About Endoscopic Sleeve Gastroplasty
Endoscopic sleeve gastroplasty (ESG), also known as the "accordion" procedure, reduces the size of your stomach without the need for surgery or incisions. BIDMC was one of the first centers in New England to perform this procedure.
During the procedure, your doctor will use an endoscope, a small flexible tube with a camera and suturing device attached, to pass down the mouth into the stomach. The tiny camera allows the doctor to see and operate inside your stomach without making incisions in your abdomen. Your doctor will place multiple sutures in your stomach. The sutures change the structure of your stomach, leaving it shaped like a banana or sleeve. This restricts the amount of food you can eat making you feel full faster and learning portion control.
Like other weight loss programs, your commitment to a healthier lifestyle will help to ensure long-term success. Studies show that the average total body weight loss after ESG ranges between 15% and 20%.
Is ESG Right for You?
To qualify for endoscopic sleeve gastroplasty (ESG) you should:
- Be 18 or older
- Have a body mass index (BMI) of 30 or higher
- Have tried medical weight loss previously through diet and exercise and have been unable to meet your goals
- Be willing to participate in a medically supervised weight loss program
- Be willing to remain on a liquid diet for several weeks following the procedure
- Commit to regularly scheduled follow-up appointments
Conditions that might prevent you from qualifying for ESG include:
- Previous gastrointestinal surgery
- A family history of stomach or esophageal cancer
- Active smoking, alcohol or substance abuse
- History of disordered eating condition
- A hernia in the esophagus or a structural abnormality in the larynx or throat
- Pregnancy, currently breastfeeding, or planning to become pregnant within one year
- Prior bleeding in the gastrointestinal tract
Endoscopic sleeve gastroplasty may not be covered by your insurance. Contact your insurance provider to find out if this procedure is covered by your insurance plan.
If you do not qualify for ESG, you may still be a candidate for weight loss surgery.
The Benefits of ESG
In addition to helping you lose weight, ESG can assist you in lowering your blood sugar and address other weight-related health risks, including:
- Sleep apnea
- Type II diabetes
- High blood pressure
- Heart disease
The Day of Your Procedure
Endoscopic sleeve gastroplasty (ESG) is performed in the hospital under general anesthesia. Before your procedure, you will need to follow specific preparation instructions, which you will discuss with your doctor in advance.
The ESG procedure typically takes several hours, and the majority of patients go home the same day. You might require a short admission to the hospital for observation after the procedure. Please note that you must have an adult present to drive you home in order to be discharged.
After Your Procedure
After the procedure, you'll be placed on a liquid diet for several weeks and then move on to a diet of semisolid foods before returning to a normal, heart-healthy diet. You may have some abdominal discomfort and nausea in the days after the procedure. You may be prescribed medication to treat these potential side effects.
Endoscopic Sleeve Gastroplasty: A Patient's Weight Loss Journey
A BIDMC patient talks about her ESG procedure and follow-up care, joined by Jonah Cohen, MD, and his expert team.
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