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Endoscopic Sleeve Gastroplasty: Risks and Side-Effects

Gastrointestinal Science

Gastrointestinal Sciences

19 October, 2021

Obesity is a pandemic condition affecting 700 million people all over the world. Further, approximately 2 billion people in the world are overweight. Although bariatric surgery is available for patients with obesity, very few people opt for the surgery due to its side effects. Endoscopic sleeve gastroplasty is a new, incision-less, minimally invasive procedure with fewer side effects.

What Is Endoscopic Sleeve Gastroplasty?

Endoscopic Sleeve Gastroplasty (ESG) is a minimally invasive technique for weight loss. Through this procedure, the doctor reduces the size of your stomach. This procedure limits the amount of food intake and delays gastric emptying resulting in significant weight loss. The procedure is minimally invasive and thus has fewer complications and early recovery. Also known as Accordion or Endosleeve procedure, it results in improving various diseases such as hypertension, diabetes, and obesity-related conditions. The main advantages of this procedure, in comparison to surgical procedure, are that there is no removal of any part of the stomach and you have no scar or incision on the body. However, like with other weight management programs, you must incorporate lifestyle changes, such as a healthy diet and regular exercise, to reach and maintain a healthy weight. 

In Which Condition Do You Require Endoscopic Sleeve Gastroplasty?

Endoscopic sleeve gastroplasty is effective in people who are overweight or obese with a BMI index greater than 30, and diet and exercise regimen has little or no effect on weight loss. You may have ESG if you are overweight or obese to reduce the risk of the following diseases:

  • Type 2 diabetes

  • Hypertension

  • Sleep apnoea

  • Heart disease and stroke

  • Non-alcoholic fatty liver disease and non-alcoholic steatohepatitis


The doctor will evaluate your health to determine if you are suitable for undergoing an ESG procedure. Not all people with BMI over 30 are eligible for this procedure. You must be ready to commit yourself towards a healthy lifestyle after this procedure to gain the maximum benefit. If you have a large hiatal hernia, you might not be eligible for this procedure. Similarly, people with an increased risk of gastrointestinal bleeding or suffering from gastritis or ulcer are also not a perfect fit for undergoing ESG procedure. If you are not eligible for an ESG procedure, discuss with your doctor about other weight loss options.


Because of its operating ease, non-incision, minimum invasiveness, and better safety profile, it is a preferred option for obese people who do not want to undergo bariatric surgery, consult with the best bariatric surgeon in India. After the procedure, you may experience nausea and pain. Doctors prescribe certain medicines to manage these post-operative conditions.

How Should You Prepare For Endoscopic Sleeve Gastroplasty?

Once you are eligible for the ESG procedure, your doctor will provide you with certain instructions related to diet and physical activity. The doctor may also advise you to undergo lab tests and imaging tests to get information about your health. You should seek all the information about the surgery regarding the duration of the procedure, recovery time, and weight management.

How The Procedure Is Performed?

The procedure involves the remodelling of stomach curvature. You will be under the effect of general anaesthesia during the surgery. It is a 1-day procedure and takes around 90 minutes. During the procedure, the doctor inserts an endoscope in the stomach through your throat. With the assistance of an endoscope, the doctor places sutures in your stomach to reduce the stomach size. The small size of the stomach will limit the amount of food you eat that may lead to weight loss.

How Is The Recovery After Endoscopic Sleeve Gastroplasty?

Because of the minimally invasive nature of the procedure, the recovery is fast as compared to bariatric surgery. The medical staff shifts you to the recovery room, where the healthcare professionals monitor your vital parameters. The doctor may not allow you to eat or drink a few hours after the surgery. The doctor will advise you to start with a liquid diet, which will continue for at least two weeks. If the doctor is satisfied with the surgery and all the parameters are normal, he may allow you to go home on the next day of surgery. You may be able to return to normal activities within 3-4 days after the procedure.

What Are The Results Of Endoscopic Sleeve Gastroplasty?

ESG procedure results in significant weight loss with fewer side effects. People strictly following the instructions and taking part in weight management programs have lost almost 12% to 20% within a year after the procedure. In a 2-year follow-up, up to 60%, excess weight loss can be expected. Visit the best gastroenterologist hospital in India for Endoscopic Sleeve Gastroplasty. 


Endoscopic sleeve gastroplasty is a minimally invasive procedure for weight management. The patient, after the procedure, must follow a healthy lifestyle to achieve the target weight. The procedure takes around one-and-a-half-hour, and the patient has a faster recovery rate.

HOD and consultant - Department of Minimal Access Surgery, Bariatric & Metabolic Surgery & Gastrointestinal Surgery