ABOUT ESG
What is the ESG Weight Loss Procedure
Endoscopic Sleeve Gastroplasty is the term given to a new weight loss procedure pioneered in 2012 and is now in use in a number of centres around the world and now available in New Zealand.
The average weight loss at 18 months to 2 years after te procedure is approximately 20% of starting body weight (eg: a 100kg patient will lose approximately 20kgs in weight on average) Most of the weight loss will occur in the first 6 months post procedure.
This procedure is preformed as a daycare, so you go home the same day.
ESG is a procedure that uses an endoscope which can suture the stomach without having to cut into any exterior skin tissue. Everything is done via an endoscope. The stomach volume is reduced by 50-70%. This is accomplished by a series of endoscopically placed sutures extending from the bottom 1/3 of the stomach to the upper stomach creating a “sleeve”. The procedure results in feeling full with reduced food intake and slowed gastric emptying, so that you feel full quicker and do not become hungry for a longer period of time. If you want to see if you're right for this procedure then click here and take the online assessment.
Your initial appointment will be with a Gastroenterologist. At this initial consultation you will be assessed as to whether endoscopic sleeve gastroplasty (ESG) is a procedure that is appropriate for you. The procedure will be discussed in more detail and you will be able to ask questions. Other family members or support people are welcome to attend this appointment.
ESG is undertaken using the OverstitchTM; Apollo Endosurgery device which attaches to the endoscope and performed under general anaesthesia. The procedure and changes made to the stomach are considered permanent. Although there is the possibility of reversing the changes, this is very rarely undertaken.
This procedure does NOT involve removal of any of the stomach as occurs with surgical laparoscopic sleeve gastrectomy’s and bypass procedures undertaken for weight loss. As a result, the procedure is significantly safer with a faster recovery time.
To achieve the best results, a multi-disciplinary approach is used. The program that has been developed incorporates regular clinical reviews with the gastroenterologist, specialist ESG nursing staff, dietitian and psychologist, to help you achieve the best possible outcome.
The average weight loss at 18 months to 2 years after te procedure is approximately 20% of starting body weight (eg: a 100kg patient will lose approximately 20kgs in weight on average) Most of the weight loss will occur in the first 6 months post procedure.
This procedure is preformed as a daycare, so you go home the same day.
ESG is a procedure that uses an endoscope which can suture the stomach without having to cut into any exterior skin tissue. Everything is done via an endoscope. The stomach volume is reduced by 50-70%. This is accomplished by a series of endoscopically placed sutures extending from the bottom 1/3 of the stomach to the upper stomach creating a “sleeve”. The procedure results in feeling full with reduced food intake and slowed gastric emptying, so that you feel full quicker and do not become hungry for a longer period of time. If you want to see if you're right for this procedure then click here and take the online assessment.
Your initial appointment will be with a Gastroenterologist. At this initial consultation you will be assessed as to whether endoscopic sleeve gastroplasty (ESG) is a procedure that is appropriate for you. The procedure will be discussed in more detail and you will be able to ask questions. Other family members or support people are welcome to attend this appointment.
ESG is undertaken using the OverstitchTM; Apollo Endosurgery device which attaches to the endoscope and performed under general anaesthesia. The procedure and changes made to the stomach are considered permanent. Although there is the possibility of reversing the changes, this is very rarely undertaken.
This procedure does NOT involve removal of any of the stomach as occurs with surgical laparoscopic sleeve gastrectomy’s and bypass procedures undertaken for weight loss. As a result, the procedure is significantly safer with a faster recovery time.
To achieve the best results, a multi-disciplinary approach is used. The program that has been developed incorporates regular clinical reviews with the gastroenterologist, specialist ESG nursing staff, dietitian and psychologist, to help you achieve the best possible outcome.
Difference between a Gasrtic Sleeve and ESG
The ESG procedure is noninvasive, there's no external stiches or scars that are visible externally. The entire procedure is preformed via the month using an endoscope and is designed to pull the stomach lining inside itself (ref diagrame above left) The other main difference is the is it allows for fast recovery and overall costs are less. Recovery is normally 2 to 3 days where a traditional gastric sleeve can be up to 2 weeks as the 'sleeve' part of your stomach is removed (ref diagram above right)
Who can have the ESG procedure?
ESG is indicated for patients with a BMI of 30 kg/m2 to 45 kg/m2 and who have failed non-invasive weight loss measures, and are aged between 20- 60 years old.
Patients who have significant medical comorbidities may not be able to have the procedure. This will be assessed by your gastroenterologist at the initial consultation.
Exclusions to having an ESG include: patients with cirrhosis of the liver and/or portal hypertension, antiplatelet therapy (excluding low dose aspirin), severe cardiac or respiratory disease, previous gastric surgery, inflammatory bowel disease, or unable to follow dietary guidelines.
CLICK HERE > TRY THE ONLNIE ASSESSMENT TOOL
Patients who have significant medical comorbidities may not be able to have the procedure. This will be assessed by your gastroenterologist at the initial consultation.
Exclusions to having an ESG include: patients with cirrhosis of the liver and/or portal hypertension, antiplatelet therapy (excluding low dose aspirin), severe cardiac or respiratory disease, previous gastric surgery, inflammatory bowel disease, or unable to follow dietary guidelines.
CLICK HERE > TRY THE ONLNIE ASSESSMENT TOOL
The ESG Process
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After the initial consultation with the gastroenterologist, if it is felt to be the appropriate procedure, you will be booked to see the dietitian and psychologist.
Before the day of the procedure you will have blood tests and commence a low calorie diet with Opti fast. The procedure is preformed under a aesthetic and takes approximately 90 minutes. After the procedure has been performed, you will be monitored for up to 4 hours before going home. You will be reviewed the following day and have close follow-ups with the bariatric team over the next 12 months |
SIDE EFFECTS
Preparation for Endoscopic Sleeve Gastroplasty
As part of preparing for your ESG procedure, it is also important to plan ahead for your recovery:
You will not be able to drive after the procedure, or for 2 days after the procedure, so arrange for someone to drive you home afterwards and to your follow up appointment the next day.
If coming from out of the Auckland area please arrange local accommodation for the first 4 days after the procedure.
Someone will need to stay with you for the first 48 hours after the ESG.
Arrange time off work. Most people return to work 10-14 days after the procedure.
Ensure you have appropriate foods and drinks available at home for both before and after the procedure. Your dietitian will advise you on appropriate food and drink choices at each stage of your journey.
Ensure you have the prescribed ESG medications to hand at least one week prior to your procedure.
You will not be able to drive after the procedure, or for 2 days after the procedure, so arrange for someone to drive you home afterwards and to your follow up appointment the next day.
If coming from out of the Auckland area please arrange local accommodation for the first 4 days after the procedure.
Someone will need to stay with you for the first 48 hours after the ESG.
Arrange time off work. Most people return to work 10-14 days after the procedure.
Ensure you have appropriate foods and drinks available at home for both before and after the procedure. Your dietitian will advise you on appropriate food and drink choices at each stage of your journey.
Ensure you have the prescribed ESG medications to hand at least one week prior to your procedure.
Medications (before and after surgery)
Pre-Surgery Diet
What are the side effects and complications with ESG
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Cramping or abdominal discomfort (30-50%) , nausea (20-30%), reflux and vomiting are common symptoms within the first 1 to 3 days after the procedure. Most of these symptoms are mild to moderate in severity and are treated with oral medications.
The risks of major complications are low. There have been no recorded deaths with this procedure with > 3000 cases having been preformed worldwide. There are risks of bleeding and infection (per-gastric collection), pneumothorax, pulmonary embolism, however the risk of a significant complications in less than 2-3%. To date, complications that have occurred have been able to be managed with endoscopic, medications and minor procedures. |
Poor sleep
You won’t be able to eat much for the first week or two and it is normal to feel tired and low in energy at this stage. Take care of yourself and rest. You will start feeling better once your dietary intake increases.
Reflux
Reflux and indigestion occur when acid moves from your stomach into your oesophagus. You will have been prescribed Omeprazole to reduce stomach acid production and take for the first 6-months after the procedure. Some people will require lifelong Omeprazole.
Other things you could try include: Gaviscon or Mylanta, ensure you remain upright after meals and wait two hours before going to bed and elevate the head of your bed at night.
Other things you could try include: Gaviscon or Mylanta, ensure you remain upright after meals and wait two hours before going to bed and elevate the head of your bed at night.
Dehydration
Aim to drink at least 2 litres of fluid each day. This includes all liquids such as water, diluted fruit juices, milk, sugar-free cordial, tea and coffee. You should avoid fizzy drinks as they can cause discomfort. If you are finding it hard to drink the recommended amount and are dehydrated you could try the following: Take small, frequent sips of fluids and use gastrolyte or enterolyte rehydration fluid.
CONTACT US
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The team at the ESG Centre are here to support and guide you towards your health goals. If you have any questions please do not hesitate to contact us on:
ESG Weight loss Centre 5 MacMurray Rd Remuera Auckland 09 930 8502 sarah@EndoscopicSleeveGastroplasty.co.nz |
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