ENDOSCOPIC SLEEVE

What is Endoscopic Sleeve?

The Endoscopic Sleeve, also known as Endoscopic Sleeve Gastroplasty (ESG), stands as a pivotal advancement in the realm of minimally invasive bariatric procedures. Employing internal suturing techniques effectively diminishes stomach size, akin to the outcomes of surgical sleeve gastrectomy. This nonsurgical approach offers a promising avenue for individuals seeking substantial weight loss and enhancements in their overall health.
Moreover, the procedure's minimally invasive nature underscores its appeal, as it circumvents the complexities and risks associated with traditional surgical interventions. Through precise internal suturing, ESG facilitates significant weight reduction and fosters improved metabolic health, rendering it a valuable option in the spectrum of weight management strategies.

How does it Work?

The endoscopic stomach-sewing procedure, performed without the need for any external incisions, represents a significant advancement in minimally invasive bariatric interventions. Conducted under anesthesia, the procedure typically lasts between 1 to 1.5 hours, with patients requiring only a short hospital stay of about 1 day. Through the insertion of an endoscope, equipped with a camera and a suturing device, into the stomach via the throat, the surgeon marks the orientation of the stomach to guide the procedure. Subsequently, 5 to 8 sutures are tightly placed to reduce the horizontal diameter and vertically shorten the length of the stomach from within, resulting in a remarkable 70% reduction in its volume.

The endoscopic stomach-sewing procedure, performed without the need for any external incisions, represents a significant advancement in minimally invasive bariatric interventions. Conducted under anesthesia, the procedure typically lasts between 1 to 1.5 hours, with patients requiring only a short hospital stay of about 1 day.
Through the insertion of an endoscope, equipped with a camera and a suturing device, into the stomach via the throat, the surgeon marks the orientation of the stomach to guide the procedure. Subsequently, 5 to 8 sutures are tightly placed to reduce the horizontal diameter and vertically shorten the length of the stomach from within, resulting in a remarkable 70% reduction in its volume.

B How Is It Done & How Does It Work

Patient is placed under anesthesia to ensure comfort and minimize discomfort during the procedure.

Endoscope, equipped with a camera and a suturing device, is inserted through the throat and guided into the stomach.

Surgeon carefully marks the orientation of the stomach to ensure precise placement of sutures.

58 sutures are tightly placed within the stomach, targeting both the horizontal diameter and the length, effectively reducing its volume by up to 70%.

Throughout the procedure, the surgeon monitors progress using the endoscope's camera to ensure accuracy.

Once sutures are placed and stomach size is reduced, the endoscope is carefully removed.

Patient is closely monitored post procedure to ensure a smooth recovery and to manage any potential discomfort.

Patients typically stay in the hospital for about 1 day for observation and to receive postoperative care.

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

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

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

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A Pre-Procedure

Eligibility
Endoscopic Sleeve Gastroplasty is recommended for individuals who meet certain criteria. These may include:

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 such as diabetes, high blood pressure, sleep apnea, heart disease, cholesterol, etc.
Patients who can’t undergo bariatric surgeries having a BMI below 35
Patients with BMI of over 60 with anesthesia risk, and need to lose weight before planned bariatric surgery
Previous unsuccessful attempts at weight loss through diet, exercise, and other nonsurgical methods
Past medical and surgical history may also affect eligibility, so it is important to come in for a consult beforehand

Benefits
Endoscopic Sleeve Gastroplasty is recommended for individuals who meet certain criteria. These may include:

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 of all being similar. Shortened hospitalization period, and the gastric dumping syndrome risk is avoided

LESS INTRUSIVE

The operation is simpler than other bariatric surgeries where only the stomach is reduced in size, it does not require change in food passage route in gastrointestinal system, and 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, infertility, sleep apneas, asthma and cancer; are reduced. It also helps in longterm control of type 2 diabetes, and less dependence on medication — or the elimination of medication altogether.

PHYSIOLOGICAL

Less hunger and increase in energy. You may also enjoy the elimination of back and joint pain with increased mobility, decreased depression, improved breathing and increased energy.

PSYCHOLOGICAL

Dramatic improvements in your overall health and quality of life with improved self image, increased self confidence and the satisfaction that comes from enjoying a wider range of activities with friends and loved ones

Results may vary depending on lifestyle changes as well, we recommend an amalgamated approach for best results and sustainability.

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C Post-Procedure

Recovery can be different for everyone, but here's what you should know:

Hospital Stay
You'll typically stay in the hospital for 1 day after the surgery to make sure you're healing well and to keep an eye on your progress. You might be able to go back to work in less than a week, but it's best to avoid heavy physical tasks for a while

Follow-up Care
Diet :
After the procedure, you'll gradually reintroduce foods into your diet with the help of a nutritionist. They'll guide you on what and how to eat with your smaller stomach
You'll start with clear liquids within 24 hours of the surgery, then move to full liquids, soft foods, and eventually your regular diet over the next few weeks
You'll need to cut back on certain foods like sugary stuff and remember to chew slowly and thoroughly. It's important not to drink anything 30 minutes before or after eating. Ignoring these guidelines could lead to issues like constipation, dehydration, or rarely, leakage of stomach acid

Precautions
Let your doctor know right away if you experience fever, coughing, vomiting, diarrhea, abdominal or chest pain, or any other unusual symptoms.
During weight loss, you might face body aches, dry skin, mood swings, temporary hair thinning, tiredness, or feeling cold. But as your weight stabilizes, these problems should improve. Weight loss typically continues for about a year before leveling off at your body's ideal BMI.

SLEEVE GASTROPLASTY (ENDOSCOPIC) Vs GASTRIC SLEEVE (LAPAROSCOPIC)

The endoscopic sleeve gastroplasty, a minimally invasive procedure, typically leads to around 15% weight loss, which is less effective compared to the more invasive laparoscopic sleeve gastrectomy, which can result in up to a 35% weight reduction. One advantage of the endoscopic method is its reversibility – the sutures used to reduce stomach size can loosen over time, allowing the stomach to return to its original shape and size based on eating habits. This approach is considered safer and less invasive than traditional bariatric surgery, as it doesn't alter the natural digestion process.

The process to get you started on your weight loss journey

Non - Surgical Approaches

Achieving and maintaining a healthy weight is essential for overall well-being.

While weight loss journeys vary from person to person, there are numerous safe and effective methods available, both surgical and nonsurgical.

Here, we explore different approaches to healthy weight loss.

Surgical Weight Loss

Gastric Sleeve

Gastric sleeve surgery, or sleeve gastrectomy, is a widely favoured, minimally invasive weight loss solution. Removing a significant part of the stomach forms a smaller, banana-shaped stomach, curbing food intake, aiding weight loss, and enhancing health in cases of moderate to severe obesity.

Gastric Bypass

Gastric bypass, a proven weight loss approach, forms a small stomach pouch and redirects the small intestine. While more invasive than the gastric sleeve, it effectively induces weight loss and improves health conditions, demanding rigorous post-surgery dietary adherence for optimal outcomes.

Mini Gastric Bypass

The mini gastric bypass streamlines the traditional process, establishing a smaller stomach pouch directly linked to the small intestine. Balancing effectiveness and invasiveness, it delivers substantial weight loss and health benefits, demanding lifelong dietary adherence for success, making it a preferred choice.

Duodenal Switch

The duodenal switch, a preferred weight loss surgery for severe obesity, involves stomach reduction and small intestine rearrangement to limit calorie absorption, leading to significant weight loss. Despite its effectiveness, careful dietary management is crucial, making it suitable for those unsuccessful with other treatments.

FAQs

Obesity surgeries are evaluated based on body mass index, previous surgeries, previous medical history, amount of weight loss desired as well as financial implication – are the variables that help determine this.

It is dependent on an individual’s body mass index (BMI) and the presence of any co-morbidities. You may qualify for surgery if you have a BMI of 40 or greater, or if your BMI is at least 35 with other obesity-related health problems e.g. diabetes, heart disease, hypertension, and sleep apnea.

Usually 1-4 days of stay in the hospital. Problems that may occur during the preoperative evaluation and postoperative recovery period may determine this period.

Communication with your team and following your doctor’s instructions can prevent majority of the complications. Some include – dumping syndrome, dehydration, and nutrient deficiencies but can be avoided if the correct diet is followed and supplements.

We will transition you from liquid diet to solid diet gradually. High carb, sugary fluids and generally junk meals are to be reduced or completely avoided for better results, minimal side effects and sustainability of weight loss

After leaving the hospital, heavy activities should be reduced. The patient should not lift heavy loads for about 6 weeks.