4Ward Wellness: What to Know Before Your Endoscopic Sleeve Gastroplasty (ESG)

Endoscopic Sleeve Gastroplasty (ESG) is a minimally invasive, non-surgical weight loss procedure designed to reduce the stomach size. Using an endoscope, a flexible tube equipped with a camera, and a suturing device, a healthcare provider creates a smaller, sleeve-shaped stomach. This reduced stomach capacity helps limit food intake, promoting weight loss. 

Unlike traditional surgical procedures like gastric bypass, ESG does not require external incisions, resulting in shorter recovery times and a lower risk of complications. This procedure is typically recommended for individuals who have not achieved significant weight loss through diet and exercise alone and are seeking an alternative to more invasive surgical options.

Who Is a Candidate for ESG?

Endoscopic Sleeve Gastroplasty (ESG) may be a suitable option for individuals struggling with obesity who have been unable to achieve significant or sustained weight loss through traditional methods such as diet, exercise, or behavioral therapy. Typically, candidates for ESG have a body mass index (BMI) of 30 or higher, though specific recommendations may vary depending on individual health circumstances. 

It is particularly recommended for those who are looking for a non-surgical weight loss solution or are not eligible for conventional bariatric surgery. Additionally, candidates should be willing to commit to long-term lifestyle changes, including healthier eating habits and regular physical activity, to ensure the procedure’s success. A thorough evaluation by a qualified healthcare provider is necessary to determine if ESG is the right choice based on medical history and weight loss goals.

How ESG Works: A Step-by-Step Overview

Endoscopic Sleeve Gastroplasty (ESG) is a minimally invasive procedure performed using an endoscope, a flexible tube with a camera and suturing equipment, that is inserted through the mouth. Here is a step-by-step overview of how ESG is conducted:

1. Preparation – Before the procedure, patients are typically required to fast and may undergo a series of tests to ensure they are ready for ESG. Sedation or general anesthesia is administered to ensure comfort during the process.
2. Endoscope Insertion – The endoscope is carefully inserted through the mouth into the stomach. This eliminates the need for any external incisions, significantly reducing recovery time and the risk of complications.
3. Suturing the Stomach – Using specialized suturing tools attached to the endoscope, the physician reduces the stomach’s size by placing a series of stitches in a specific pattern. This effectively creates a sleeve-like shape, limiting the stomach’s capacity for food.
4. Procedure Completion – Once the sutures are secure and the desired stomach size is achieved, the endoscope is gently removed. The entire process typically takes about 60 to 90 minutes.
5. Post-Procedure Recovery – Following ESG, patients are monitored for a short period before being discharged the same day. Recovery instructions, including dietary guidelines and activity restrictions, are provided to support healing and maximize results.

Through this method, ESG helps patients feel full sooner and maintain the feeling of fullness longer, promoting effective weight loss without the need for invasive surgery.

Benefits of ESG Compared to Traditional Bariatric Surgery

Endoscopic Sleeve Gastroplasty (ESG) offers several advantages over traditional bariatric surgery, making it an appealing option for patients seeking effective weight loss solutions. Key benefits include:

• Minimally Invasive Approach – Unlike traditional bariatric surgeries, ESG requires no external incisions, significantly reducing the risk of infection, scarring, and complications.
• Faster Recovery Time – Patients undergoing ESG generally experience a quicker recovery period, often resuming normal activities within a few days, compared to weeks of downtime after surgical procedures.
• Lower Risk of Complications – The non-surgical nature of ESG lowers the chances of adverse events such as blood clots, wound issues, or hernias that are more common with traditional surgery.
• Same-Day Discharge – ESG is typically performed as an outpatient procedure, allowing patients to return home on the same day, minimizing hospitalization and associated costs.
• Preservation of Anatomy – Since ESG does not involve removing or rerouting any part of the stomach or intestines, it maintains the natural anatomy, which can reduce the risk of long-term nutritional deficiencies.

These factors make ESG a safer and more convenient option for individuals aiming for significant weight loss without the challenges and risks associated with traditional bariatric surgery.

Preparing for Your ESG Procedure

Proper preparation is essential to ensure the success of your Endoscopic Sleeve Gastroplasty (ESG) procedure. Before the procedure, your healthcare provider will likely conduct a thorough medical evaluation, including blood tests and imaging studies, to confirm your eligibility and overall health status. You may also be advised to adhere to a specific diet plan in the days leading up to the procedure, which often includes a liquid or low-residue diet to prepare your stomach. 

Additionally, it is important to inform your doctor about any medications or supplements you are taking, as some may need to be adjusted or temporarily discontinued. Preparing mentally and emotionally is equally crucial; understanding the lifestyle changes required post-procedure will help set the foundation for long-term success. Be sure to follow all pre-procedure instructions provided by your medical team to achieve the best possible outcomes with ESG.

Medical Evaluations and Tests

Prior to undergoing Endoscopic Sleeve Gastroplasty (ESG), your doctor will perform a series of medical evaluations and tests to ensure you are a suitable candidate for the procedure. These typically include a comprehensive medical history review, blood tests to assess your overall health, and imaging studies such as an abdominal ultrasound or an endoscopy. These evaluations help identify any underlying conditions that could affect the safety or effectiveness of the procedure. Additionally, your healthcare provider may assess your nutritional status and discuss any necessary vitamin or mineral supplementation to prepare your body for the changes post-ESG. These thorough assessments play a critical role in minimizing risks and optimizing the success of the procedure.

Dietary Guidelines Before the Procedure

Adhering to specific dietary guidelines before undergoing Endoscopic Sleeve Gastroplasty (ESG) is essential to ensure the procedure’s success and reduce potential risks. Your doctor or dietitian may recommend a low-calorie, high-protein diet in the weeks leading up to the procedure to help reduce the size of your liver and improve surgical access. It is often advised to limit or completely avoid high-fat, sugary, and processed foods during this period. Additionally, staying well-hydrated by drinking plenty of water is crucial, but you may be asked to avoid beverages containing caffeine or alcohol. You might also be instructed to stop eating or drinking several hours before the procedure to ensure your stomach is empty. Following these dietary recommendations will prepare your body for ESG and enhance your recovery process post-procedure.

Lifestyle Changes to Implement Early

Making key lifestyle changes prior to undergoing Endoscopic Sleeve Gastroplasty (ESG) can significantly contribute to the procedure’s success and your overall health. Begin incorporating regular physical activity into your routine, as even moderate exercise can improve cardiovascular health and aid in weight management. Focus on developing mindful eating habits, such as eating slower and paying attention to portion sizes, which are crucial for long-term success after ESG. Stress management is also important, as chronic stress can impact your weight and overall health—practices like meditation, yoga, or deep breathing exercises can be helpful. Additionally, aim to establish a consistent sleep schedule to ensure your body has adequate rest, which supports recovery and weight loss. Starting these changes early will help create a strong foundation for a healthier lifestyle post-procedure.

What to Expect on the Day of Your Procedure

On the day of your Endoscopic Sleeve Gastroplasty (ESG) procedure, it is essential to arrive prepared and comfortable. You will typically be instructed to avoid food and drink for a certain period prior to the procedure, usually starting the night before. Upon arrival at the medical facility, the healthcare team will guide you through the check-in process and ensure you are ready for the procedure. You may receive a sedative or anesthesia to ensure your comfort during the ESG. 

The procedure itself is minimally invasive and performed endoscopically, meaning no external incisions are required. It typically takes less than two hours to complete, depending on individual circumstances. After the procedure, you will be monitored in a recovery area until you are ready to return home. Be sure to arrange for someone to drive you home, as the effects of anesthesia may take time to wear off. Following the healthcare team’s instructions carefully will help ensure a smooth experience on the day of your procedure.

Recovery After ESG: Timeline and Tips

Recovery after Endoscopic Sleeve Gastroplasty (ESG) is generally straightforward, but following the recommended guidelines is essential for a safe and effective healing process. Most patients can resume light activities within 24 to 48 hours after the procedure, although it is advised to avoid strenuous exercise for at least a week. You may experience mild side effects such as nausea, abdominal discomfort, or a sore throat, which typically subside within a few days. 

A liquid diet is often required during the first week post-procedure, gradually transitioning to soft foods as instructed by your healthcare provider. Staying hydrated and adhering to your prescribed dietary plan are crucial for optimal recovery and long-term success. Regular follow-up appointments with your medical team will help monitor your progress and address any concerns during your recovery period.

Long-Term Lifestyle Adjustments

To achieve lasting success after your Endoscopic Sleeve Gastroplasty (ESG), committing to long-term lifestyle adjustments is crucial. This includes adopting a balanced diet rich in lean proteins, vegetables, and whole grains while avoiding high-calorie, sugary, and processed foods. Consistent portion control is essential, as your stomach’s capacity is reduced, and overeating may cause discomfort. 

Regular physical activity should also become a part of your routine, with at least 150 minutes of moderate exercise per week recommended to maintain weight loss and overall health. Establishing healthy habits, such as mindful eating and managing stress, can help you sustain your results. Additionally, ongoing follow-up visits with your healthcare provider or nutritionist ensure you stay on track and address any challenges or questions along the way.

Tips for Maintaining Weight Loss After ESG

Maintaining weight loss after Endoscopic Sleeve Gastroplasty requires dedication and consistency. Start by keeping a food journal to monitor your eating habits and hold yourself accountable. Tracking your meals can help identify any patterns or behaviors that may lead to overeating. 

Plan your meals in advance to ensure nutritious and portion-controlled options are readily available, reducing the temptation to make unhealthy choices. Staying hydrated is also critical—drinking water throughout the day helps curb hunger and prevents dehydration. 

Prioritize sleep, as poor sleep habits can disrupt hormone levels and contribute to weight gain. Surround yourself with a supportive community, whether that involves friends, family, or support groups, to stay motivated and share experiences. Finally, be patient and kind to yourself—success is a gradual process, and small, sustainable changes are more effective than drastic measures.

When To Talk to Your Doctor

It’s important to maintain open communication with your doctor throughout your weight loss journey, especially after undergoing Endoscopic Sleeve Gastroplasty (ESG). Reach out to your doctor if you experience persistent nausea, vomiting, or abdominal pain, as these could indicate complications requiring medical attention. Regular follow-ups are essential for tracking progress, managing any medical conditions, and ensuring long-term success. Don’t hesitate to contact your doctor with any concerns or questions—they are there to support you every step of the way.