New endoscopic sleeve gastroplasty technique

A new option for weight loss without surgery

I am very excited to share that I have recently started performing the endoscopic sleeve gastroplasty in Adelaide, South Australia. The procedure is also known as the ESG or endosleeve, and I am the only doctor currently performing this technique in South Australia, as well as the only surgeon performing this technique in Australia.  I feel strongly about implementing new techniques to assist my patients and improve outcomes, however safety is always the most important consideration. Myself and my patients also have the support of our very experienced allied health team at the rooms on Ward Street, North Adelaide.

There has been a recent article in The Lancet published in late 2022 (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)01280-6/fulltext) that demonstrated total body weight loss of 13.6% at 52 weeks, with majority of the weight staying off at 104 weeks (2 years). Previous trials have also demonstrated durable weight loss outcomes at 5 years (https://pubmed.ncbi.nlm.nih.gov/33011292/).

The endoscopic sleeve gastroplasty is a novel technique, that uses an endoscopy to shorten the length of the stomach by around 30-50% as well as decrease the volume by around 50%.

The ESG works by decreasing the quantity of food that you can eat before feeling full, as well as slowing down the emptying of the stomach so that you feel full for longer. The procedure is performed with non-absorbable (permanent) sutures and is an overnight stay in hospital. Patients are usually back to work within 5 days, as it is an endoscopic procedure and not an operation. The endosleeve can be performed from a BMI of 30 to 50 and has lower risks than bariatric/weight loss surgery. The expected weight loss outcomes are around 15-20% total body weight loss over 2 years, however this is variable.

There is continuing data that is demonstrating further weight loss results with the addition of GLP-1 agonist medications with patients who have had an ESG. This is an evolving area, and one that I am continuing to monitor in my patient cohort.

I recently travelled to Taiwan, where I liaised with other clinicians about the ESG procedure. The endoscopic sleeve gastroplasty is a commonplace treatment in Taiwan, and it was great to see that the outcomes and safety are strong in a real-world setting. It was also good to see that the way I perform an ESG in Adelaide is similar to how it is performed overseas! It is always important to engage with other specialists from around the world, to ensure you are providing the best outcomes for patients.