Endoscopic sleeve gastroplasty (ESG)
ESG is performed through the mouth using an endoscope. Sutures are placed inside the stomach to reduce its volume. It is generally considered less invasive than surgical sleeve gastrectomy.
How it works
- Performed under sedation as an outpatient endoscopic procedure in most cases.
- An endoscopic suturing device places a series of sutures inside the stomach.
- Effective volume of the stomach is reduced without external incisions.
Risks and considerations
- Nausea, abdominal discomfort in the first days
- Uncommon complications including bleeding or perforation
- Weight-loss outcomes are generally lower than surgical sleeve gastrectomy
Follow-up
Nutritional guidance and follow-up are recommended for long-term maintenance.
May be discussed for
- Adults seeking a less invasive option who understand outcomes differ from surgical sleeve
- Patients who prefer to avoid abdominal surgery
When it may not be appropriate
Patients with certain gastric anatomy or bleeding disorders may not be candidates.
Dr. Ariel Ortiz Lagardere, MD, FACS, FASMBS
Bariatric & Metabolic Surgeon · Founder, Obesity Control Center
- Content reviewed
- Educational overview of Endoscopic sleeve gastroplasty (ESG).
- Last reviewed
- 2026-06-01
See our medical review policy, editorial policy, and references.
Dr. Ariel Ortiz Lagardere, MD, FACS, FASMBS
Bariatric & Metabolic Surgeon · Founder, Obesity Control Center
Last reviewed: June 2026
Educational claims on this page are supported by independent guidelines, peer-reviewed evidence, and verifiable accreditation listings. See Sources & Verification and Science & Evidence.
Medical notice. This content is educational only and does not replace professional medical advice. Do not start, stop, or change GLP-1 medication without consulting your physician.