Endoscopic Sleeve Gastroplasty

Selim Surgery Center

Endoscopic Sleeve Gastroplasty

An endoscopic sleeve gastroplasty – also known as the accordion procedure – is a minimally invasive, weight loss procedure offered to patients who do not meet the requirements for bariatric surgery. 

ESG is an endoscopic procedure using a small suturing device and camera that is passed down the patient’s esophagus into the stomach to reduce the size of the stomach, so patients feel full faster, digest more slowly, and lose weight.  

What happens during the procedure? 

Using an endoscopic suturing device, the endoscopist constricts the stomach, resulting in a “sleeve”. The patient is placed under general anesthesia, and the doctor places a scope down the patient’s throat sutures are inserted in a specific pattern from the bottom of the stomach (antrum) to the top (fundus). 

The series of sutures is then tightened in a fashion that resembles an accordion, constricting the volume of the stomach. Patients generally follow a liquid diet for a brief amount of time after the procedure, and often can go home that same day. After the procedure, the patients can only consume a small amount of food. This procedure is performed alongside diet and exercise to achieve weight loss. 


Who May Qualify for an Endoscopic Sleeve Gastroplasty (Accordion)? 

The endoscopic sleeve gastroplasty (ESG) procedure is designed for patients who are not morbidly obese and are also not able to undergo bariatric surgery.  

Patients may include: 

  • Those with a body mass index (BMI) that does not exceed 40 without comorbidities [add BMI scale link] 
  • Those with a BMI of 30-35 with HTN, hyperlipidemia, type-2 diabetes, or sleep apnea. 

What is the Endoscopic Sleeve Gastroplasty (Accordion) Outcomes? 

Findings demonstrate that patients may lose 30% to 60% of their excess body weight within six months of their procedure.  

We have seen: 

  • 15-20% excess weight loss 3 months from the endoscopic sleeve 
  • 30-60% excess weight loss 6 months from the endoscopic sleeve 
  • Results in improvement in comorbidities, such as sleep apnea and high blood pressure. 

Is the Endosleeve right for you? 

Non-surgical sleeve gastroplasty leads to significant weight loss. This procedure was created to assist you in losing weight by limiting how much you can eat. It’s minimally invasive which aids in reducing the risk of operative complications. 

Mimicking other weight-loss procedures, Endoscopic Sleeve Gastroplasty requires a commitment to improve your lifestyle and making healthier choices. Permanent healthy changes to your diet and get regular exercise are the only way to help ensure the long-term success of the “Accordion” procedure. 

Endoscopic sleeve gastroplasty is not for every patient who is overweight. A screening process helps doctors see if the procedure might be the right course of treatment. It’s important to note that you must be willing to commit to healthy lifestyle changes and regular medical follow-ups. 

Do I Qualify?

Bariatric Surgery

Millions of people would like to lose weight. Severely obese patients are considered viable candidates to undergo bariatric surgery.

Severe obesity is defined as weight that is at least 100 pounds more than the ideal body weight for a person’s height and age.

Severe obesity (Morbid Obesity) is defined by the patient’s body mass index, or ratio of fat to lean body mass. It is an equation that uses weight, height and age in the calculation.

BMI Calculator