Healthcare: Weight Loss and Metabolic Center

Endoscopic Sleeve Gastroplasty in Houston


Endoscopic sleeve gastroplasty (ESG) is a new nonsurgical bariatric procedure that achieves a similar effect as gastric sleeve surgery. ESG requires no incisions or cutting into the stomach – the procedure is even less invasive than laparoscopic gastric sleeve surgery. The patient experiences little or no pain during the procedure and no scarring. An outpatient procedure, ESG is associated with an even quicker recovery time than minimally invasive weight loss surgical procedures.

During ESG the stomach is accessed using a flexible endoscope, a thin tube with a small camera allowing the surgeon to see your gastrointestinal tract. Although the procedure is relatively new, ESG is considered safe and effective in treating conditions related to moderate obesity.

Like gastric sleeve surgery, ESG restricts food intake without altering your normal digestion process. ESG may provide the added benefit of reducing the hunger hormone ghrelin. The procedure is not reversible but can be repeated if needed. For some patients, ESG can be used as a bridge to a more invasive bariatric surgery, such as gastric bypass.

At the Weight Loss and Metabolic Center at Baylor Medicine in Houston, our surgical team specializes in ESG. Our team is happy to offer patients who qualify for ESG this new procedure that uses no incisions, leaves no scarring and has a faster recovery period.


Advantages of Endoscopic Sleeve Surgery

  • No incisions and no scarring
  • Natural digestion procession is not altered
  • May reduce hunger
  • Lower overall cost than gastric sleeve surgery
  • No overnight hospital stay

About the Procedure


Endoscopic sleeve gastroplasty (ESG) is done using a flexible endoscope, allowing your surgeon to see inside your stomach. An endoscopic stitching system allows the surgeon to place stitches in the intestines. The new stomach will be tube shaped and about the size of a banana, similar to the stomach left intact after gastric sleeve surgery.

The procedures takes around one to three hours (60 to 180 minutes). Although ESG does not use surgical incisions, patients undergo general anesthesia during the procedure. ESG is done as an outpatient procedure. Most patients return home the same day. Patients can return to work and resume daily activity one to three days after the procedure. After four weeks patients can expect a full recovery.


Weight Loss after Endoscopic Sleeve Gastroplasty Surgery


Like gastric sleeve surgery, endoscopic sleeve gastroplasty (ESG) works by reducing the size of the stomach. The patient has no scarring and experiences little or no pain during the procedure. Although the procedure is in its early phases, ESG is widely considered safe and effective in treating obesity-related conditions.

As ESG is a new procedure, short term and long term weight loss after ESG are unknown. There are encouraging findings from a recent study of 91 moderately obese patients (with a BMI of 30 to 40) who had ESG from 2013 to 2016. In this study, patients lost 56 percent of excess weight at one year after ESG. These results are comparable to excess weight loss after popular bariatric procedures, like gastric sleeve surgery and gastric band surgery.

Like other bariatric procedures, long-term weight loss success after ESG depends heavily on the patient’s commitment to a healthy lifestyle program, including dieting and regular exercise.


Health Benefits After Endoscopic Sleeve Gastroplasty Surgery


Unfortunately, because endoscopic sleeve gastroplasty (ESG) is a new procedure short and long term health benefits after ESG are unknown. Possible health benefits of ESG may include:

  • Desire for smaller meal portions
  • Improvement or complete resolution of obesity-related health conditions, such as type 2 diabetes and heart disease
  • Relief from joint pain
  • Improved mood and energy level

Possible Complications of Endoscopic Sleeve Surgery


As an outpatient procedure, endoscopic sleeve gastroplasty (ESG) may carry less risk and complications than those associated with bariatric surgical procedures. Patient compliance with diet guidelines before and after the procedure and follow-up appointments greatly impact complications after the procedure.

As with other bariatric procedures serious complications may occur soon after the procedure. These complications may include bleeding, leaks, pulmonary embolism, ulcers, gastroesophageal reflux disease. Other time, patients may develop nutritional deficiencies.