The Endoscopic Sleeve Gastroplasty (ESG) or "EndoSleeve" works by making the stomach smaller, so patients feel full sooner and eat smaller portions. It also helps food stay in the stomach longer, which can prolong the feeling of fullness. The procedure is most successful when combined with healthy eating, regular physical activity, and long-term lifestyle changes.
EndoSleeve may be appropriate for adults with obesity, generally with a BMI of 30 or higher, who have not been able to achieve or maintain weight loss through diet and exercise alone. It may also be an option for patients who want a less invasive alternative to traditional bariatric surgery. A consultation is needed to determine whether the procedure is right for your medical history, weight goals, and overall health.
Weight loss varies from person to person. Most studies report an average weight loss of approximately 15–20% of total body weight after ESG, especially when patients follow the recommended nutrition, exercise, and lifestyle program. Results depend heavily on long-term commitment.
Both procedures reduce stomach size, but they are very different. A laparoscopic sleeve gastrectomy is surgery that removes a portion of the stomach. EndoSleeve is performed through the mouth using an endoscope, without abdominal incisions or removal of any part of the stomach. This generally means a faster recovery and a lower surgical impact, although weight-loss surgery may produce greater weight loss in some patients.
Most patients go home the same day. Many return to light activities within 24–48 hours and return to work within a few days. Some patients may experience nausea, abdominal discomfort, vomiting, bloating, or throat soreness early after the procedure. These symptoms are usually temporary and are managed with medication, hydration, and close follow-up.
Patients follow a gradual diet progression after the procedure. This usually starts with liquids, then soft foods, and eventually small portions of regular foods over several weeks. The long-term goal is not simply to “eat less,” but to develop a sustainable pattern focused on protein, hydration, portion control, and avoiding high-calorie foods and drinks.
The sutures used during EndoSleeve are durable and do not dissolve. Over time, the stomach tissue heals around the new shape. However, as with other weight-loss procedures, the stomach can stretch over time, and sutures can loosen or break. In selected cases, the sleeve can be tightened again. Reversal may be possible in some patients, but it requires careful evaluation and should not be assumed lightly.
The most common side effects include nausea, abdominal pain, vomiting, constipation, burping, heartburn, and diarrhea. Most symptoms improve over time. Serious complications are uncommon but can occur, including bleeding, infection, injury to the stomach, leak, or the need for further treatment. As with any medical procedure, risks should be reviewed carefully during consultation
Insurance coverage varies. Some plans may provide coverage, while others may consider the procedure self-pay. Our team can help verify benefits, review financing options, and provide cost information before scheduling the procedure.
EndoSleeve is considered a minimally invasive endoscopic procedure and generally has a lower complication rate than traditional bariatric surgery because it does not require abdominal incisions or removal of part of the stomach. However, it is still a medical procedure and does carry risks, including bleeding, infection, stomach injury, nausea, vomiting, abdominal pain, or the need for additional treatment. These risks should be reviewed carefully during consultation.
Yes. EndoSleeve is performed while you are asleep under anesthesia. The endoscope and suturing device are passed through the mouth into the stomach, so there are no external incisions.
The procedure usually takes about 60 to 90 minutes, although timing may vary depending on anatomy and individual circumstances. Most patients are monitored afterward and can go home the same day
In some patients, EndoSleeve may be part of a broader medical weight loss plan that includes nutrition support, lifestyle changes, and sometimes medications. Whether GLP-1 medications are appropriate before or after EndoSleeve depends on your medical history, weight loss goals, side effects, insurance coverage, and your doctor’s recommendation
Weight regain can happen if the stomach stretches, sutures loosen, or lifestyle habits are not maintained. In some cases, the sleeve can be retightened or revised endoscopically. A consultation is needed to determine the best next step