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EndoSleeve Vs Sleeve Gastrectomy

ESG vs SG.png

The Endoscopic Sleeve Gastroplasty, or ESG, is performed through the mouth using an endoscope. The stomach is sutured from the inside. There are no abdominal incisions, and no part of the stomach is removed.
 

Sleeve gastrectomy is a laparoscopic surgical operation. Most of the outer portion of the stomach is permanently removed, resulting in a smaller, tube-shaped stomach.

The MERIT randomized trial found ESG produced significant weight loss at one year, with 13.6% total body weight loss at 52 weeks, and reported serious ESG-related adverse events in 2% of treated participants, without mortality or need for surgery/ICU in that trial.

Lancet. 2022 Aug 6;400(10350):441-451 ild

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A recent study showed that ESG had a comparable short-term safety profile and was associated with potential advantages such as shorter hospital stay and lower rates of certain complications, including gastric leak and reflux. Obes Surg. 2026 Apr 18. doi: 10.1007/s11695-026-08619-z

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Why Choose EndoSleeve Instead of Sleeve Gastrectomy?

The EndoSleeve offers selected patients an incisionless alternative to traditional sleeve gastrectomy.

Unlike sleeve gastrectomy, EndoSleeve does not require abdominal incisions and does not remove any part of the stomach. Instead, the procedure is performed through the mouth using a flexible endoscope. Internal sutures are placed to reduce the size of the stomach and help patients feel full with smaller meals.
 

For many patients, the appeal of EndoSleeve is that it is organ-sparing, incisionless, and typically associated with a faster recovery than surgery. It may be especially attractive for patients who want a more durable option than medication alone, but who are not ready for a permanent surgical procedure.

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