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Endoscopic Sleeve Gastroplasty...

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Also referred to as the Accordion procedure, the Endoscopic Sleeve Gastroplasty (ESG) is a minimally invasive, laparoscopic weight loss procedure. The endoscopic community created the ESG successfully as a non-surgical technique where no incisions are made to emulate the gastric sleeve procedure. The result of a gastric sleeve procedure is a stomach volume reduction of 70-80%. The ESG reduces the stomach volume by 70% without making incisions. Because the ESG is non-surgical, it is a less aggressive procedure than the gastric sleeve. Developed as a less invasive weight loss procedure option, qualifying a patient for the ESG depending on how much weight a patient needs to lose and the severity of any weight related diseases. In certain cases, the gastric sleeve may be a more effective option. 

The ESG is also an effective technique for both band revision surgery and bypass revision surgery.


ESG also helps food to be emptied at a much slower level. This prevents the patient from being physically able to consume large quantities of food, and therefore a much lower amount of calories are absorbed by the body.

Like any other weight loss procedure, patients need to adhere to a proper diet and exercise regimen to maximize results. After the first 6 months, patients can expect to lose 50% of their excess body weight. At the one year mark, patients can expect to have lost a total of 60% of their excess body weight.


Endoscopic Sleeve Gastroplasty Process


  1. The patient is sedated under general anesthesia.

  2. The surgeon inserts an endoscope through the mouth into the stomach. At the end of the endoscope is a camera allowing the surgeon to see the stomach.

  3. The front and back walls of the stomach are marked to guide the placement sutures along the stomach.

  4. A running suture pattern connects the front and back walls together, creating a total of 12 sutures. The sutures are then tightened which results in a tube-shaped stomach with a 70% decrease in volume.

  5. The entire procedure is completed in 90 minutes - 2 hours. The majority of patients are able to return home the same day and recover within 1-3 days.




The patient follows a liquid diet for the first three week post-procedure. Slowly, they incorporate semi-solid foods and are able to return to a normal diet two weeks after the procedure.



As compared to other weight loss surgeries, there is much less downtown with the ESG. Since this a purely endoscopic procedure where no incisions are made during the procedure, there is also a lower risk of complications. In addition to weight loss, the patient’s metabolic improves. As a result, the Endoscopic Sleeve Gastroplasty can help improve or eliminate:

  • Stabilize your blood sugar

  • Sleep Apnea

  • High blood pressure

  • Mood

Who is a Candidate?


  • Patients with a BMI over 30

  • Patients who either do not want surgery or can not have surgery because of criteria

  • Patients who need revision surgery

  • Patients who have not lost weight through diet, exercise, or medication


To learn more about the Endoscopic Sleeve Gastroplasty, you can either book online or call our office:


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