What is Endoscopic Sleeve Gastroplasty ? Benefits Side-effects Procedure

English

Endoscopic Sleeve Gastroplasty (ESG) is a minimally invasive, non-surgical weight loss procedure designed to help individuals lose weight and improve their overall health. It is also known by other names such as “accordion procedure” and “endoscopic gastric plication.” 

ESG is typically performed by a gastroenterologist or bariatric surgeon.

Here’s an overview of the ESG procedure:

• Procedure: During ESG, a flexible endoscope (a thin, tube-like instrument with a camera and other tools) is inserted through the mouth and into the stomach. No incisions are made in the abdomen, making it a non-surgical approach.
• Suturing: Inside the stomach, the endoscope is used to place sutures or stitches along the greater curvature of the stomach. These sutures are designed to gather and fold the stomach tissue, essentially reducing the size of the stomach, and create a sleeve-like shape.
• Reduced Stomach Size: By creating this sleeve, the stomach’s capacity is reduced, which can lead to earlier feelings of fullness during meals. As a result, individuals tend to eat less and, in turn, lose weight.
• Weight Loss: ESG restricts the amount of food a person can consume, which can lead to weight loss over time. It can be an effective option for individuals who have struggled to lose weight through diet and exercise alone.
• Minimally Invasive: One of the key advantages of ESG is that it is minimally invasive, meaning it does not require any incisions, which can reduce the risks and complications associated with traditional surgical weight loss procedures like gastric bypass or sleeve gastrectomy.
• Reversible: ESG is considered a reversible procedure. The sutures can be adjusted or removed if needed, which sets it apart from irreversible surgical procedures.
• Patient Selection: ESG is generally recommended for individuals who are moderately to severely obese and have not responded to conventional weight loss methods. A thorough evaluation by a healthcare provider is necessary to determine if ESG is a suitable option.
• Lifestyle Changes: Like any weight loss procedure, ESG is most effective when combined with lifestyle changes, including a healthy diet and increased physical activity.

If you’re considering ESG as a weight loss option, it’s crucial to consult with a qualified healthcare provider who can assess your individual needs and discuss the risks and benefits associated with the procedure. ( Know more about – What is Bariatric Surgery ? )

Does ESG have any side effects? How to manage them ?

Endoscopic Sleeve Gastroplasty (ESG) is generally considered to be a safe and minimally invasive weight loss procedure. However, like any medical intervention, it can have side effects and potential risks. 

The severity and occurrence of these side effects can vary from person to person. Here are some common side effects and how to manage them:

• Nausea and Vomiting: Nausea and vomiting can occur after the procedure, especially during the first few days. This is often due to the reduced stomach size and the need to adapt to eating smaller meals.
  • Management: Follow your healthcare provider’s dietary recommendations. Start with clear liquids and gradually transition to soft, pureed, and solid foods as advised. Eat slowly and chew your food thoroughly to minimize discomfort.
• Pain or Discomfort: Some individuals may experience mild abdominal discomfort or pain after ESG, which usually resolves within a few days.
  • Management: Over-the-counter pain relievers may be recommended by your healthcare provider to manage discomfort. Follow your healthcare provider’s guidance for pain relief.
• Gastroesophageal Reflux Disease (GERD): In some cases, ESG can exacerbate or lead to GERD symptoms, such as heartburn or acid reflux.
  • Management: Your healthcare provider may prescribe medications or recommend dietary changes to manage GERD symptoms. It’s essential to report any persistent symptoms to your healthcare provider for appropriate management.
• Suture-Related Complications: ESG involves the placement of sutures in the stomach, and although rare, complications like suture migration or infection can occur.
  • Management: If you experience signs of infection (e.g., fever, severe pain, redness, swelling), or if you suspect suture-related issues, contact your healthcare provider immediately. In some cases, a follow-up endoscopy or other interventions may be necessary.
• Inadequate Weight Loss: While ESG can be effective, there is the possibility of not achieving the desired weight loss.
  • Management: It’s essential to continue working closely with your healthcare provider to monitor your progress. Adjustments to your dietary and lifestyle habits may be needed, or other weight loss strategies may be explored if necessary.
• Regaining Weight: Over time, some individuals may regain weight if they do not adhere to dietary and lifestyle recommendations.
  • Management: Continue to follow up with your healthcare provider and seek guidance on maintaining a healthy weight. This may include changes in your diet and exercise routine.
• Long-Term Data: ESG is a relatively new procedure, and long-term data on its effectiveness and safety are still being collected. Discuss the latest research and data with your healthcare provider and make informed decisions about your weight management journey.

Work closely with your healthcare provider before and after ESG to address any side effects, concerns, and questions. They can provide you with a personalised care plan and guidance to help you achieve and maintain your weight loss goals. ( Know more about- What is Obesity ? )

How effective is ESG ?

The effectiveness of Endoscopic Sleeve Gastroplasty (ESG) in promoting weight loss can vary from person to person, and it depends on several factors, including the individual’s starting weight, adherence to post-procedure guidelines, and lifestyle changes. 

Here’s an overview of ESG’s effectiveness:

• Moderate to Significant Weight Loss: ESG has been shown to be effective in helping individuals achieve moderate to significant weight loss. Weight loss outcomes may vary, but many individuals have reported losing a substantial amount of excess body weight.
• Percentage of Excess Weight Loss (%EWL): ESG often results in a percentage of excess weight loss in the range of 40-60% or more. This means that, on average, patients can expect to lose a significant portion of their excess body weight.
• Improvement in Comorbidities: ESG is associated with improvements in obesity-related comorbidities, such as type 2 diabetes, high blood pressure, sleep apnea, and high cholesterol. Many individuals experience better control of these conditions after the procedure.
• Quality of Life: Patients who undergo ESG often report an improved quality of life, as they can engage in more physical activities, have increased energy levels, and experience a boost in self-esteem.
• Reversibility: One advantage of ESG is that it is considered a reversible procedure. If necessary, the sutures placed during the procedure can be adjusted or removed, allowing for a degree of reversibility not seen with traditional surgical weight loss procedures.
• Non-Surgical Approach: ESG is a non-surgical procedure, which typically means fewer risks and complications compared to traditional bariatric surgeries like gastric bypass or sleeve gastrectomy.

Individual results can vary, and the long-term effectiveness of ESG is still an area of ongoing research, as it is a relatively new procedure. Some individuals may experience slower weight loss than others, and long-term maintenance of weight loss is closely tied to adherence to dietary and lifestyle changes.

To maximize the effectiveness of ESG:

• Follow the dietary and lifestyle recommendations provided by your healthcare provider or a registered dietitian.
• Stay committed to regular follow-up appointments for monitoring and adjustments.
• Engage in regular physical activity.
• Maintain a healthy and balanced diet.

Before considering ESG or any weight loss procedure, consult with a bariatric specialist to determine if it is the right option for your specific needs and to discuss the potential benefits and risks based on your individual circumstances.

Does Endoscopic Sleeve Gastroplasty reduce risk of other diseases ?

Endoscopic Sleeve Gastroplasty (ESG) can help reduce the risk of certain diseases and health conditions associated with obesity. While the primary goal of ESG is weight loss, the resulting reduction in excess body weight and improved metabolic health can lead to a decreased risk or improved management of several obesity-related conditions. 

Here are some of the diseases and health benefits that ESG may help mitigate:

• Type 2 Diabetes: ESG has been shown to lead to improvements in insulin sensitivity and glycemic control. This can result in a significant reduction in the risk of developing type 2 diabetes or improved management of the condition in those who already have it.
• Hypertension (High Blood Pressure): Weight loss after ESG can lead to reduced blood pressure, which can lower the risk of hypertension or improve blood pressure control in individuals with preexisting high blood pressure. ( Know more about- What is Hypertension ? )
• Hyperlipidemia (High Cholesterol): ESG can lead to favorable changes in lipid profiles, resulting in lower cholesterol levels. This can reduce the risk of heart disease and stroke.
• Obstructive Sleep Apnea: Weight loss achieved through ESG can alleviate or improve symptoms of sleep apnea, such as snoring and interrupted breathing during sleep.
• Heart Disease: Weight loss and the associated improvements in risk factors like blood pressure and cholesterol levels can lower the risk of heart disease.
• Non-Alcoholic Fatty Liver Disease (NAFLD): ESG can improve liver health and reduce the risk of non-alcoholic fatty liver disease, a condition often associated with obesity.
• Gastroesophageal Reflux Disease (GERD): ESG may alleviate or reduce symptoms of GERD by reducing pressure on the lower esophageal sphincter and decreasing the likelihood of stomach acid flowing back into the esophagus.
• Joint Pain and Osteoarthritis: Reduced body weight can relieve stress on joints and decrease joint pain and the risk of osteoarthritis.

Note that while ESG can be an effective tool for improving metabolic health and reducing the risk of these conditions, individual results may vary, and success depends on factors like adherence to post-procedure guidelines and lifestyle changes.

ESG should be considered as part of a comprehensive approach to managing obesity and related health concerns. Lifestyle modifications, including a healthy diet and regular physical activity, are crucial components of a successful long-term outcome. 

When is Endoscopic Sleeve Gastroplasty contraindicated ?

Endoscopic Sleeve Gastroplasty (ESG) may not be suitable for everyone, and there are certain situations and medical conditions in which ESG is contraindicated, meaning the procedure is not recommended. Some common contraindications include:

• Severe Medical Illness: ESG is generally not recommended for individuals with severe medical conditions that could increase the risks associated with the procedure. This includes severe heart disease, severe lung disease, and other conditions that may make the patient a poor candidate for anesthesia or endoscopy.
• Pregnancy: ESG is not recommended during pregnancy due to the potential risks it may pose to both the mother and the fetus. Women who are pregnant or planning to become pregnant in the near future should typically delay consideration of ESG.
• Prior Gastrointestinal Surgery: ESG may not be suitable for individuals who have had prior gastrointestinal surgeries, as the anatomy of the digestive tract may be altered, making the procedure technically challenging or less effective.
• Active Infection: Active infections in the gastrointestinal tract or any systemic infection may be a contraindication. The presence of an infection could increase the risk of complications during the procedure and recovery.
• Bleeding Disorders: Individuals with bleeding disorders, such as hemophilia, or those taking anticoagulant medications, may not be good candidates for ESG, as the procedure can involve the risk of bleeding.
• Unrealistic Expectations: Patients who have unrealistic expectations about the outcomes of ESG or who are unwilling to commit to the necessary dietary and lifestyle changes may not be good candidates for the procedure.
• Psychological Factors: Severe psychiatric conditions, such as untreated depression or an active eating disorder, may be considered contraindications, as these conditions can impact the success of ESG and a patient’s ability to follow post-procedure recommendations.
• Allergy or Intolerance: Individuals with allergies to materials used during the procedure, such as those used for endoscopic suturing, may not be candidates for ESG.
• Severe Gastroparesis: Gastroparesis is a condition where the stomach takes too long to empty its contents. ESG may not be appropriate for individuals with severe gastroparesis.

Potential candidates must undergo a comprehensive evaluation by a bariatric specialist to determine their suitability for Endoscopic Sleeve Gastroplasty. Always consult with a qualified healthcare professional for guidance tailored to your specific needs and circumstances. Get ESG done by the best Bariatric Surgeons at H N Reliance Hospital Mumbai.