Endoscopic Sleeve Gastroplasty (ESG) – endoscopic gastric reduction or suturing, is an innovative, non-surgical, and fully reversible method of obesity treatment, consisting in reducing the volume of the stomach by endoscopic suturing, i.e. sewing the stomach from the inside. This procedure in obese patients can be performed as a primary procedure in people who do not want to undergo bariatric surgery or have contraindications for surgery, or as a revisional bariatric surgery after previous bariatric procedures.
At the KCM Bariatric and Metabolic Surgery Center, after comprehensive diagnostics, this procedure is performed by a very experienced surgeon, well-known in Poland and Europe, a specialist in general surgery, and gastroenterologist, Artur Raiter, MD, PhD
Endoscopic gastric sleeve, so-called endoscopic gastric reduction or endoscopic sleeve gastroplasty is a modern procedure in the treatment of obesity, which complements the offer of surgical treatment of obesity, such as a laparoscopic gastric sleeve or gastric bypass.
For which patients may endoscopic sleeve gastroplasty be recommended?
Gastric suturing can already be performed in patients with a BMI of 27, thus not eligible for more invasive obesity treatments such as bariatric surgical procedures. The endoscopic gastric reduction can therefore be performed in patients already with obesity stage I, as a primary procedure. In this case, this procedure can be an alternative treatment to gastric balloons. Endoscopic gastric suturing can also be used as a revisional bariatric surgery, for example, if a patient has undergone obesity surgery years ago, but his stomach stretches again. Endoscopic gastroplasty may be the recommended revisional procedure due to much lower risk than a revisional surgical procedure.
Another group of patients who may benefit from endoscopic stomach suturing are patients with a BMI above 60 and can effectively lose weight for the safety of the planned surgical procedure like gastric sleeve or bypass. In this case, endoscopic stomach reduction is performed as the first step of obesity treatment. The planned bariatric surgery can be performed as the second step – after the patient is already much thinner and the risk of surgery and anesthesia is much lower
This minimally invasive procedure involves suturing from the inside of the stomach using the video-gastroscope with a small HD camera and Overstitch suturing device, thus reducing the volume of the stomach by 60-80%. A disposable suturing system is inserted into the stomach through the endoscope’s channel to allow sutures to reduce the stomach. During the procedure, which lasts up to about 1 hour, the surgeon, using the appropriate size and type of thread, begins to suture the stomach. After the procedure, the device is removed from the patient’s body.
The main advantage of endoscopic stomach stitching is the fact that it is fully reversible. The second main advantage of this treatment is its low invasiveness, without surgical alteration of the anatomical shape of the stomach, without leaving scars or incisions in the stomach wall.
Endoscopic gastroplasty in patients who comply with the recommendations shows a little less effective than the more invasive laparoscopic reduction of the stomach, i.e. sleeve gastrectomy (gastric sleeve). The endoscopic gastric suturing procedure is performed under general anesthesia, the hospital stay is very short, the patient goes home the same or the next day after the procedure.
Endoscopic gastric sleeve is a relatively safe and much less invasive procedure compared to bariatric surgery.
It is a minimally invasive and fully reversible procedure. The sutures/threads placed in order to reduce the capacity of the stomach can be cut out any time endoscopically after the loss of weight, i.e. also non-surgically, and they are excreted with food.