Endoscopic Sleeve Gastroplasty: What to Expect After Your Procedure.

Endoscopic sleeve gastroplasty (ESG) is a minimally invasive alternative to traditional weight loss surgery. It doesn’t involve incisions or removal of any part of your digestive tract. However, like other bariatric surgeries, it brings significant lifestyle changes.

At Transform Bariatrics in Greenbelt and Rockville, Maryland, our experienced weight loss surgeon, Dr. Hitesh Amin, offers ESG as one of many options to help patients achieve their weight goals. However, achieving lasting success doesn’t depend solely on the procedure but also on what you do afterward. 

Here, we explain what to expect after your endoscopic sleeve gastroplasty and how to prepare for success.

About ESG

Endoscopic sleeve gastroplasty, or ESG, is a nonsurgical weight loss procedure we perform using an endoscope, a thin, flexible tube with a light and camera we insert in your mouth and advance to the stomach.

Using specialized tools passed through the endoscope, we place sutures that reduce the size and change the shape of your stomach, similar to a gastric sleeve. However, ESG doesn’t involve removing any part of the stomach. Instead, we fold and stitch the outer portion to limit the food you can eat.

The procedure takes 90 minutes or less, and you go home the same day. Though ESG is less invasive than traditional weight loss procedures, you must set aside time to recover and adjust to your smaller stomach. 

The first few days

Immediately after the procedure, you spend time in the recovery room for observation before going home. We use anesthesia for ESG, and you must have someone drive you home after and take it easy the rest of the day.

It’s normal to experience mild abdominal pain, bloating, and nausea during the first few days after the procedure. We may prescribe medications to ease symptoms, but they usually resolve quickly.

Hydration is vital during this phase, but you may find it challenging. You start on a clear liquid diet that includes water, broth, apple juice, and ice pops. We recommend starting with small sips and gradually increasing the amount as tolerated. 

Once your nausea passes, you transition to a full liquid diet that includes protein shakes, milk, plain yogurt, and strained cream soups. 

The first few months

Healing takes time, and following your diet plan is essential to reducing the risk of complications. You continue on the full liquid diet for two weeks and then start a puree diet that may include mashed potatoes, applesauce, and blended lean proteins.

By week three or four, you may add soft foods like scrambled eggs, fish, soft-cooked vegetables, and ripe bananas. You gradually transition to regular foods about 6 to 8 weeks after your ESG. 

Throughout each stage of the diet plan you must eat small portions several times a day and avoid foods high in sugar and fat. We also encourage drinking in between meals.

Life following ESG

Many lose up to 20% of their weight within the first year after ESG. However, lasting results depend on your ability to adopt and maintain healthy lifestyle habits, including:

• Eating balanced meals
• Establishing a consistent exercise routine
• Attending follow-up visits

Our registered dietitian provides personalized nutrition guidance and support throughout your journey.

ESG is reversible if needed, and we can perform additional procedures, such as sleeve retightening, in the future.

If you’re struggling with weight loss but aren’t sure surgery is right for you, endoscopic sleeve gastroplasty may be the solution you’re looking for. 

Call our office today or request an appointment online to schedule a consultation with Dr. Amin to learn more about ESG and whether it makes the right choice for you.