Introduction:

Endoscopic Sleeve Gastroplasty (ESG) is a relatively new and innovative weight loss procedure that has gained popularity in recent years. This non-surgical, minimally invasive technique is designed to help individuals who are struggling with obesity to achieve significant weight loss without the risks and complications associated with traditional bariatric surgery. In this lecture, we will explore ESG in detail, including how it works, the benefits and risks associated with the procedure, and an animation of the procedure performed with the Apollo ESG™.
 
What is ESG and How Does it Work?
 
ESG is a minimally invasive weight loss procedure that involves the use of an endoscope, a thin, flexible tube with a camera and light attached, to create a sleeve-like structure within the stomach. This sleeve limits the amount of food that can be consumed, which in turn leads to weight loss. The procedure typically takes between 60 to 90 minutes and is performed under general anesthesia on an outpatient basis.
 
The endoscope is passed through the mouth and down the throat into the stomach, where the surgeon uses a series of sutures to create the sleeve. The sutures are placed in a specific pattern that helps to create a consistent, uniform sleeve. The procedure is less invasive, less risky, and requires less recovery time than traditional bariatric surgery.
 
Benefits of ESG:
 
ESG offers several benefits over traditional bariatric surgery, including:
 
Non-surgical: ESG is a non-surgical option for individuals who are not eligible for traditional bariatric surgery. This includes individuals who are too overweight or too medically fragile to undergo surgery, as well as those who do not want to undergo surgery for personal or religious reasons.
 
Minimally invasive: ESG is a minimally invasive procedure that does not involve any incisions or alteration of the gastrointestinal tract. This means that there is no risk of infection, bleeding, or other complications associated with incisions or sutures.
 
Shorter recovery time: ESG requires less recovery time than traditional bariatric surgery. Most patients are able to return to their normal activities within a few days of the procedure.
 
Lower risk of complications: ESG is associated with fewer risks and complications than traditional bariatric surgery. There is a lower risk of complications such as leakages, strictures, and malabsorption, which are more common with traditional bariatric surgery.
 
Risks and Potential Complications:
 
Like any medical procedure, ESG does come with some risks and potential complications. These include:
 
Bleeding: There is a risk of bleeding during the procedure or in the days following the procedure.
 
Perforation: There is a risk of perforation of the stomach or esophagus during the procedure.
 
Infection: There is a risk of infection following the procedure.
 
Sleeve stretching or breaking down: There is a risk of the sleeve stretching or breaking down over time, which can lead to weight regain.
 
It is important to carefully consider the potential risks and benefits of ESG before making a decision and to work closely with a qualified medical professional to determine if ESG is the right option for you.
 
Animation of the Procedure Performed with the Apollo ESG™:
 
The Apollo ESG™ is a device that is used to perform ESG. The device consists of a series of needles that are inserted into the stomach through the endoscope. The needles are then used to place the sutures that create the sleeve.
 
The animation of the procedure begins with the insertion of the endoscope into the mouth and down the throat. The camera on the endoscope provides a view of the inside of the stomach, allowing the surgeon to identify the best location for the sutures.
The surgeon will then use a device called the OverStitch Endoscopic Suturing System to create the sleeve. The OverStitch device consists of a small camera attached to a long, flexible tube, as well as a series of suturing tools that can be maneuvered through the tube. The surgeon will use the suturing tools to create a series of stitches along the length of the stomach, which will eventually create the sleeve-like structure.
 
The procedure usually takes between 60 to 90 minutes to complete, and patients are typically able to go home the same day. Recovery time is minimal, and most patients are able to return to work and normal activities within a few days.
 
Benefits of ESG
 
There are several benefits to choosing ESG over traditional bariatric surgery. One of the primary benefits is that ESG is a less invasive procedure, which means that there is less risk of complications and a shorter recovery time. Patients who undergo ESG are typically able to return to work and normal activities within a few days, while patients who undergo traditional bariatric surgery may require several weeks or months to fully recover.
 
Another benefit of ESG is that it is a non-surgical procedure, which means that there are no incisions or wounds to heal. This can reduce the risk of infection and other complications associated with surgery. Additionally, because ESG is a non-surgical procedure, it may be a viable option for patients who are not candidates for traditional bariatric surgery due to their medical history, age, or other factors.
 
ESG is also an effective weight loss option for many patients. Clinical studies have shown that ESG can result in significant weight loss, with patients typically losing between 15% and 20% of their total body weight within the first year after the procedure. This can help patients to achieve their weight loss goals and improve their overall health and quality of life.
 
Risks and Considerations
 
Like any medical procedure, ESG does carry some risks and potential complications. These may include bleeding, infection, perforation of the stomach or esophagus, or a reaction to the anesthesia. In some cases, patients may experience abdominal pain, nausea, or vomiting after the procedure, although these symptoms usually resolve within a few days.
 
It is also important to note that ESG is not a magic solution for weight loss. Patients who undergo ESG will still need to make lifestyle changes, such as improving their diet and increasing their physical activity, in order to achieve and maintain weight loss. Additionally, ESG may not be effective for everyone, and some patients may experience weight regain over time.
 
Before undergoing ESG, it is important to carefully consider the potential risks and benefits of the procedure, and to discuss these with a qualified medical professional. Patients should also be aware that ESG is not covered by all insurance plans, and may require out-of-pocket expenses.
 
Conclusion
 
Endoscopic Sleeve Gastroplasty (ESG) is a relatively new and innovative weight loss procedure that has gained popularity in recent years. This non-surgical, minimally invasive technique is designed to help individuals who are struggling with obesity to achieve significant weight loss without the risks and complications associated with traditional bariatric surgery.
 
The ESG procedure involves using an endoscope to create a sleeve-like structure within the stomach, which limits the amount of food that can be consumed and leads to weight loss. The procedure is typically performed on an outpatient basis, and patients are able to return to work and normal activities within a few days.
 
There are several benefits to choosing ESG over traditional bariatric surgery, including a shorter recovery time, fewer complications, and eligibility for patients who may not be candidates for surgery. However, it is important to carefully consider the potential risks and benefits of ESG before making a decision, and the sutures are then tightened to create the sleeve-like structure within the stomach. This process may be repeated several times until the desired size of the sleeve is achieved.
 
Once the sleeve is created, the endoscope is removed and the patient is taken to the recovery area. Most patients are able to go home on the same day as the procedure, but may need to stay in the hospital overnight for observation in some cases.
Patients are usually advised to follow a liquid diet for the first week after the procedure, and then progress to a soft food diet for the next few weeks. Patients are typically able to return to normal activities within a few days after the procedure, but may need to avoid strenuous exercise for several weeks.
 
The Apollo ESG™ system is one of several devices that have been developed for performing ESG. Other devices include the OverStitch™ Endoscopic Suturing System and the Endomina™ Endoscopic Suturing System. These devices all work on a similar principle, using sutures to create a sleeve-like structure within the stomach.
 
ESG is a relatively new procedure, and research on its effectiveness and safety is ongoing. However, the available evidence suggests that ESG can be an effective option for weight loss in certain individuals. A meta-analysis of several studies on ESG found that patients lost an average of 17.2% of their excess weight after the procedure, with few serious adverse events reported (1).
 
ESG is also associated with several potential advantages over traditional bariatric surgery. For example, ESG is a minimally invasive procedure that does not involve incisions or alterations to the gastrointestinal tract, reducing the risk of complications such as bleeding and infection. ESG also has a shorter recovery time than traditional bariatric surgery, with most patients able to return to normal activities within a few days after the procedure.
 
However, ESG is not appropriate for everyone. The procedure is typically recommended for individuals with a body mass index (BMI) between 30 and 40 who have not been successful with diet and exercise alone. ESG may not be appropriate for individuals with certain medical conditions, such as severe gastroesophageal reflux disease (GERD) or a history of gastric surgery.
 
In addition, ESG is not a magic solution for weight loss. Patients who undergo ESG will still need to make lifestyle changes, such as following a healthy diet and getting regular exercise, to achieve and maintain their weight loss goals. The procedure may also have limitations in terms of the amount of weight loss that can be achieved, with some patients experiencing weight regain over time.
 
In conclusion, ESG is a promising option for individuals who are struggling with obesity and looking for a minimally invasive weight loss procedure. The Apollo ESG™ system is one of several devices that have been developed for performing ESG, and research on the safety and effectiveness of this procedure is ongoing. While ESG has several potential advantages over traditional bariatric surgery, it is not appropriate for everyone and patients should carefully consider the potential risks and benefits before undergoing the procedure. Working closely with a qualified medical professional can help patients determine if ESG is the right option for them.