Endoscopic Sleeve Gastroplasty (ESG)

Endoscopic sleeve gastroplasty (ESG) is a minimally invasive, non-surgical procedure used for weight loss in obese individuals. It involves the use of an endoscope, a flexible tube with a camera and instruments on the end, to reduce the size of the stomach.

Procedure Overview

The ESG procedure typically takes 1-2 hours to complete and is performed under general anesthesia or conscious sedation. The endoscope is inserted through the mouth and guided into the stomach. A series of sutures are then placed in the stomach using a specialized device, which reduces the stomach's volume by approximately 70-80%.

Technique

The technique used for ESG involves:

• Insertion of the endoscope into the stomach
• Identification of the stomach's anatomy and marking of the suture sites
• Placement of sutures in a specific pattern to reduce stomach volume
• Tightening of the sutures to create a sleeve-like shape

Benefits

The benefits of ESG include:

• Significant weight loss, with average losses ranging from 15-20% of initial body weight
• Improvement in obesity-related comorbidities, such as type 2 diabetes and hypertension
• Reduced risk of complications associated with traditional bariatric surgery
• Minimally invasive procedure with reduced recovery time

Risks and Complications

Possible risks and complications of ESG include:

• Bleeding or perforation of the stomach
• Infection or abscess formation
• Adverse reactions to anesthesia or sedation
• Nausea, vomiting, or abdominal pain

Candidate Selection

ESG is typically recommended for individuals with a body mass index (BMI) of 30-40 kg/m² who have failed to achieve significant weight loss through diet and exercise alone. Candidates should also meet certain medical criteria, including:

• Age 18-65 years
• No history of prior bariatric surgery
• No significant gastrointestinal disease or bleeding disorders

Post-Procedural Care

After the procedure, patients typically follow a liquid diet for 1-2 weeks, followed by a gradual transition to solid foods. Regular follow-up appointments with a healthcare provider are necessary to monitor weight loss progress and address any potential complications.

Long-Term Outcomes

Studies have shown that ESG can result in significant and sustained weight loss over 1-2 years, with some patients achieving weight losses of up to 25% of initial body weight. However, long-term data is still limited, and further research is needed to fully understand the procedure's efficacy and safety.

Frequently Asked Questions (FAQs)

What is Endoscopic Sleeve Gastroplasty (ESG)?
A minimally invasive procedure to reduce stomach size.

How is ESG performed?
Using an endoscope with a suturing device.

Is ESG a surgical procedure?
No, it's an endoscopic procedure.

What are the benefits of ESG?
Weight loss and reduced hunger.

Is ESG reversible?
Yes, it is reversible.

How long does the ESG procedure take?
About 1-2 hours.

Do patients need general anesthesia for ESG?
Yes, typically under general anesthesia.

What are the common side effects of ESG?
Nausea, vomiting, and abdominal pain.

Can anyone undergo ESG?
Typically for obese patients with BMI 30-40.

How much weight can be lost with ESG?
Up to 20% of initial body weight.