What is Endoscopic Sleeve Gastroplasty (ESG)?

ESG is a minimally invasive weight-loss procedure using an endoscope, a flexible tube with a camera, and an endoscopic suturing device attached. Using the endoscope, your surgeon places sutures in the stomach to change the structure of your stomach. Shaping the stomach into a tube restricts the amount of food you can eat because you feel fuller sooner. 

It helps you lose weight by limiting how much you can eat. Like other weight-loss procedures, endoscopic sleeve gastroplasty requires being dedicated to maintaining a healthier lifestyle. You must make permanent healthy changes to your diet paired with regular exercise to help ensure the long-term success of ESG.

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Who is a Good Candidate for Endoscopic Sleeve Gastroplasty?

Endoscopic sleeve gastroplasty helps you lose weight while potentially lowering your risk of serious weight-related health problems. Examples of such issues include:

  • Heart disease and stroke
  • High blood pressure
  • Nonalcoholic fatty liver disease (NAFLD) or nonalcoholic steatohepatitis (NASH)
  • Sleep apnea
  • Type 2 diabetes
  • Osteoarthritis (joint pain)

You're likely a great candidate for endoscopic sleeve gastroplasty in NYC if:

  • Your BMI is above 30.
  • You haven't been successful in maintaining weight loss with lifestyle modification alone.
  • You don't qualify for or want to pursue traditional bariatric surgery.
  • You're willing to commit to healthy lifestyle changes, regular medical follow-ups, and participate in behavioral therapy.
  • You're in NYC, NJ, and surrounding areas.
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What is the Endoscopic Sleeve Gastroplasty (ESG) Process?

Before the Procedure

If you qualify for endoscopic sleeve gastroplasty, our team will give you specific instructions on how to prepare. The following are some of the most common preparations for ESG:

  • Various lab tests and exams before surgery
  • Restrictions on eating, drinking, and which medications you can take
  • Starting a physical activity program

You should also plan for recovery after the procedure, such as arranging for someone to help at home for a few days.

During the Procedure

Endoscopic sleeve gastroplasty is an outpatient procedure using general anesthesia, so you'll be unconscious. The procedure is performed orally with no incisions and generally takes up to ninety minutes.

ESG uses an endoscope, a flexible tube with a camera, and an endoscopic suturing device attached. Your surgeon places sutures in the stomach to change the structure of your stomach. ESG reduces the size of the stomach by 70-80%. Shaping the stomach into a tube restricts the amount of food you can eat. Food stays in the stomach for a longer time, allowing patients to feel fuller.

This procedure does not remove any part of the stomach. Because the procedure is minimally invasive by going through the mouth and avoiding incisions, it reduces the risk of operative complications and allows for a quick return to daily activities.

After the Procedure

Most ESG patients return home the same day after recovering from sedation. However, some patients might require a short hospital stay for observation, generally no more than one day and night.

After the procedure, you won't be allowed to eat for a few hours. When you are released to eat, you will start a liquid diet lasting at least two weeks. After those two weeks, you can move on to semisolid foods before beginning a regular, healthy diet.

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What are the Results of Endoscopic Sleeve Gastroplasty (ESG)?

As with any weight-loss program, your commitment to nutrition, physical activity, emotional health, and resiliency will largely influence your ESG results. A patient who completes the entire program and follows all guidelines can expect to lose about 12% to 20% of their body weight in one year.

It is important to remember that it’s possible you may not lose significant weight or could regain weight after any type of weight-loss procedure, even if the procedure itself works correctly. That is why it is imperative to follow the recommended healthy lifestyle changes.

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Why Choose NYBG for ESG?

Our experience is a record of success and caring, and it is what separates us as the very best surgeons from the average ones. We do everything to ensure a safe and comfortable endoscopic sleeve gastroplasty procedure in NYC, followed by a successful weight loss journey and a long, energetic life. With post-procedure care and support programs, our patients consistently enjoy better results than other practices.

Past patients will tell you our experience does not stop after your procedure. We know what it takes to lose weight and keep it off, so our comprehensive after-care program gives you an excellent chance of success.

The weight loss surgeons at New York Bariatric Group are recognized in New York City as leading bariatric surgeons and are also recipients of multiple national awards and commendations. Dr. Garber and his team are regularly asked to train other weight loss surgeons around the country and are actively sought out for their expertise in all areas of bariatrics. The team is proud to use its experience to help develop new methods and bariatric surgery options.

When ready for an incision-free solution to bariatric surgery, choose the New York Bariatric Group for all-oral ESG.


Lost 145lbs

Thomas' success story

I went in for surgery. An hour later, I came out a new man.

Everybody treated me like a king. The day of surgery, I was excited. The hospital couldn’t be any nicer. I went in for surgery. An hour later, I came out a new man. My recovery was awesome. I was out of bed that day. My wife and kids were my motivation on getting this surgery. They are my whole life. I’m happy I’m going to be around for them.

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Lost 76lbs

Nicole's success story

I hit my goal weight ... and I feel fabulous

I had the gastric bypass. I am Type 2 Diabetic and I wanted to gain control of my sugar. I hit my goal weight in about 5 and half months and I feel fabulous. The procedure has completely changed my life for the better because it has empowered me as a middle aged woman that I can really do everything and anything that I want to do. I don't put an age on anything. I don't say I'm too old for something.

Listen to Nicole’s testimonial


Lost 76lbs

Robert's success story

I was tired of the way I looked. I was tired of the way I felt.

I knew if I didn't change something soon, I was going to be in a lot of trouble. The consultation process was a lot easier than I expected. I was met with open arms. I was treated like I was the only patient here. Not only did they answer all of my questions, they had questions for me to make sure I was the right candidate for the surgery. After surgery and that weight started dropping off, my life started changing for the better.

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Lost 92lbs

Samantha's success story

I feel like a completely different person.

I had the gastric sleeve procedure. The driving factor behind me getting this procedure was my health. I didn't feel good physically or mentally. I had joint pains, even standing was difficult sometimes. Emotionally, this surgery completely turned my life around. I have so much more confidence. So much more happiness. I feel like a completely different person. I feel stronger. I feel able to accomplish more.

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Lost 99lbs

Eileen's success story

It saved my life.

The driving factor behind me getting my procedure was that I couldn't get up off the floor with my granddaughter. That was my why. That was my big reason for having this surgery done. After surgery, it was a little bit of a struggle with what to eat. What you put in your mouth that you don't even think about. You don't think about what you're eating or how you're eating and portion size. It's what I do now every single day. The procedure has changed my life in so many ways. It saved my life.

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Lost 126lbs

Brittany's success story

I am totally comfortable in my own skin.

I think I always grew up identifying myself as less than other people because I was fat. I decided to tackle that and just live my life. I had a sleeve gastrectomy. It changed how I view myself. How I communicate with people. I'm able to be much more of myself and live the life I always thought I should have been living. I am totally comfortable in my own skin. You have the tools you need to succeed here.

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Lost 157lbs

Desiree's success story

I have a brand new life. I can do things I couldn't do before.

I had a vertical sleeve gastrectomy because I had just become diabetic, and I had hypertension for many years. I lost a total of 157 pounds in 11 months. I have a brand new life. I can do things I couldn't do before. Everyone at New York Bariatric Group has been wonderful. They are kind. They are understanding. They make you feel comfortable. They will guide you every step of the way on your journey so that you can be successful.

Listen to Desiree’s testimonial

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Note: A BMI of 30 – 34.9 or BMI 35 – 39.9 with no comorbidities qualify for lap band but is usually not covered by insurance.

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