Endoscopic Sleeve Gastroplasty (ESG) is an endoscopic weight-management procedure that reduces the functional size of the stomach without removing part of the stomach. It is performed through the mouth using a flexible endoscope and an endoscopic suturing system.

During ESG, a series of full-thickness sutures are placed in the stomach to create a smaller, sleeve-like configuration. This can reduce the amount of food the stomach can comfortably hold and may slow gastric emptying, helping patients feel full with smaller meals.

ESG may be considered for selected patients with obesity who have not achieved adequate weight reduction through lifestyle measures alone and who are suitable for an endoscopic approach. A detailed assessment is required to review weight history, medical conditions, previous treatments and nutritional factors.

Successful outcomes depend on long-term participation in dietary modification, physical activity and follow-up. Possible risks include pain, nausea, bleeding, infection or complications related to sutures, although serious complications are uncommon when the procedure is performed in appropriately selected patients.