ESG (Endoscopic Sleeve Gastroplasty)

What is ESG?

Endoscopic Sleeve Gastroplasty (ESG) is a minimally invasive, non-surgical weight loss procedure performed through the mouth using an endoscope. Sutures are placed in the stomach to reduce its volume, creating a sleeve-like shape. This helps you feel full faster and eat less, leading to sustainable weight loss all without any abdominal incisions or scars.

Why choose ESG?

• Non-surgical no cuts, no scars, no hospital stay
• Preserves natural anatomy stomach is not removed, only reshaped
• Significant weight loss average 15-20% total body weight loss
• Improves obesity-related conditions like diabetes, hypertension, fatty liver
• Shorter recovery time compared to surgical sleeve gastrectomy
• Outpatient or short-stay procedure (usually 24 hours or less)

Who is a candidate for ESG?

• Adults with BMI 30–40 kg/m² (with or without obesity-related conditions)
• Those who have not achieved sustained weight loss with diet and exercise alone
• Patients who prefer a non-surgical alternative to bariatric surgery
• Individuals with BMI 27–30 with significant metabolic conditions (diabetes, high BP)
• Not suitable for patients with large hiatal hernias, severe GERD, or prior gastric surgery

Duration & Recovery Time

• Procedure duration: 60–90 minutes (performed under sedation or general anesthesia)
• Hospital stay: Usually overnight observation; same-day discharge in select cases
• Recovery time: Most patients return to normal activities within 3–5 days

Before Your Procedure

• Diet: Clear liquid diet for 24–48 hours before procedure.
• Fasting: Nothing to eat or drink after midnight prior to procedure.
• Medications: Stop blood thinners, NSAIDs, and certain diabetes medications as instructed by your doctor.
• Pre-procedure evaluation: Complete blood work, EKG, and anesthesia clearance.
• Arrange for a family member or friend to drive you home after the procedure.

After Your Procedure (Post-ESG Diet & Recovery)

• Week 1: Clear liquids only (water, broth, sugar-free gelatin).
• Week 2: Full liquids (protein shakes, thin soups, yogurt).
• Week 3: Pureed/soft foods (mashed vegetables, scrambled eggs, soft fish).
• Week 4 onward: Gradual transition to solid foods small portions, chew thoroughly.
• Medications: Anti-nausea and acid-reducing medications as prescribed.
• Activity: Walking encouraged immediately; avoid heavy lifting for 2 weeks.
• Follow-up: Regular appointments with dietitian and weight loss clinic team for monitoring.

Expected Results & Benefits

• Total body weight loss: 15–20% sustained at 12–24 months
• Improvement or remission of type 2 diabetes, high blood pressure, sleep apnea
• Reduction in liver fat (improves fatty liver disease)
• Better quality of life and mobility
• No foreign body (unlike gastric balloons)
• The sutures are permanent but the stomach can dilate over time with poor lifestyle hence lifelong habits matter.

Potential Complications (Rare)

• Nausea, vomiting, or abdominal pain (common in first week, usually resolves)
• Suture site bleeding or perforation (less than 1% risk)
• Dehydration requires adequate fluid intake
• Gastric obstruction (very rare)
• Weight regain if dietary guidelines not followed

Not Suitable For (Tell Your Doctor If…)

• You have untreated severe GERD or large hiatal hernia
• Previous gastric surgery (e.g., sleeve, bypass, fundoplication)
• Uncontrolled coagulopathy or bleeding disorder
• Pregnancy or planning pregnancy in the next 12 months
• Active eating disorder (bulimia, binge eating without control)
• Severe cardiopulmonary disease making sedation unsafe

Register for ESG Procedure

To register for ESG, please contact the clinic front desk, call our helpline, or use the appointment booking form. Free consultations available at Civil Hospital Karachi campus.

Patient Frequently Asked Questions