The Endoscopic Sleeve Gastroplasty, or ESG,
is an endoscopic procedure to help patients with weight loss.
When we describe an endoscopic procedure,
we mean that patients are put to sleep,
they get anesthesia with it, and then
we use a flexible tube about the size of a finger that goes down
into the stomach to do these procedures.
The benefit is that it's completely
an outpatient procedure.
There's no incisions, so no scarring,
and there's no anatomy that gets altered,
so that it is a fully reversible procedure.
The endoscopic sleeve procedure is
designed for those patients that just need the jump start
to lose additional weight.
So we really are targeting patients with a BMI of 30 to 40
who really need to lose anywhere from 30 to 60 pounds.
All the patients who are interested in having
an endoscopic sleeve gastroplasty procedure
come to see us in the clinic for evaluation.
We undergo a multi-disciplinary evaluation
which includes our dietitian, our psychologist, one
of our endocrinologists, and myself before going through
with the procedure.
Once that's completed, we then make a decision
in a multi-disciplinary fashion whether or not
the patient is a good candidate.
On that day, then we actually have
the patients pick up medications a few days
before the procedure.
They show up the morning of the procedure, and they get it,
and they go home the same day.
The procedure on average takes around an hour to hour
and a half to be completed.
We then observe the patient for two hours
after the procedure to make sure it's safe for them to go home.
After the procedure, patients are observed for two hours,
and then they go home.
We recommend they take certain medications
to help control some of the common symptoms afterwards,
which include nausea, vomiting, or some abdominal cramping.
However, I expect most patients to have complete resolution
of the symptoms anywhere from three to five days
after the procedure and be back to their normal self
completely within a week.
The endoscopic sleeve procedure is the most durable procedure
for endoscopic procedures that we do for weight loss.
However, we do really believe that these are reversible
as well, and that if a patient was unsatisfied,
we could actually not only strengthen or tighten
the sleeve but we could also undo it and reverse it.
The endoscopic sleeve gastroplasty
is a very safe procedure.
If you look at the data that's been published,
there is about a 2% risk of serious adverse events.
That means 98% of the patients don't have one
of these serious poor outcomes.
However, the most common effect is actually nausea, vomiting,
or abdominal cramping, which can happen in 30% to 40%
of patients, but this is a transient thing
and it does tend to resolve within a few days.
The endoscopic sleeve gastroplasty procedure,
and any endoscopy procedure that is
performed for the goal of weight loss,
is contingent on the patient.
And so making changes in their dietary and lifestyle habits
are probably the most important factor
in determining the degree of weight loss.
With that being said, most patients
lose anywhere from 30 to 60, even 70 pounds
with this procedure.
And I expect within three months,
they'll lose 10% of their total body weight.
And by two years, they may lose nearly 20%.
Here at the University of Chicago,
we're happy to see any patients who
would be interested in procedures or other methods
for weight loss.
However, for this particular endoscopic sleeve gastroplasty
procedure, we're looking for patients
who are really in need for that jump start
to lose about 30 to 60 pounds of weight.
So on average, the patients we perform the procedure on
have a BMI of between 30 to 40.
However, we will do patients with a lower BMI or even
a higher BMI, depending on the case.
Here at the University of Chicago Medicine,
we are happy to provide multiple endoscopic procedures
for weight loss, including new novel treatments
in the form of clinical trials.
Currently, we are performing intragastric balloons,
or balloons that are silicone and they sit in the stomach
to help aid for weight loss.
We're also offering aspiration therapy
to help with losing more weight through a tube
that's connected directly from the skin into the stomach.
So we do offer multiple procedures here,
including but not limited to the endoscopic sleeve.