I am one of the few weight loss doctors who will tell you right away that obesity is a chronic disease and that we do not have a cure for it yet. For some people, achieving a sense of fullness is a constant struggle that affects them every day. When an individual continually feels hungry, it impedes their ability to lose weight. A doctor may determine that weight loss surgery is the best course of action to help them achieve and maintain a healthy weight.
Weight Regain after Weight Loss Procedure
Weight regain is common after both non-surgical and surgical bariatric procedures. The reasons behind this regain are often complex and not always patient-related.
There was a need to develop an effective, safe, and repeatable procedure to manage excess weight for patients such as these. Today, we have the Endosleeve or the medical terminology is endoscopic sleeve gastroplasty (ESG.) This non-surgical procedure is close to being the holy grail of weight loss procedures for these patients. Endoscopic sleeve gastroplasty (ESG) has proven a viable option for patients who may not be able to undergo a lengthy surgery.
Names Used to Describe ESG vs LSG
Endosleeve, endoscopic sleeve gastroplasty, ESG, and accordion procedure are all used to describe the same non-surgical weight loss procedure.
Laparoscopic sleeve gastrectomy, vertical gastric sleeve, VSG, LSG, or just gastric sleeve are all used to describe the same surgical weight loss procedure.
Endoscopic Sleeve vs. Laparoscopic Sleeve
These two procedures are not the same, so let’s explore the differences between laparoscopic sleeve gastrectomy (LSG) vs endoscopic sleeve gastroplasty (ESG).
Until recently, the most common procedure used to help patients alleviate the feeling of being hungry all the time was a minimally invasive surgery called laparoscopic sleeve gastrectomy (LSG). Recently, an alternative procedure became available called endoscopic sleeve gastroplasty (ESG) which provides a less invasive option and delivers very similar results.
Comparing these two options can help a patient prepare for a consultation with a doctor to determine which procedure can best help give them control over their appetite and effectively lose weight.
What Is a Laparoscopic Sleeve Gastrectomy (LSG)?
Laparoscopic sleeve gastrectomy or LSG is a surgical procedure that reduces the storage capacity of a patient’s stomach allowing them to feel full after consuming a much smaller portion of food than before the weight loss surgery. This helps patients control their appetite, eating habits, and portion control assisting them in losing weight.
How Is Laparoscopic Sleeve Gastrectomy Surgery Performed?
The patient is put under general anesthesia and then undergoes a 40-70 minute laparoscopic surgery. During the procedure, the surgeon makes five small incisions to access the stomach and between 70% and 80% of the stomach is cut away and removed. The remainder of the stomach is stapled together along the edges to form a narrow sleeve-like pouch. This reduced stomach size limits the amount of food the patient can consume at one time so they eat less, maintain the feeling of being full longer, and can lose weight.
LSG requires at least an overnight stay in the hospital, a few weeks of wound care, and about a 4-6 week recovery. Laparoscopic sleeve surgery is permanent and cannot be reversed however, it can be converted into gastric bypass surgery if necessary.
What Is an Endoscopic Sleeve Gastroplasty (ESG)?
Endoscopic sleeve gastroplasty or ESG is a newer weight loss procedure but has been gaining status in recent years as the many benefits have been proven by multiple studies. Endoscopic sleeve gastroplasty reduces the size of the patient’s stomach using an endoscopic suturing device offering similar results to LSG but without the need for surgery. During the procedure, the patient’s stomach is made smaller, they are no longer able to eat large portions, feel full longer, and can effectively lose weight.
How Is Endoscopic Sleeve Gastroplasty Performed?
Endoscopic sleeve gastroplasty (ESG) is not considered surgery because there are no incisions and the procedure is performed endoscopically, however, the technique used for ESG requires the use of general anesthesia. The surgery is performed through an endoscope that is placed down the patient’s throat to access the stomach. The surgeon reshapes the stomach to make it smaller using between 7 to 12 strategically placed sutures. The new stomach area will be much smaller, about 25% of its original size, and resemble a small sleeve-like pouch.
ESG does not require a hospital stay and patients can return home the same day. Typically patients take an average of 3 days to recover but do not have any lifting type restrictions as they would with a laparoscopic sleeve gastrectomy. An endoscopic sleeve gastroplasty can be a permanent solution as the sutures are strong however it can be reversed or revised if desired.
Endoscopic Sleeve Gastroplasty (ESG) or Accordion Procedure: Everything You Need to Know
Dr. Chris explains what Endoscopic Sleeve Gastroplasty (ESG) procedure is, how it is done, and what its benefits are.
Which Weight Loss Surgery Is The Best Option?
If you are wondering if gastric sleeve surgery or endoscopic sleeve gastroplasty is better for weight loss, the answer depends on the circumstances.
1. Both ESG and LSG Work Through Restrictive Means
Both ESG and LSG work through restrictive measures meaning the patient can not eat a large amount of food in one sitting. Both procedures result in the patient’s hunger pangs being relieved since the smaller stomach size takes longer to digest food and keeps the patient feeling full longer. These two elements work together to help the patient lose weight.
2. Surgery vs. Non-surgical
LSG is surgery, has increased risk factors and a longer recovery time, and ESG is a non-surgical procedure offering a shorter recovery time.
3. The Risks Of VSG vs ESG
The risks associated with the use of general anesthesia apply to both LSG and ESG.
- Risks of LSG include: bleeding, leaking along the staple line, abscess.
- Risks of ESG include temporary vomiting and nausea (1-3 days), however, to date, ESG has shown a favorable safety profile.
4. Dietary Considerations
Both procedures require a special diet immediately afterward to give the stomach and digestive system time to adjust to the alterations that have been made. The return to solid foods takes between 3-4 weeks after ESG and typically about 3 months for LSG.
5. Weight Loss Potential LSG vs ESG
Both procedures offer patients the opportunity to lose a significant amount of weight if they choose to commit to a lifetime of healthy lifestyle choices.
Since both LSG and ESG are tools that work very similarly, the amount of weight a patient loses depends on their level of lifestyle changes and how well they adhere to their dietary plan.
LSG patients tend to lose weight more quickly in the first few months because their stomach has to heal after surgery and they are required to stay on an extended liquid diet. ESG patients can lose the same amount of weight, but it may take a little longer, however, patients have lost as much as 114 pounds after non-surgical ESG.
Patient Testimonial - Endoscopic Sleeve Gastroplasty (ESG) - IBI Healthcare Institute
Kimberly talks about her Endoscopic Sleeve Gastroplasty (ESG) and shares her keys to success on the trip to lose weight. It is not just a procedure, it is about adopting better eating and lifestyle habits. Help us to celebrate these 71 pounds less in just 6 months!!! Now on her 7 month anniversary, she lost 93 pounds.
If you are interested in losing weight the best thing to do would be to set up a consultation with a knowledgeable, highly-skilled bariatric surgeon to find out which procedure would be best for your circumstances.
Contact IBI Healthcare Institute today to learn more about weight loss procedure options and taking control of your weight and health. Take the first step in your weight loss journey and contact us today for your personal consultation.