ESG - ENDOSCOPIC SLEEVE GASTROPLASTY

Eligibility Criteria

• Body Mass Index (BMI) of 30 or higher, indicating obesity (class I or higher).
• BMI of 27 or higher may qualify if accompanied by obesity-related health conditions (diabetes, high blood pressure, sleep apnea, heart disease, cholesterol, etc.).
• Patients who cannot undergo bariatric surgeries having a BMI below 35.
• Patients with a BMI of over 60 with anesthesia risk, needing to lose weight before a planned bariatric surgery.
• Previous unsuccessful attempts at weight loss through diet, exercise, and other nonsurgical methods.

Benefits

Less Risk: The operation is simple, as it only reduces the stomach size and this means less complication/risk during and after the procedure compared to other more intrusive surgeries whilst the benefits are similar. Shortened hospitalization period, and the gastric dumping syndrome risk is avoided.

Less Intrusive: Simpler than bariatric surgeries requiring change in food passage route; the risk of malnutrition is low as compared to the gastric bypass.

Medical: Obesity related illnesses such as high blood pressure, stroke, type 2 diabetes, cholesterol, sleep apnea, and heart risk are reduced.

Surgical Process

• Patient is placed under anesthesia to ensure comfort and minimize discomfort during the procedure.
• An endoscope, equipped with a camera and a suturing device, is inserted through the throat and guided into the stomach.
• The surgeon carefully marks the orientation of the stomach to ensure precise placement of sutures.
• 5 to 8 sutures are tightly placed within the stomach, targeting both the horizontal diameter and the length, reducing its volume by up to 70%.
• The endoscope is carefully removed once suturing is complete.

Mechanism of Weight Loss

Portion Control: Following the procedure, patients experience a reduction in stomach capacity, leading to improved portion control and reduced food intake.

Digestion: The altered stomach shape accelerates digestion and limits the absorption of fatty foods, contributing to weight loss.

Satiety: Patients experience increased feelings of fullness with smaller food portions, aiding in satiety and supporting their weight loss journey.

Diet & Follow-up Care

Dietary Progression: Slowly reintroduce foods with the help of a nutritionist. Start with clear liquids within 24 hours of surgery, then move to full liquids, soft foods, and eventually regular solid foods over the next few weeks.

Precautions: Cut back on sugary foods, chew slowly and thoroughly, and do not drink liquids 30 minutes before or after eating to avoid complications like constipation or acid reflux.

Hospital Stay & Monitoring

Hospital Stay: Typically stay in the hospital for 1 day after surgery to ensure proper healing. Return to work is usually possible in less than a week, but avoid heavy physical tasks initially.

Weight Loss Timeline: Weight loss typically continues for about a year before leveling off at your body's ideal BMI. Temporary symptoms like dry skin, tiredness, or body aches are normal and resolve as weight stabilizes.