation of a Sleeve: The sutures effectively create a tube-like or “sleeve” structure, significantly limiting the amount of food your stomach can hold. This also slows down the emptying of food from your stomach, helping you feel fuller for longer.
5. Procedure Duration: The entire procedure typically takes between 60 to 90 minutes.
6. No Removal of Stomach Tissue: It’s important to note that, unlike a surgical sleeve gastrectomy, no part of your stomach is cut or removed during ESG. The stomach is simply reshaped and reduced internally.
7. Recovery Room: After the procedure, you’ll be moved to a recovery room where medical staff will monitor you as you wake up from anesthesia. Most patients go home the same day or stay overnight for observation.

This innovative technique offers the benefits of gastric restriction without the complexities and longer recovery times associated with traditional surgery, making your ESG recovery much smoother.

Expected Weight Loss Timeline: What to Anticipate

The weight loss journey with endoscopic sleeve gastroplasty is progressive and requires patience and dedication. While individual results vary, here’s a general timeline of what you can expect:

• First 3 Months: This is often the period of most rapid weight loss. You might lose 20-30% of your excess body weight. The significant reduction in stomach size and early dietary changes contribute to this initial drop.
• 6 Months: By this point, many patients have lost 30-40% of their excess body weight. You’ll likely be more accustomed to your new eating habits and incorporating regular physical activity.
• 12 Months: This is typically when patients achieve their maximum weight loss, often reaching 40-60% or more of their excess body weight. The focus shifts from rapid loss to maintaining healthy habits and preventing regain.
• Beyond 1 Year: Sustaining your weight loss is the long-term goal. Continued adherence to dietary guidelines, regular exercise, and follow-up appointments with your care team are crucial for maintaining your endoscopic sleeve results.

Remember, these are averages. Your personal weight loss trajectory will depend on various factors, including your starting weight, adherence to the post-procedure plan, metabolic rate, and activity level. Consistent follow-up with our team at Be Better Bariatrics is key to maximizing your endoscopic sleeve results.

Risks & Side Effects: Understanding the Possibilities

While endoscopic sleeve gastroplasty is considered a very safe procedure, like any medical intervention, it carries some potential risks and side effects. Being informed helps you make the best decision for your health.

Potential risks and side effects include:

• Nausea and Vomiting: Common in the first few days post-procedure as your stomach adjusts. This is usually managed with medication.
• Abdominal Pain: Mild to moderate pain or discomfort is normal and can be managed with pain relievers.
• Dehydration: Due to reduced fluid intake and potential nausea, dehydration can occur. It’s vital to sip fluids constantly.
• Bleeding: While rare, there’s a small risk of bleeding at the suture sites.
• Infection: A very low risk of infection, typically managed with antibiotics if it occurs.
• Perforation: An extremely rare but serious complication where a hole forms in the stomach wall.
• Suture-Related Issues: In some cases, sutures may loosen or break, potentially reducing the effectiveness of the procedure.
• Acid Reflux/Heartburn: Some patients may experience new or worsened reflux, though this can often be managed with medication.

Our team at Be Better Bariatrics takes every precaution to minimize these risks. We will thoroughly discuss all potential complications with you during your consultation, ensuring you are fully aware and comfortable with the procedure.

Post-Procedure Diet & Activity: Your Path to Lasting Success

The period immediately following endoscopic sleeve gastroplasty is critical for both healing and establishing new, healthy habits. Your ESG recovery involves a carefully structured diet and a gradual return to activity.

Post-Procedure Diet Progression:

Your diet will progress in stages to allow your stomach to heal and adapt:

1. Days 1-3 (Clear Liquids): Immediately after the procedure, you’ll start with clear liquids like water, clear broths, and sugar-free gelatin. This helps prevent nausea and allows your stomach to rest.
2. Days 4-14 (Full Liquids): You’ll advance to full liquids, including protein shakes, thin cream soups, and strained fruit juices. Protein intake is crucial during this phase to preserve muscle mass.
3. Weeks 3-4 (Pureed Foods): Gradually introduce pureed foods like mashed vegetables, blended lean meats, and soft scrambled eggs. Focus on small, frequent meals.
4. Weeks 5-6 (Soft Solids): You can start incorporating soft, easily chewable solid foods. Avoid tough meats, fibrous vegetables, and sugary items.
5. Beyond Week 6 (Regular Diet): You’ll transition to a regular, healthy diet, focusing on lean proteins, non-starchy vegetables, and whole grains. Portion control and mindful eating become your new normal.

Throughout all stages, hydration is paramount. You’ll also be advised to take vitamin and mineral supplements to prevent deficiencies.

Activity During ESG Recovery:

• Immediately Post-Procedure: Rest is important. You’ll be encouraged to walk around gently to aid circulation and prevent complications.
• First Few Weeks: Avoid strenuous activities, heavy lifting, and intense exercise. Light walking is generally encouraged.
• Gradual Return to Exercise: As you heal and your energy levels improve, you can gradually reintroduce more moderate exercise, typically after 2-4 weeks. Always listen to your body and consult with your care team before starting new exercise routines.

Adhering to these guidelines is fundamental for a smooth ESG recovery and achieving optimal endoscopic sleeve results.

Real Outcomes: What to Expect from ESG Results

The primary goal of endoscopic sleeve gastroplasty is significant and sustainable weight loss, leading to improved health and quality of life. The endoscopic sleeve results can be truly life-changing for many individuals.

Here’s what real outcomes typically show:

• Significant Weight Loss: Patients can expect to lose, on average, 15-20% of their total body weight, or 40-60% of their excess body weight, within 12-18 months. These results are comparable to some surgical bariatric procedures but achieved with a less invasive approach.
• Improvement or Resolution of Co-morbidities: Many patients experience a dramatic improvement or even complete resolution of obesity-related health conditions, including:
  • Type 2 Diabetes
  • High Blood Pressure (Hypertension)
  • Sleep Apnea
  • High Cholesterol
  • Joint Pain
  • Fatty Liver Disease
• Enhanced Quality of Life: Beyond the numbers, patients often report increased energy levels, improved mobility, better self-esteem, and a greater capacity to participate in activities they once enjoyed.
• Sustained Results: With commitment to lifestyle changes, the endoscopic sleeve results can be maintained long-term. Regular follow-ups and support from our team at Be Better Bariatrics play a crucial role in this ongoing success.

It’s important to remember that ESG is a tool that empowers you to make lasting changes. The best endoscopic sleeve results are achieved when the procedure is combined with a dedicated effort towards a healthier lifestyle.

Frequently Asked Questions (FAQs) About ESG

We understand you likely have many questions about endoscopic sleeve gastroplasty. Here are some of the most common ones we hear at Be Better Bariatrics:

Is ESG reversible?

While the sutures can theoretically be removed, ESG is generally considered a permanent procedure. The goal is long-term weight loss, and the stomach is reshaped to support this.

How long do the results last?

With proper adherence to dietary and lifestyle changes, the endoscopic sleeve results can be very long-lasting. Studies show sustained weight loss for several years, with many patients maintaining their weight loss beyond five years.

Will I regain weight after ESG?

Weight regain is possible with any weight loss intervention if healthy habits are not maintained. ESG provides a significant advantage by physically restricting food intake and promoting satiety. However, consistent effort in diet, exercise, and behavioral modification is essential to prevent regain. Our team offers ongoing support to help you maintain your success.

What’s the difference between ESG and traditional gastric sleeve surgery?

The main difference is how the stomach is reduced. Traditional gastric sleeve surgery (Laparoscopic Sleeve Gastrectomy) involves surgically removing about 80% of the stomach, requiring external incisions. Endoscopic sleeve gastroplasty, on the other hand, reshapes and reduces the stomach internally using sutures, without any cutting or removal of tissue, making it less invasive.

How soon can I return to work after ESG?

Most patients can return to light work within 2-5 days after the procedure. If your job involves strenuous physical activity, you may need a longer recovery period, typically 1-2 weeks.

Take the Next Step Towards a Healthier You

Endoscopic sleeve gastroplasty offers a powerful, less invasive path to significant and sustainable weight loss. If you’re ready to explore this transformative option and take control of your health, our expert team at Be Better Bariatrics is here to guide you every step of the way.

We believe in empowering our patients with knowledge, support, and the most advanced procedures available. Your journey to a healthier, happier life starts with a conversation.

Book ESG consult with Be Better Bariatrics today and discover if ESG is the right solution for your weight loss goals. Let us help you achieve the endoscopic sleeve results you deserve.