Endoscopic Sleeve Gastroplasty (ESG)
Endoscopic Sleeve Gastroplasty (ESG) using the Overstitch device is the latest non-surgical procedure that is revolutionising the treatment of Obesity. It offers patients who are eligible for invasive operations a much safer option with comparable weight loss outcomes. Cairns Gastroenterology is proud to be the first and only practice to introduce this solution to North and Far North Queensland.
Endoscopic Sleeve Gastroplasty was developed in the Mayo Clinic, USA in 2012 and is now widely practiced across the globe and in Australia. The procedure is non-surgical and is performed by a specialist interventional endoscopist under general anaesthetic in an accredited private hospital.
Once asleep, a camera (endoscope) is inserted via the mouth into the stomach of the patient with the Overstitch device attached to it’s tip. A series of stitches are then placed to lace up the stomach internally to reduce its volume by up to 75%. The stitches are non-dissolvable but can be removed if required. However, this is designed to be a permanent procedure. The procedure takes up to 2 hours to perform and the patient is usually discharged the next day.
How does it work?
The procedure mimics the effect of invasive operations such as Sleeve Gastrectomy to reduced the volume of the stomach by 75% into tubular (banana) shape. ESG also slows stomach emptying which increases satiety after a meal.
Who is it for?
At the moment, we are only treating patients with Body Mass Index (BMI) of between 30 and 40 and have no significant cardio-respiratory co-morbidities. We will expand the indications as we accumulate more experience with this new procedure.
How effective is it?
Studies show that in combination with intensive dietary and lifestyle programmes, average weight loss of 20-25% TBWL can be expected (Total Body Weight Loss: eg a 120kg person could lose up to 30kg on average). One study suggests that for patients with BMI 30-40, this procedure was equivalent to Surgical Sleeve weight loss over 18 months.
Like all obesity procedures, some weight regain is expected after 3 to 5 years. That is why it is important for a patient to maintain contact with our Multi Disciplinary Team (MDT) over at least 2 years after the procedure.
ESG is also the solution of choice for the revision of previous bariatric procedures such as Gastric Sleeve and Roux-En-Y Gastric bypass where patients are putting on weight again. It is anticipated that ESG patients will also be eligible for revision procedures down the track should they regain weight again.
What are the side effects and risks?
Side effects after the procedure may include abdominal pain, nausea, cramping and vomiting, however we have developed a unique programme to minimise the risk of these side effects, particularly nausea and vomiting. These side effects last 2-3 days and then typically disappear.
The risks of complications are surprisingly small. There have been no deaths documented with this procedure with well over 2000 cases having been performed worldwide. There are risks of bleeding and infection, however the total risk is less than 1%.
To date, complications that have occurred have been able to be managed with endoscopies, medications or minor procedures. No complication has yet required surgery to resolve, however there is a very small risk that this may be required.
Optimising your weight loss journey
Studies demonstrate that a critical component of successful weight loss procedures is engaging with your team of doctors, dietitians, psychologists exercise physiologists and exercise physiologists to help support and guide you through your weight loss journey both before and after your procedure.