At Healthier Weight we are the first UK clinic to offer the traditional surgical sleeve and the new non-surgical alternative, the endoscopic sleeve gastroplasty (ESG).
Which is the better option for you will depend on how you view the risks and benefits. The traditional sleeve (1) is a more invasive procedure with a generally higher risk profile, particularly that of staple line leakage, but it's been shown over many years to deliver excellent weight loss results. The ESG (2) is less invasive with faster recovery times but as a new procedure, there is little data available on medium and long term outcomes. The available studies show good weight loss, broadly comparable to those with gastric banding, we simply need more time to see the long term effect. This is true of all new procedures.
What is an endoscopic sleeve gastroplasty?
The endoscopic sleeve gastroplasty is a new procedure for those who want the benefits of weight loss surgery but from a less invasive, non-surgical procedure. It involves stapling the stomach from the inside to significantly reduce its capacity by about 80%. After the procedure, the stomach remains intact but has been stitched from top to bottom to leave a smaller banana shaped stomach through which the food you eat passes.
The major benefit of the endoscopic sleeve gastroplasty is that it is performed endoscopically with a stitching device placed into the stomach through the mouth. This means that unlike surgery, there is no cutting or stapling, no scarring and no wounds. The procedure is carried out by pioneering surgeon Jamie Kelly, in Southampton, under general anaesthetic and usually takes 1-1.5 hours.
The procedure works by reducing stomach capacity and slowing down the speed at which food passes into the bowel. The food you eat goes into a small pocket at the top of the stomach before working its way down through the reduced, banana shaped stomach, and emptying into the bowel.
Read our frequently asked questions on the ESG
Am I eligible for an endoscopic sleeve gastroplasty?
We will explain all of your options, including all pros and cons, at consultation, but as a guide, you may be eligible if:
- Your BMI is 32-45kg/m2 (if you have weight related health issues eg type 2 diabetes, surgery may be more suitable) - Check BMI
- You've tried to lose weight through diet and lifestyle changes
- You don't want the maintenance commitments of a gastric band
- You don't want a more invasive procedure such as the surgical sleeve gastrectomy
- You want a procedure that is more effective in the long term than a gastric balloon
What results can I expect?
It isn't possible to predict how much weight you will lose following an endoscopic sleeve gastroplasty as results vary according to many factors including your willingness to adapt your diet and your physical activity.
The evidence we have suggests patients can expect to lose about half of their excess weight over a 12-18 month period*. At this stage, because this is still a new procedure, longer term weight loss results are not yet available.
| ||Weight loss (of starting weight) |
|At 6 months |
|16.8% * |
|At 12 months |
|18.2% * |
|At 18 months |
|19.8% * |
Based on a group of 242 patients with a mean starting BMI of 37.8