Endoscopic Sleeve Gastroplasty (ESG) is a minimally invasive procedure that can help individuals achieve weight loss by reducing the size of the stomach. In this article, we will discuss what ESG is, its potential benefits and drawbacks, what the procedure includes, its cost, candidacy requirements, preparation tips, how it works, the duration of the procedure and its effects, safety considerations, recovery process, and more.
What is Endoscopic Sleeve Gastroplasty (ESG)?
Endoscopic Sleeve Gastroplasty, also known as ESG or the "Accordion procedure," is a non-surgical bariatric procedure designed to facilitate weight loss by reducing the stomach's capacity. It involves using an endoscope, a long flexible tube with a camera and suturing instruments, to create a series of stitches that reduce the stomach's size.
Initially, the endoscope is inserted through the mouth and into the stomach. Using the suturing instruments, the surgeon then anchors the folds of the stomach wall together to create a narrow, sleeve-like shape. As a result, the stomach's capacity decreases, which can lead to reduced food intake and weight loss.
What can Endoscopic Sleeve Gastroplasty achieve?
ESG aims to help individuals achieve weight loss by reducing the stomach's size without requiring surgical intervention, such as gastric bypass or gastric banding. The procedure can promote early satiety, help in controlling portion sizes, and potentially aid in long-term weight management.
What's included in the ESG procedure?
An ESG procedure typically includes the following steps:
- Initial consultation: A thorough assessment of the individual's medical history, current health condition, and BMI (Body Mass Index) to determine eligibility.
- Preparation: Fasting for a specific period and following pre-procedure instructions provided by the medical team.
- Procedure: The insertion of the endoscope, suturing of the stomach walls, and monitoring under sedation or general anesthesia.
- Recovery: Post-procedure monitoring, pain management, and advice on dietary changes and lifestyle modifications.
What are the pros and cons of Endoscopic Sleeve Gastroplasty?
As with any medical procedure, ESG has advantages and disadvantages:
Pros:
- Minimally invasive: No surgical incisions or scars.
- Reduced risks: Lower complication rates compared to traditional bariatric surgeries.
- Shorter recovery time: Typically, patients can resume normal activities within a week.
- No foreign objects: Unlike gastric bands, ESG does not require the placement of any devices.
Cons:
- Weight loss may vary: Individual results can differ, and some individuals may not achieve the desired weight loss.
- Reversible effects: The stomach can gradually expand over time, potentially regaining some of the lost weight.
- Restrictions post-procedure: Specific dietary changes and lifestyle modifications are necessary for successful weight management.
How much does Endoscopic Sleeve Gastroplasty cost?
The cost of ESG in the United Kingdom can vary depending on factors such as the clinic, location, surgeon's fees, and additional services provided. On average, the cost can range from ￡6,000 to ￡10,000.
Who is a good candidate for Endoscopic Sleeve Gastroplasty?
Ideal candidates for ESG are individuals who:
- Have a BMI between 30 and 40 or in the overweight to obese range.
- Have failed to achieve significant weight loss through diet and exercise alone.
- Do not have any contraindications for endoscopy or anesthesia.
- Are committed to making long-term lifestyle changes to support successful weight management.
Is ESG worth it?
Deciding whether ESG is worth it primarily depends on individual circumstances, motivations, and weight loss goals. It is essential to have realistic expectations and discuss potential risks and benefits with a qualified healthcare professional.
How should you prepare for an Endoscopic Sleeve Gastroplasty?
Prior to the procedure:
- Consult with a bariatric specialist who can provide guidance based on your medical history and current health condition.
- Follow any pre-procedure instructions provided, such as fasting requirements.
- Obtain necessary clearances from other healthcare providers, if required.
How does Endoscopic Sleeve Gastroplasty work?
The ESG procedure involves reducing the stomach's size using suturing techniques. It limits the volume of food the stomach can hold and promotes feelings of fullness more quickly. By creating a sleeve-like shape, the procedure restricts calorie intake, potentially leading to weight loss.
How long does an ESG procedure take?
An ESG procedure typically lasts between 60 and 90 minutes, depending on various factors such as the individual's anatomy and the surgeon's expertise.
How long do the effects of Endoscopic Sleeve Gastroplasty last?
The effects of ESG can vary among individuals. However, research suggests that the procedure can lead to sustained weight loss over several years. It is crucial to follow the necessary dietary and lifestyle modifications recommended by healthcare professionals to maintain long-term success.
Is Endoscopic Sleeve Gastroplasty safe?
ESG is considered a safe procedure when performed by trained and experienced healthcare professionals. However, as with any medical intervention, there are risks involved. Potential complications may include bleeding, infection, or adverse reactions to anesthesia. It is essential to discuss these risks with the treating physician.
How soon will you see results after an Endoscopic Sleeve Gastroplasty?
Weight loss results can vary among individuals. However, many individuals begin to notice changes within two to three weeks after the procedure. The rate of weight loss may vary further over time.
What is the recovery process like?
After the procedure:
- Patients may experience some discomfort, bloating, or nausea, which typically resolves within a few days.
- A liquid diet is typically followed for a week, followed by a gradual transition to soft and then regular foods.
- Regular follow-up visits are essential to monitor progress and receive guidance on proper nutrition and physical activity.
Frequently Asked Questions (FAQs)
1. Can ESG be reversed?
ESG is considered a reversible procedure, but it may require further interventions in case of complications or if weight regain occurs.
2. Will insurance cover the cost of ESG?
Insurance coverage for ESG varies. It is advisable to check with your insurance provider to determine if the procedure is covered.
3. How long does the weight loss effect last?
The long-term weight loss effect of ESG depends on the individual's commitment to dietary modifications and lifestyle changes.
References:
1. National Institute for Health and Care Excellence (NICE). (2019). Endoscopic sleeve gastroplasty for obesity.
2. Goyal, D., Riddle, M. C., & Raman, M. (2017). Endoscopic Bariatric and Metabolic Therapies: Surgical Analogues and Mechanisms of Action. Clinical Diabetes, 35(3), 154–165.
3. Abu Dayyeh, B. K., & Rajan, E. (2017). Endoscopic Sleeve Gastroplasty: a Potential New Tool for Managing Obesity. Gastrointestinal Endoscopy Clinics of North America, 27(2), 277–292.
