At Healthier Weight we are the first UK clinic to offer the traditional surgical sleeve and a 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, but a little less than with the surgical sleeve.
What is an endoscopic sleeve gastroplasty?
The endoscopic sleeve gastroplasty (ESG) 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 up to 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 ESG 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 about an hour.
It 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
Who should choose an ESG?
An ESG is a good option if you :
- Don’t want the maintenance commitment of a gastric band, e.g. band fills
- Don’t want the risks and recovery time associated with a surgical procedure
- Don’t want a procedure that leaves visible scarring
- Want a non surgical procedure that gives better long term results than a gastric balloon
Am I eligible for an endoscopic sleeve gastroplasty?
Your consultant will explain all of the options available to you at your 1:1 consultation. As a guide, you will be eligible for ESG if:
- Your body mass index is in the range 32-45 kg/m2 – check BMI
- You’ve tried and failed to lose weight through diet and lifestyle changes
- Your weight is having an impact on your health and/or your day to day life
Important: If you are living with weight related co-morbidities, such as type 2 diabetes, the surgical weight loss procedures are likely to be more beneficial for you.
These notes are for guidance only and your consultant will make an assessment based on the full picture presented at consultation.
What results can I expect?
It isn't possible to predict how much weight you will lose following an ESG as results vary according to many factors including your willingness to adapt your diet and your physical activity.
The evidence we have suggests people 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 available.
The weight loss results in the chart below are the published results from a study of 248 ESG patients. They show average total body weight loss (TBWL) as a percentage of the starting weight. We’ve also shown how much weight this equates to assuming different starting weights.
In summary, based on the published data you can expect to lose just over half of your excess weight after 24 months after your procedure. This is similar to the weight loss with a gastric band and a little below the weight loss we’d expect with a surgical sleeve or gastric bypass.
| ||Weight loss (of starting weight) ||Weight loss assuming start weight of 16 stone ||Weight loss assuming start weight of 20 stone |
|At 6 months |
|15.2% * ||34lbs ||43lbs |
|At 18 months |
|18.6% * ||42lbs ||52lbs |
Based on a group of 248 patients with a mean starting BMI of 37.8