Endoscopic Sleeve Gastroplasty or Gastric Sleeve Surgery – Which Weight Loss Procedure Should You Choose?

Endoscopic Sleeve Gastroplasty or Gastric Sleeve Surgery – Which Weight Loss Procedure Should You Choose?

Medical advancements have proven beneficial for morbidly obese patients struggling to shed those pounds through diet and exercise alone. Today, there are multiple weight loss procedures, both surgical and non-surgical, available. Endoscopic sleeve gastroplasty and gastric sleeve surgery are two of these weight loss procedures. In this blog, we will discuss the meaning and differences between these procedures to help you make an informed decision.

What is Endoscopic Sleeve Gastroplasty (ESG)?

Endoscopic Sleeve Gastroplasty, also known as ESG, is a minimally invasive weight loss procedure that involves reducing the size of the stomach using an endoscope. During the procedure, a series of sutures are placed to create a sleeve-like structure within the stomach, restricting its capacity. This results in a feeling of fullness, leading to reduced food intake and ultimately weight loss. ESG is a relatively new procedure that has gained popularity due to its minimally invasive nature and shorter recovery time compared to traditional surgical options. For those considering endoscopic sleeve gastroplasty in Dallas, it is recommended to consult a qualified healthcare professional specializing in this procedure

What is Gastric Sleeve Surgery?

Gastric Sleeve Surgery, also known as Sleeve Gastrectomy, is a surgical procedure that involves the removal of a large portion of the stomach, leaving behind a small sleeve-shaped stomach pouch. This procedure permanently reduces the size of the stomach, which limits the amount of food that can be consumed. Additionally, it restricts the production of hunger hormones by the stomach, resulting in decreased appetite and fewer cravings. Gastric Sleeve Surgery is a well-established procedure that has been widely performed for many years, consistently delivering significant and sustained weight loss results.

Difference between Endoscopic Sleeve Gastroplasty and Gastric Sleeve Surgery

Endoscopic Sleeve Gastroplasty and Gastric Sleeve Surgery differ on numerous grounds, including:


ESG is a non-surgical procedure performed using an endoscope, which is inserted through the mouth and into the stomach. The sutures are placed to create the sleeve-like structure, without the need for any incisions. On the other hand, Gastric Sleeve Surgery is a surgical procedure that requires incisions on the abdomen to remove a portion of the stomach and reshape it.


The ESG procedure is usually considered suitable for individuals with a BMI of 30 or higher who have not achieved significant results with diet and exercise alone. Patients who are ready to commit to lifestyle changes are also considered eligible for the procedure. On the other hand, gastric sleeve surgery is recommended for individuals with severe obesity, which is defined as a BMI of 40 or higher, and who have at least one obesity-related health condition. Surgery is typically recommended only when a person has failed to achieve weight loss through medical weight loss procedures.


ESG is considered a relatively safe procedure with a low risk of complications. Since it is non-surgical, it avoids the risks associated with major surgery. However, as with any medical procedure, there are still potential risks and side effects that should be discussed with a healthcare professional. Gastric Sleeve Surgery also has a good safety profile, but being a surgical procedure, it carries a slightly higher risk of complications.


Gastric Sleeve surgery typically requires a slightly longer recovery period compared to ESG. This is because Gastric Sleeve involves a few incisions in the stomach. Patients undergoing Gastric Sleeve surgery usually require 2-3 weeks to fully recover and resume their normal activities. On the other hand, Endoscopic Sleeve Gastroplasty is performed through a natural opening, namely the mouth, which results in a slightly shorter recovery time. With ESG, you can expect to return to your normal activities within 2-3 days.


Both ESG and Gastric Sleeve Surgery have shown promising weight loss outcomes. ESG has been found to result in an average weight loss of around 20-25% of excess body weight within the first year. Gastric Sleeve Surgery, on the other hand, has demonstrated greater weight loss, with an average of 60-70% of excess body weight loss within the first year. However, individual results may vary based on their lifestyle. 


The choice between ESG and Gastric Sleeve Surgery depends on several factors, including medical history, body mass index, and personal preferences. ESG offers a non-surgical, minimally invasive option with a shorter recovery time, while Gastric Sleeve Surgery provides a more significant and sustained weight loss outcome. The ultimate goal of both procedures is to help individuals achieve their weight-loss goals. To determine the most suitable weight loss option for you,  consult with a qualified healthcare professional. They can provide valuable information, discuss available options, and offer personalized guidance based on individual needs and goals. If you want to opt for endoscopic sleeve gastroplasty in the DFW area, choose a trusted bariatric surgeon who is experienced in conducting weight loss procedures.

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