Lifestyle and medical therapy alone unfortunately do not achieve sustained-long term weight loss in a large number of patients. Among available surgical techniques, laparoscopic sleeve gastrectomy (LSG aka Surgical Sleeve) and Roux-en-Y gastric bypass surgery have been proven to be safe, highly effective procedures, but there is a wide gap between the number of patients with obesity and those who undergo surgical treatment. The American Society for Metabolic and Bariatric Surgery estimates that only approximately 1% of all patients who qualify for surgery actually undergo surgery. There are also many patients who may not qualify for bariatric surgery, for example, due to not meeting body mass index (BMI) requirements. Finally, some patients may opt to avoid traditional surgery.
Endoscopic sleeve gastroplasty (ESG) is an additional option for those patients who do not qualify for or want traditional bariatric surgery. The procedure involves insertion of an endoscope through the mouth (under anesthesia) using a suturing device to recreate the anatomy of a surgical LSG. In an LSG, the stomach is stapled vertically so that a small 'tube' is left behind and the majority of the stomach is removed from the flow of ingested food. This creates restriction, reducing that amount of food you can eat, and also alters satiety-inducing hormones.
ESG uses the suturing device to create the tube or sleeve internally without removing any part of the stomach. This technique allows for an 'incisionless operation,' with a low rate of complications, lower cost, and faster recovery times compared with the surgical approach.
To optimize the chance of successful weight loss, prospective patients are recommended to undergo a consultation with our multidisciplinary team (In COMET or the Center for Human Nutrition) prior to the procedure. This may include a dietician, a bariatric surgeon, a medical weight loss specialist, and/or other team members prior to surgery as well as follow-up counseling after the procedure. The patient is educated about the type of diet that should be followed post-surgery to avoid complications, facilitate weight loss and maintain long-term weight loss.
A follow-up appointment with the endoscopist is scheduled for one month after the procedure.
A review of multiple studies including > 1800 patients who underwent ESG demonstrated that patients achieved a ~15% loss of total weight and ~60% loss of excess weight at one year. There was a very low rate of complications with a favorable safety profile compared to LSG. ESG may also help patients achieve improvements in other weight-related health issues, such as obstructive sleep apnea, type II diabetes, and high blood pressure. Other studies have reported up to 17-20% weight loss, on average, after the ESG. These numbers can be exceeded in highly motivated patients, especially in combination with other weight loss programs and/or medications.
To schedule an appointment, call 310-267-3636