Thanks to the advancement of endoscopic technology, more patients who struggle with excess weight and associated metabolic conditions such as sleep apnea or high cholesterol are able to receive interventional treatments that work with diet and exercise to improve their health. The Center for Advanced Digestive care includes an extensive weight loss surgery program for patients who qualify for bariatric surgery. However, when patients do not qualify for bariatric surgery but still carry excess weight despite conventional lifestyle changes, the CADC’s advanced endoscopy team can recommend an endoscopic approach, such as Endoscopic Sleeve Gastroplasty, also described as a “sleeve gastroplasty” or a “scarless sleeve”.
The endoscopic sleeve gastroplasty (ESG) procedure is designed for patients who are not morbidly obese, but are also not able to undergo bariatric surgery. Patients who may not be surgical candidates can include:
- Those with a body mass index (BMI) of less than 40 without comorbidities
- Those with a BMI of 30-35 with HTN, hyperlipidemia, type-2 diabetes or sleep apnea
- Those who have large amounts of abdominal scarring from injuries or previous procedures
How Endoscopic Sleeve Gastroplasty Works
In the course of this two-hour procedure, the patient is put under general anesthesia. An endoscopist advances the endoscope through the mouth into the stomach, where sutures are inserted in a specific pattern from the bottom (antrum) portion of the stomach up to the top (fundus). The series of sutures is then tightened in a fashion that resembles an accordion, constricting the overall usable volume of the stomach. Patients generally follow a liquid diet for a brief amount of time after the procedure, and often can go home that same day.
Both our bariatric surgery program and our gastroenterologists who perform the ESG work closely with a team of doctors including an endocrinologist and nutritionist to monitor one’s food intake and metabolic health before and after the procedure. Diet and exercise remain an integral part of a patient’s health regimen before and after the procedure, but constricting the stomach to reduce the amount of food one can eat helps turn the corner toward weight loss.
Endoscopic Sleeve Gastroplasty Outcomes
The Center for Advanced Digestive Care at NewYork-Presbyterian/Weill Cornell Medical Center was one of the first centers in the country to perform the endoscopic sleeve gastroplasty, and published some of the earliest effectiveness research. Findings demonstrate that patients may lose 30% to 60% of their excess body weight within six months of their procedure. Not only does a patient see a decrease in body weight, but often related comorbidities such as high blood pressure, diabetes and sleep apnea can improve after having this procedure.
The CADC values the ability to provide as many available treatment options to its patients as possible, and the ability to perform sleeve gastroplasty procedures expands the scope of its interventional weight loss capabilities to reach patients that previously could not receive interventional care.