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Transform weight loss with ESG

Minimally invasive solution for sustainable weight loss

Introducing Endoscopic Sleeve Gastroplasty (ESG)

endoscopic-sleeve-gastroplasty-esg

The IFSO Bariatric Endoscopy Committee endorses Endoscopic Sleeve Gastroplasty (ESG) as an effective and valuable treatment for obesity.1

​ESG is a minimally invasive weight loss procedure that offers a safe and clinically effective alternative to surgery.

ESG is particularly beneficial for patients with class I and II obesity, as well as for those with class III obesity who are not suitable candidates for metabolic bariatric surgery.1

No incisions or scars

Typically, a same-day procedure

Organ-sparing, and revisable

Preserves future treatment options

How the ESG procedure is performed

A trained gastroenterologist or surgeon who performs bariatric procedures uses the OverStitch™ system to create a series of plications in the stomach, forming a sleeve endoscopically. Over time, scarring and bridging tissue help to maintain the newly formed gastric shape. In addition to reducing volume, studies have shown that the ESG procedure delays gastric emptying, resulting in prolonged satiety.2, 3

Check out how sutures are placed in a U-shaped pattern along the greater curve of the stomach.


6-8 running sutures are placed in a U-shaped pattern along the greater curve of the stomach.

Check out how sutures are placed in a U-shaped pattern along the greater curve of the stomach.


When tightened and secured, the sutures draw together the anterior and posterior walls of the greater curve to shorten gastric length and reduce diameter.

The endoscopic plications result in the stomach forming a much shorter and narrower shape.


The endoscopic plications result in the stomach forming a much shorter and narrower shape, with the fundus and antrum remaining unchanged.

Meaningful results

The ESG procedure reduces stomach volume by 70-80% and delays gastric emptying, resulting in earlier satiety and weight loss.

One major clinical study showed that ESG patients were able to lose 13.6% of their total body weight after 12 months.4

ESG can be safely performed as a day case procedure, with most patients able to return to daily activities within 2-3 days.4

Clinical evidence

Clinical evidence shows that ESG can result in significant, lasting weight loss when used in conjunction with a prescribed diet and exercise program.

The body of evidence supporting the safety, efficacy, and durability of the ESG procedure has been developed over 10 years and includes both level 1 evidence and large meta-analyses.

  • 40,000 ESG procedures performed worldwide1
  • 15,000 patients included in clinical studies1
  • Over 200 clinical papers and abstracts published on the ESG procedure1
  • Follow-up reported up to 5 years5

The MERIT Study

The Multicenter Endoscopic Sleeve Gastroplasty Randomized Interventional Trial (MERIT)2 was conducted to evaluate the safety and efficacy of ESG compared to a medically monitored programme of diet and lifestyle modification.

Over a 2-year period, 209 patients between the ages of 21-65, with class 1 or 2 obesity were included in the study. All of whom agreed to comply with the necessary dietary restrictions.

49%

Excess body weight loss 12 months after the procedure.4

68%

68% of patients maintained most of their weight loss 2 years after the procedure.4

2%

In the MERIT Study, ESG had a 2% rate of serious adverse events.6

ESG Patient Stories: Joanna‘s Story

Listen to Joanna’s story as she shares her transformative weight loss journey with ESG.

ESG for Patients

Key Resource

ESG Physician Brochure

Setting the bar for endobariatrics.

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ESG-physician-brochure.pdf
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653 KB
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application/pdf
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References

1. IFSO (International Federation for the Surgery of Obesity and Metabolic Disorders) Bariatric Endoscopy Committee Evidence‑Based Review and Position Statement on Endoscopic Sleeve Gastroplasty for Obesity Management. 2024.
2. MERIT Study. The Lancet. 2022.
3. Sharaiha, et al. CGH. 2020.
4. Abu Dayyeh BK, et al. Endoscopic sleeve gastroplasty for treatment of class 1 and 2 obesity (MERIT): a prospective, multicentre, randomised trial. Lancet. 2022; 400(10350):441-451.
5. Asokkumar R., et al. DEN Open. 2023.
6. Clavien-Dindo grade III or higher.

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