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Endoscopic Sleeve Gastroplasty (ESG) or Gastric Sleeve?

30 Day Surgical Warranty
New Non-Surgical 'Sleeve'


Lower risk alternative to sleeve surgery

Diagrams of both Endoscopic Sleeve Gastroplasty and surgical Gastric Sleeve

Healthier Weight is proud to have been selected as the first UK centre to offer the non surgical sleeve procedure, the Endoscopic Sleeve Gastroplasty (ESG). This new procedure offers similar weight loss to the established surgical procedures but with lower risk. It's a minimally invasive procedure that does not involve any cutting of the stomach so there are no scars and recovery time is short. 

Most patients will be feeling back to themselves within 24 hours. In fact, a speedy recovery is one of the main reasons people opt for the ESG over the surgical alternatives. One of our ESG patients told us, "I had some discomfort from nausea in the first 24 hours after ESG but was okay after that". Read about her experience here.

If you’d like to learn more about the ESG please complete our short enquiry form here and ask your question. It’s free and we’re happy to help.

How the ESG works

The ESG works by reducing the space inside your stomach and by slowing down the rate at which food empties from your stomach. Unlike the band, sleeve and bypass however, which are surgical procedures, the ESG procedure is non surgical. Access to the stomach is gained not through incisions in the abdomen but endoscopically, i.e. through the mouth. Like the surgical procedures, the ESG is performed under general anaesthetic, and it takes about 1 hour to complete. 

A device called the 'Overstitch' is inserted into the stomach and reduces the stomach capacity from the inside by stitching the stomach together with a series of approx 6 stitches.

Is the Endoscopic Sleeve Gastroplasty (ESG) suitable for me?

The ESG is aimed at people with a BMI of 32-45kg/m2 who have been unable to manage their weight through diet and exercise alone. It's an alternative to the established gastric band and gastric sleeve surgical procedures. If you think you would find it difficult to maintain the regime required to be successful with a gastric band, but you don't want the invasiveness of the sleeve, the ESG may be the better option for you. 

It is important to note, however, that as with all surgical procedures, weight loss success with the ESG can only be achieved if the procedure is combined with long term behavioural change.


*Weight loss surgery results and benefits differ for each individual. Results cannot be guaranteed
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How does the ESG compare with surgical weight loss procedures?

The biggest benefit of the non-surgical sleeve(endoscopic sleeve gastroplasty, or ESG) is that it is a lower risk alternative to the surgical weight loss options. There is no cutting of the abdomen or stomach so the risks are lower, especially compared to gastric sleeve surgery.

All weight loss procedures bring a degree of uncertainty - this is true of any surgery - but in the case of the bandand the sleevewe have a good understanding of the risks. As a new procedure, however, its impossible to have the same degree of certainty about the ESG. We know that some of the risks of surgery do not apply (as this is an endoscopic procedure) but new patients need to accept that there are some unknowns that will only be answered as the number of cases increases in the years ahead. To a lesser degree the same is also true of the surgical sleeve. Although well established in the UK, there remains an absence of long term (5 year plus) data. There is more published data available for the gastric band and gastric bypass.

There are pros and cons for the surgical sleeve and ESG, click herefor a table designed to help you compare the differences.

Considerations when comparing procedures

ESG or surgical sleeve?

If you are considering the surgical and non surgical (ESG) sleeves you are likely to choose the ESG if you have a lower BMI (in the 32-45 range), your weight is not yet causing you weight related health problems and you want a lower risk procedure (one without the implications of staple line leakage). 

If your BMI is over 45 and/or you are experiencing health problems due to your weight, such as type 2 diabetes, hypertension, etc, the surgical sleeve will be the better choice.

Ask your personal questions about the ESG here on our enquiry form. We’re here to help and answer your questions.

ESG or gastric band?

Most people thinking about an ESG will be making the choice between ESG and the gastric band. They are both good options for those with a BMI below 45. There are more unknowns with the ESG than the band as it’s the newer procedure but you’ll tend to choose the ESG if you want a lower maintenance procedure (no band fills), one that is lower risk than surgery and one that seems to be a little more powerful. As the ESG slows gastric emptying it seems to help patients change their diet and reduce their calorie intake, certainly in the period soon after surgery. The band is a safe, effective option. You’ll opt for it if you want something that is minimally invasive, proven to deliver good weight loss and health improvement over a long period, and that is totally reversible. Both offer a speedy recovery time.

Ask us about the ESG here on our enquiry form. We’re ready to help and answer your questions


Read our frequently asked questions on the ESG

For prices & finance options, get a quote online or call 0121 693 4488

*Weight loss surgery results and benefits differ for each individual. Results cannot be guaranteed

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*Weight loss surgery results and benefits vary and are different for each individual. As such, Healthier Weight cannot guarantee specific weight loss goals.