Endoscopic Sleeve Gastroplasty (ESG)
A smaller stomach. Without removing part of it.
Endoscopic sleeve gastroplasty (ESG) is a minimally invasive weight-loss procedure that reshapes the stomach using internal stitches. Performed through the mouth, it requires no abdominal incisions and removes no stomach tissue. For suitable patients, ESG offers another treatment option when lifestyle changes alone have not provided enough weight loss.
What is ESG?
ESG uses a flexible camera tube called an endoscope, fitted with a specialised stitching device. The doctor places stitches inside the stomach to bring its walls together, creating a narrower shape with less capacity.
This can help you feel satisfied with smaller meals. ESG also slows stomach emptying, which may help fullness last longer. The stomach remains in place, and the intestines are not bypassed.
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How much weight can I lose?
Published outcomes commonly fall around 12–20% of starting body weight within one year, alongside dietary and lifestyle support. For someone weighing 100 kg, this would represent approximately 12–20 kg. This is an illustration, not a prediction of your result.
Your response may be higher or lower. Your doctor will discuss realistic goals, the support you need and how progress will be reviewed.
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Who may be suitable for ESG?
ESG may be considered for adults who need additional help with weight management and prefer a less invasive procedure.
International guidance supports endoscopic weight-loss treatments alongside lifestyle care for adults with:
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A BMI of 30 or above, or
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A BMI of 27–29.9 with at least one obesity-related health condition.
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Conditions such as active stomach ulcers, a large hiatus hernia or bleeding disorders may make ESG unsuitable or require treatment first.
Frequently asked questions
Is ESG reversible?
ESG is intended as a lasting treatment. Revision or reversal may be possible in selected cases, but should not be assumed to be simple or guaranteed. Discuss future treatment options with your doctor before proceeding.
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Can I regain weight after ESG?
Yes. Weight regain or less weight loss than expected can occur. Ongoing follow-up helps identify problems and review whether your treatment plan needs to change.
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Will I still need to change how I eat?
Yes. ESG supports smaller meals, but nutritious food choices, adequate hydration and regular physical activity remain part of care. The early recovery diet is especially important while your stomach heals. ​
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Find out whether ESG is right for you
Choosing a weight-loss treatment starts with understanding your health and the options available. Speak with the team at Andrea Bariatric Surgery to discuss ESG and whether it fits your needs.
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What does the ESG journey involve?
Our Strength: Comprehensive and Multidisciplinary Expertise
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Consultation and assessment
Discuss your health, weight history and treatment preferences. Your doctor assesses whether ESG is appropriate and explains alternatives, expected results and risks.
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Procedure and Observation
ESG is usually performed under general anaesthesia and takes approximately one to two-and-a-half hours. Afterwards, the team monitors your recovery. Discharge is usually after an overnight stay, depending on your condition.
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Preparation
You may need blood tests and other assessments. You will receive individual instructions about fasting and any changes to your medicines.
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Recovery and follow-up
You begin with liquids, then gradually progress to soft foods and regular textures according to your prescribed plan. Many patients resume desk work within about a week; recovery varies with symptoms and the demands of your job.
Follow-up should address food tolerance, nutrition, physical activity and weight maintenance, with adjustments when needed.