Advanced Surgical Partners of Virginia, part of the HA Virginia Physicians network and an affiliate of Parham Doctors’ Hospital in Richmond, is the region’s leading provider of surgical weight loss and is recognized as a Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP®) by the American College of Surgeons. Serving the Mid-Atlantic, the program is the only one in the region offering a new weight loss procedure called endoscopic sleeve gastroplasty (ESG). Matthew Brengman, MD, a board-certified and fellowship-trained bariatric surgeon, explains why ESG is a revolutionary weight loss procedure for some patients.
What is endoscopic sleeve gastroplasty (ESG)?
ESG is a minimally invasive, nonsurgical, outpatient procedure designed to permanently reduce the size of the stomach endoscopically through the mouth, as opposed to traditional weight loss surgery that requires incisions in the abdominal wall. The primary goal of the procedure is to help patients feel less hungry, while still feeling satisfied with a much smaller meal. As Dr. Brengman points out, “ESG looks a lot like sleeve gastrectomy, but we do not have to remove 80 percent of the stomach. In general, over the course of about nine months, most patients lose 20 percent of their body weight, which equates to roughly 60 percent of their excess weight.”
Patients are given general anesthesia and the ESG procedure takes place in the endoscopy suite instead of the operating room. During the procedure, an endoscope with an attached suturing device is inserted through the mouth, down the esophagus, and into the stomach. The stomach is then sewn, reducing its capacity to hold food by around 75 percent of its original size. Patients go home the same day as their procedure.
Following ESG, patients begin to feel full after eating significantly smaller meals, about one half cup of solid food, and most see a dramatic impact to their overall health and quality of life.
Who is a candidate for ESG?
The best candidates for ESG are those on the lower spectrum of needing to lose weight, with a body mass index (BMI) between 30 and 40. While some patients find temporary success with weight loss medications, many gain the weight back after stopping medicinal treatment. ESG is a great option for those seeking long-term weight loss success.
Unfortunately, not everyone is a good candidate for ESG, including:
- Those outside of the 30 to 40 BMI range
- Those who have had prior stomach surgery
- Those with large hiatal hernias
Our surgical team, dieticians, nurse practitioners, and physician assistants listen to patients’ end goals and help them decide if ESG is the right procedure for them.
What are the risks and benefits of ESG?
ESG is considerably safer than more invasive weight loss operations, with a complication risk as low as two percent. The benefits of ESG often include:
- Resolution of serious medical conditions like diabetes, sleep apnea, and joint pain
- Increased energy and improvements in mood
- Better sleep
- Improved blood pressure
Short-term side effects may include nausea, vomiting, and abdominal pain. Of course, all surgeries come with some risk. Potential risks of ESG include:
- Bleeding at the suture site
- Pulmonary embolism
- Adverse reaction to anesthesia
- Breakdown of the suture line
What is the recovery like from ESG?
Recovery from ESG typically takes seven to 14 days, with patients needing to take five to seven days off from work. This is considerably shorter than the two to four week timeframe needed to recover from traditional gastric bypass surgery.
How does ESG differ from vertical sleeve gastrectomy surgery?
ESG is less invasive than traditional gastric sleeve surgery, in addition to these key differences:
- ESG does not involve cutting the stomach, so the risk of infection and other complications is considerably lower than gastric sleeve.
- ESG is performed through the mouth, eliminating the need for incisions.
- Recovery time with ESG is faster than gastric bypass.
- ESG is an outpatient procedure, while gastric sleeve requires a hospital stay.
- Weight loss with ESG is about 20 percent of body weight, while gastric bypass is 25 to 30 percent.
- ESG is not associated with an increase in acid reflux, which often is seen following gastric sleeve procedures.
What makes our weight loss program unique?
Advanced Surgical Partners of Virginia and Parham Doctors’ Hospital are the regional leader for weight loss procedures with more options than any other program of its kind in the Richmond area, and currently the only program in the area offering ESG. With more than 25 years of surgical experience and hundreds of weight loss procedures performed each year, our specialists are experts in helping patients achieve their weight loss goals. Our surgeries are performed at Parham Doctors’ Hospital which is recognized as a Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP®) by the American College of Surgeons. This accreditation means that our program offers patients the highest level of safety, optimal outcomes, and our care is specially designed for patients with obesity.
To learn more about ESG, watch this video with Dr. Brengman or call (804) 360-0600.
Find out if you’re a candidate. Take our weight loss surgery health risk assessment.