Endoscopic Sleeve Gastroplasty (ESG)

Endoscopic Sleeve Gastroplasty (ESG) is also known as the non-surgical sleeve, endosleeve, or accordion procedure. Moreover, it is a newer type of weight-loss procedure.

Furthermore, an endoscopic sleeve reduces the size of your stomach using an endoscopic suturing device without the need for surgery. This procedure may be an option if you’re a significantly heavier person, with a body mass index of 30 or more, and diet and exercise haven’t worked for you.

Is Endosleeve right for you?

Play Video about Endoscopic Sleeve Gastroplasty

Non-Surgical Sleeve Gastroplasty leads to significant weight loss. It helps you lose weight by limiting how much you can eat. And the procedure is minimally invasive, reducing the risk of operative complications.

Like other weight-loss procedures, endosleeve requires a commitment to a healthier lifestyle. You need to make permanent healthy changes to your diet and get regular exercise to help ensure the long-term success of the accordion procedure.

What is Endoscopic Sleeve Gastroplasty?

Endoscopic Sleeve Gastroplasty

Endoscopic Sleeve is a weight loss procedure that uses an endoscopic suturing device to reduce the size of the stomach by 70-80%.

With reduced stomach size, patients will feel full sooner and the stomach will not be able to secrete as many hunger-inducing hormones.

The Most Effective Weight Loss without Surgery

The highlight of the accordion procedure is that it is NON-SURGICAL. This equates to no incisions, no scars, and little or no pain after the procedure which usually lasts under two hours. In essence, ESG is an even less invasive version of the minimally invasive vertical sleeve gastrectomy (VSG).

The Clinical Gastroenterology and Hepatology Journal reported that endoscopic sleeve gastroplasty results in significant weight loss and a decrease in body mass index as well as metabolic complications associated with obesity. The non-surgical sleeve may improve conditions often related to being a person in a higher weight body, including gastroesophageal reflux disease (GERD), heart disease or stroke, high blood pressure, severe sleep apnea, and type 2 diabetes.

ESG is now the most effective non-surgical weight loss procedure resulting in an average of 49% excess body weight loss within a year post-op according to the MERIT Study Outcomes. Endosleeve can deliver results comparable to the ones of more popular gastric sleeve surgery (LSG or VSG) and gastric bypass surgery (RYGB).

The invention of endoscopic suturing systems such as OverStitch™ made weight loss without surgery possible and dramatically reduced associated with bariatric surgery risks ensuring, in addition to the effectiveness, the safety of the ESG procedure.

Who is a Candidate for ESG?

Endoscopic Sleeve Gastroplasty

A non-surgical gastric sleeve is a great option for patients who have a higher weight, (BMI>30) and therefore are not ideal candidates for, or do not desire Bariatric Surgery.

The ESG procedure is available to people whose body mass index (BMI) is above 30 and who haven’t been successful in maintaining weight loss with other methods. ESG can help higher-weight people with (or help prevent) diabetes, high blood pressure, high cholesterol or triglycerides, obstructive sleep apnea, and heart disease or stroke.

Endosleeve May Be Right For You!

Play Video about Endoscopic Sleeve Gastroplasty Surgery
The Non-Surgical Gastric Sleeve is performed in the surgery center as an outpatient procedure. The procedure uses general anesthesia, rendering you unconscious. Healthcare professionals perform the procedure using an endoscope, a flexible tube with a camera, and an attached endoscopic suturing device.
The endoscope is inserted down your throat into the stomach. The tiny camera allows the doctor operating the endoscope to see and operate inside your stomach without making incisions in your abdomen.

How much weight can I lose with ESG?

Play Video about Endoscopic Sleeve Gastroplasty

Endosleeve can lead to significant weight loss. The amount of weight you lose also depends on how much you can change your lifestyle habits. However studies have shown promising results. A recent study of people with an average BMI of around 38 found that the accordion procedure led to an average weight loss of 39 pounds after 6 months.

After 12 months, weight loss was 42 pounds. In a study of people with an average BMI of about 45, the procedure resulted in an average weight loss of about 73 pounds during the first six months.

When will I start seeing Results?

Within the first month after the ESG procedure, the most drastic weight loss occurs. This is most likely due to being on a no-solid foods diet. The weight loss range is usually between 11-24 lbs for the first month. After one year of following a healthy diet, some patients have managed to lose an incredible 73 lbs.

How long will the Results last?

Due to the ESG procedure being so new, there has not been enough time to gather data on its longevity. However, it is safe to say that it will last a minimum of 24 months.

Endoscopic Sleeve Gastroplasty Before and After Photos

These are the real results*, that our patients achieved after having endosleeve at IBI Healthcare Institute. Watch ESG patients’ video testimonials on our YouTube Channel where they share inspiring weight loss success stories and what to expect from undergoing non-surgical gastric sleeve at IBI.
Disclaimer: Individual results may vary.

Risks and Side Effects Associated With ESG

Overall the ESG is a very safe procedure. The only risks involved include being under general anesthesia, bleeding (<1%), leakage (<1%), obstruction, and injury to the esophagus. However, these are very rare. The only discomfort you may have after the procedure is a sore throat and that is due to having the endoscope placed inside of your esophagus throughout the procedure. Because the procedure is still new and not in wide use, questions remain about its long-term effectiveness and risks.

The chance of occurring side effects from a non-surgical sleeve is low but if present they are not severe and last up to 5 days. The possible endoscopic sleeve side effects include nausea, cramping, reflux, vomiting, or diarrhea.

What to expect from the Accordion Procedure?

Before the Procedure

Patients may need to have various lab tests and exams before surgery. May have restrictions on eating, drinking, and which medications you can take. Additionally, may be required to start a physical activity program.

It’s helpful to plan for your recovery after the procedure. For instance, arrange for help at home if you think you will need it. Recovery from an endoscopic sleeve generally only takes a day or two.

After the Procedure

After the procedure, you generally won’t be allowed to eat for about eight hours. Then, you will be allowed to start a liquid diet, which you need to continue for at least two weeks. Over four weeks, you will move on to semi-solid foods, and then to a regular healthy diet. You will also have medical checkups and meet with a nutritionist and psychologist frequently after your procedure.

Endoscopic Sleeve Diet Plan

This guidebook covers the dietary recommendations you will follow before and after endoscopic sleeve gastroplasty including diet progression, and vitamin and mineral supplements.

Diet Plan

Download the updated manufacturer’s dietary guidebook for the ESG, Balloons, GSRe, and TORe procedures: English Version and Spanish Version.

How Much Does Endoscopic Sleeve Gastroplasty Cost?

IBI Healthcare Institute always sets transparent pricing. The average national cost of an endoscopic sleeve procedure is around $12,500. IBI Healthcare is now offering ESG for a special self-pay price. Take advantage of our special prices.

At IBI Healthcare Institute we provide our patients with a quote that includes all fees:

  • Consultations and pre-op support fees.
  • ESG procedure fees.
  • Facility fees.
  • Physician fees.
  • Aftercare fees.

The cost of a non-surgical sleeve is lower than the cost of bariatric surgery, e.g. gastric sleeve (VSG) or gastric bypass (RYGB), since fees for surgical procedures are traditionally higher than fees for non-surgical ones, as well as ESG patients return home the same day and do not require an overnight hospital stay charged extra.

Is ESG covered by Insurance?

Given that it is a new procedure, endosleeve is not yet covered by health insurance companies. However, IBI Healthcare Institute offers flexible Financing Options for qualified patients.

FAQ about Endoscopic Sleeve

Play Video about ESG
Can ESG be reversed?

Yes, endosleeve is a reversible procedure. The sutures used during the procedure are made from polypropylene and do not dissolve.

How long will I have to take off of Work?

After ESG, It is recommended that you plan for at least 3-5 days of inactivity to help your body recover.

Endoscopic Sleeve Gastroplasty Locations

Our easily accessible locations and ample appointment availability make it effortless to find the top-rated endoscopic sleeve gastroplasty doctors near me. IBI Healthcare Institute offers ESG to patients at five convenient locations throughout the Southeast region. We are growing and new offices are coming soon


  • 371 East Paces Ferry Rd Suite 802 Atlanta, GA 30305 United States.
  • 367 Athens Hwy, Suite 100C Loganville, GA 30052 United States.
  • 3970 Rogers Bridge Rd, Duluth, GA 30097 United States.


  • 14012 US-19, Hudson, FL 34667 United States.
  • 5931 Webb Rd, Tampa, FL 33615 United States.