Endoscopic Sleeve Gastroplasty (ESG)

Endoscopic sleeve gastroplasty (ESG) is a non-surgical weight-loss procedure done through the mouth with an endoscope. Using a suturing device, the doctor places stitches inside the stomach that fold it into a narrower, tube-like shape so you feel full on smaller portions. There are no cuts on the skin and no part of the stomach is removed. It is offered as part of a structured programme with dietitian support and regular follow-up.

ESG may suit adults living with obesity who have not reached or kept a healthy weight with diet and exercise, and who want an option between medication and weight-loss surgery. It is chosen after a full assessment of your weight, medical history and goals. How much weight each person loses varies, and the procedure works best when combined with lasting changes to eating habits, activity and regular follow-up.

1. First you have a consultation, blood tests and an upper endoscopy to confirm the stomach is suitable and to check for problems such as ulcers or a large hiatal hernia
2. The procedure is done under general anaesthesia or deep sedation, as decided by the anaesthesia team
3. The endoscope is passed through the mouth and the suturing device places a pattern of stitches that reshape the stomach into a sleeve
4. You are observed after the procedure and usually go home the same day or the next day, depending on how you feel
5. A staged diet (liquids, then soft foods, then normal textures) and regular visits with the doctor and dietitian follow over the next months

Procedure about 1–2 hours; follow-up programme over 12 months

• ✓Complete the pre-procedure tests (blood tests and upper endoscopy) before the date
• ✓Fast as instructed and tell us about all medicines, especially blood thinners and diabetes treatments
• ✓Plan time off and arrange for someone to accompany you home

• •The assessment visit decides whether ESG, a gastric balloon, medication or surgery is the best fit for you
• •Nausea, stomach cramps and a sore throat are common for the first few days and can be treated with medicines
• •You follow a staged diet, starting with liquids, and gradually return to soft and then regular foods
• •Most people return to light daily activities within a few days; your doctor will tell you when to resume exercise
• •Regular visits with the doctor and dietitian over the following months are part of the programme and important for lasting results

• ✓Adults living with obesity who have not reached or kept a healthy weight with diet and exercise
• ✓People who want an option between medication and weight-loss surgery
• ✓Those who are ready to commit to a structured programme with dietitian support and follow-up
• ✓People who prefer a procedure without skin incisions or removal of part of the stomach
• ✓Patients who are medically suitable after assessment, including an upper endoscopy

• •Nausea, stomach cramps and sore throat are common for the first few days and are treated with medicines
• •Less commonly there can be bleeding, infection or leakage at the stitch sites, which may need further treatment or hospital care
• •Weight can be regained if eating habits and activity do not change or follow-up is missed
• •Some people develop or notice worsening reflux after the procedure
• •Not everyone is suitable, so a full assessment comes first and your doctor will explain the risks for you

Weight loss varies from person to person and depends on your starting point, eating habits, activity and follow-up. Your doctor will set realistic goals with you and track progress at regular visits; no specific result can be promised.