Endoscopic Sleeve Gastroplasty (ESG)

What is Endoscopic Sleeve Gastroplasty (ESG)?

ESG is a minimally invasive and incisionless endoscopic weight loss procedure that is performed to reduce the size of the stomach to help you lose weight. It is usually performed as an outpatient procedure with sedation and is well tolerated by most patients. This procedure has a significantly shorter recovery time compared to traditional weight loss surgeries and avoids external incisions/scarring to your skin.

Are you a candidate?

To be a candidate, you must be of at least 21 years of age (as authorized by the FDA) with a body mass index (BMI) of at least 30 (calculate your BMI here) and have not been able to lose adequate weight with diet and exercise alone. ESG is also a great option for those who want to avoid surgery or for those who are not candidates for surgery. You will have a consultation with the doctor to review your medical history to determine if you are a candidate for ESG prior to scheduling the procedure. We encourage you to ask any and all questions you may have regarding the procedure during this office visit. Undergoing an ESG is the start to a long-term journey for weight loss as it is performed in conjunction with hands-on lifestyle coaching by experts offered by our practice.

While you are sedated, your physician will insert a small camera attached to a thin and flexible tube through your mouth and into your stomach. A suturing device is connected to the tube, enabling stitches to be placed inside the stomach. After the stitches are placed and tightened, the stomach shrinks resembling an “accordion” as the sides of the stomach come together. This will significantly and permanently reduce the size of the stomach to about 25 % of its original size. This will allow food to remain in the stomach longer, making you feel full faster/longer and ultimately eat less. This is especially helpful if you struggle with temptations to overeat. You will be carefully monitored after the procedure for a few hours and then safely discharged home the same day as the procedure.

How is ESG performed?

Estimated weight loss from ESG is about 15-20% of the starting total body weight or 60-70% of excess body weight at 1-2 years following the procedure. This in conjunction with a low fat diet and adequate exercise may even enable you to lose more weight than the projected range. Other health benefits, in addition to weight loss, include improvement in gastroesophageal reflux, high blood pressure, type 2 diabetes, high cholesterol, fatty liver, and obstructive sleep apnea.

How is ESG performed?

How much weight can you expect to lose?

What can you expect after the procedure?

Compared to weight loss surgeries that usually require hospitalization for at least a couple of days, you will be going home the same day after your ESG with a much shorter recovery time. Most patients will experience mild symptoms after and for a few days following the procedure, including abdominal discomfort and nausea. These symptoms usually disappear after your body becomes accustomed to your reduced stomach size and you will likely be able to return to work in 2-3 days. There are medications that we will prescribe you before and after your procedure to help with these symptoms. As compared to surgery, the possibility of serious complications is drastically reduced. Serious symptoms requiring medical attention will be thoroughly discussed at your visit and prior to your procedure.

Will you have any dietary/activity restrictions after the procedure?

Yes, now that your stomach has significantly shrunken in size as a result of this procedure, you will find yourself feeling fuller with smaller quantities of food. You will be given a booklet with dietary recommendations regarding what kind and quantity of food you should eat in the coming days to weeks after the procedure while your stomach adjusts to its new size. In addition to dietary modifications, we will also assist you in exercise planning with trained experts that will work with you individually to track your progress. These lifestyle changes are intended to be lifelong to help you with lasting maintenance of your weight loss.

What are the risks?

As with any procedure, there are risks for potential complications. However, compared to laparoscopic surgery, the risks of this procedure are significantly less since there are no incisions being made from outside the body. According to the landmark MERIT Trial published in 2022, ESG is considered a safe and low risk intervention to help patients achieve and maintain weight loss.

Why should you choose us?

ESG is a complex endoscopic procedure that should be performed by highly skilled gastroenterologists. We at 4ward Wellness are advanced endoscopists who have completed additional training in complex and high risk endoscopic procedures. We possess the skills and tools to not only perform these procedures but to also manage the unlikely risk of potential complications associated with any endoscopic procedure. Rooted in the Capital Region, we are proud to offer an individualized approach in achieving your weight loss goals. We are here to listen to you and work with you to help choose the best option in the next step in your journey in losing weight and achieving wellness to overall live a healthier life.

Follow-up

Remember, this is not just a one-time visit, but is rather a long-term journey. you will also have concierge aftercare. This will include weekly calls with a board certified bariatric counselor/nutritionist and 24/7 access for any questions or concerns to provide you with the tools you need in this next chapter of your life.

How much does ESG cost?

The ESG procedure costs $11,999. This cost not only covers the procedure but also your journey to wellness consisting of post procedure follow-up appointments and concierge aftercare with 24/7 access for up to one year. These procedures are not currently covered by all insurance companies. We understand financial limitations can be a barrier to undergoing elective treatments to improve your health. We offer various financing options including CareCredit to help you move 4ward in your wellness journey.

Consent Form (for BOOKLET ONLY, not website)

The following is the consent form that you will be asked to sign on the day of your procedure. Please thoroughly read this prior to your procedure and feel free to reach out to us with any questions or concerns.

Are you from out of town?

We at 4ward Wellness welcome patients from anywhere, and we know it is crucial to have the right accommodation when visiting us. Located 20 minutes from Albany International Airport, 4ward Wellness have partnered with these hotel(s) (Hyperlink). If you wish to stay elsewhere, our friendly staff will help you find accommodation that is suitable for your needs. When travelling, all patients must have a responsible adult accompanying them. Let us know how we can help.

Pricing

Initial Consultation

$99*

ESG

$11,999*

Initial office consultation
ESG Procedure (includes: facility, anesthesia and physician fees)
Up to 1 year of bariatric nutrition/lifestyle counselling
24/7 direct physician access
Post procedure IV hydration

Bariatric Revisions

$9,999*

Initial office consultation
- Revision procedure (includes: facility, anesthesia and physician fees)
Up to 1 year of bariatric nutrition/lifestyle counselling
24/7 direct physician access
Post procedure IV hydration

Gastric Balloons

$9,999*

Initial office consultation
ORBERA Procedure (Includes: facility, anesthesia and physician fees)
Up to 1 year of bariatric nutrition/lifestyle counselling
24/7 direct physician access
Post procedure IV hydration