Overview & Concern of Endoscopic Sleeve Gastroplasty, Dallas


Endoscopic sleeve gastroplasty is a newer type of minimally invasive weight-loss procedure. In endoscopic sleeve gastroplasty, a suturing device is inserted into your throat and down to your stomach. 
The Endoscopic Sleeve Gastroplasty (ESG) is a weight loss procedure that uses an endoscopic camera with a suturing device to reduce the size of your stomach. ESG patients have had good weight loss results, losing 30-60% of excess weight and usually have improvement or remission of diseases like type 2 diabetes, hypertension, and other obesity-related comorbidity diseases. 
· Feel full sooner while eating, so you will eat less and lose weight
· Lose an average of 18% of total body weight after two years
· Reduce your systolic blood pressure and improve the overall health
An endoscope is a flexible tube with a camera on the end. With ESG the patient is completely asleep for the procedure, and the endoscope is inserted through the mouth into the stomach and all the work is done.
Patients who underwent the endoscopic sleeve gastroplasty (ESG) suffered fewer post-procedural adverse events than patients who underwent the more commonly performed surgical laparoscopic sleeve gastrectomy 
All patients who underwent the endoscopic sleeve had their procedures performed as a day case without the need for an overnight stay.
The procedure takes less than 2 hours, and the patient wakes up with no scars! ESG is a nice option for some patients because the thought of surgery can be daunting for some patients because it is invasive and can have significant complications.
Endoscopic sleeve gastroplasty is done in the endoscopy unit as an outpatient procedure. General anesthesia is used for the procedure, so you'll be unconscious.
Concerns of Endoscopic Sleeve Gastroplasty
In general, the first few weeks after a procedure is an important period to monitor for problems, as the majority of complications will occur during this time. Bleeding and abdominal infection, which are the most serious problems, tend to occur just after surgery and are less likely later in this period
Stomach Leak
This is potentially a life-threatening complication.  Theoretically, a stomach leak after ESG is from bacteria tracking out along a full thickness suture, and causing an infection in the abdominal space.
In general, the treatment for a micro-leak after ESG is less invasive than the treatment of a leak after a surgical sleeve operation1. However, unusual or extreme cases could require an operation to manage.

Blood Clots

This is a rare problem which occurs in less than 1% of patients. Obese patients are more prone to developing blood clots in the veins of the legs than are normal weight patients.
The treatment is prevention of the formation of blood clots. Our patients are given a short-acting blood thinner before their procedure and sequential leg squeezing devices are fitted over the legs during the operation.

Stenoses

A stenosis is a narrowed area somewhere along the tapered tube of stomach. Since the ESG is done under endoscopic observation it is unlikely that the stomach would be closed off by a suture. More conceivable is a case where the particular patient’s gastric squeezing function is mismatched to the degree of tapering that has been done.

Esophageal Injury

Performing an ESG requires placement of instruments and tubes through the esophagus to reach the stomach. These include, in order, a small caliber diagnostic endoscope, a large caliber over-tube, and a dual channel operating endoscope with the mounted suturing device. A partial thickness injury to the esophagus can probably be managed conservatively.
Conclusion
If someone completes the entire program and follows all the guidelines, he or she can expect to lose about 12% to 20% of his or her body weight in one year. It's possible to not lose enough weight or to regain weight after any type of weight-loss procedure, even if the procedure itself works correctly.
Treatment Reference

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