Endoscopic Sleeve Gastroplasty | Endosleeve

The Endoscopic Sleeve Gastroplasty is a new and effective procedure that helps patients who may not be ready for surgery but are unable to achieve weight loss with diet and exercise alone.

Eviva was the first medical center to perform the ESG in Washington State and has since completed over 300 procedures!

What is the Endoscopic Sleeve Gastroplasty?

The Endoscopic Sleeve Gastroplasty (ESG) is a weight loss procedure that uses an endoscopic camera with a suturing device to reduce the size of your stomach. An internal suture pattern is used to collapse 70-80% of your stomach, but no portion of the stomach is removed and there are no incisions and no scars. The procedure is permanent but reversible if necessary. ESG patients have had good weight loss results, losing 30-60% of excess weight and usually have improvement or remission of diseases like type 2 diabetes, hypertension and other obesity related comorbidity diseases. The ESG is also known as the Endosleeve or the Accordion procedure. 

Is the ESG permanent? Is the ESG reversible?

Yes, the Endoscopic Sleeve Gastroplasty is permanent, but, it is also reversible. We use permanent sutures that do not dissolve and 5 year data has demonstrated that the procedure is durable. 

The ESG suture could be removed endoscopically if necessary to reverse the ESG procedure. It is very rare that this is needed, and is best to be done by an endoscopist who is experienced with performing the ESG.

Who qualifies for the ESG?

We always approach each patient individually and consider BMI, body composition, and the presence of diseases like hypertension, type 2 diabetes, hypertriglyceridemia, obstructive sleep apnea, polycystic ovarian syndrome (PCOS), and fatty liver disease.

If you have one of the below conditions, you may qualify for the procedure:

  • Unable to successfully maintain weight loss despite diet and exercise.
  • BMI greater than 27.
  • Body fat percentage greater than 35%
  • Metabolic diseases such as type 2 diabetes, hypertension, hypertriglyceridemia, obstructive sleep apnea, polycystic ovarian syndrome (PCOS), and fatty liver disease.

What is the recovery like after the Endosleeve?

After the procedure, most patients feel some abdominal discomfort and nausea, but are able to be adequately treated with oral medication. Patients are sipping fluids and walking within an hour of the procedure and go home within a few hours of the procedure. Most patients are able to return to work after just 2-4 days!

What does gastroplasty mean?

Gastroplasty means “stomach molding” and comes from the latin term “gastro-”, which means stomach, and “-plasty”, which means to mold.

Conversely, gastrectomy means to remove a part of the stomach and derives from the latin suffix “-ectomy”, which means to remove.

Endoscopic sleeve gastroplasty is the scientific name of a procedure that is performed endoscopically to remodel the stomach from the shape of a large bag into a tight sleeve.

The endoscopic sleeve gastroplasty is also called the ESG, Endosleeve, or the Accordion procedure.

Will my diabetes and hypertension get better after the ESG?

Yes! Studies have also shown that metabolic diseases like type 2 diabetes, hypertension, fatty liver disease, and hypertriglyceridemia, experience significant improvement, if not put into complete remission.

What are possible complications after Endoscopic Sleeve Gastroplasty?

ESG has a the lowest complication rate compared to other bariatric procedures like gastric balloon, lap band, gastric sleeve, and gastric bypass. Serious complications are very rare, but include gastric leak, perigastric fluid collection, pneumothorax, and pulmonary embolism. It is extremely rare for any of these complications to require additional procedures or surgery to treat. No patient has died as a result of complications with ESG.

Is the ESG covered by insurance?

At this time, unfortunately, it is not covered by insurance. We have competitive pricing and have helped many patients find financing for this important investment in themselves.

graphic of stomach showing the size reduction from endosleeve suturing

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Weight loss surgery entails much more than an anatomical change. Our patients receive a comprehensive and highly individualized aftercare plan.
Our team is well-versed in insurance intricacies and can guide you through the process with ease. Whether you need clarification on your coverage, or help understanding the benefits available to you, we are here to provide the support you need.