Endoscopic Sleeve Gastroplasty (ESG):

ESG is a non-surgical weight loss procedure that is performed using a small suturing device and camera that is passed down the patient’s esophagus into the stomach. ESG reduces the size of the stomach by up to 80% helping patients eat less, feel full faster and stay full longer. This results in fast, safe and durable weight loss.

• ESG is performed without incisions or scars.
• ESG is safe and less invasive than other interventions.
• ESG is done as outpatient where most patients go home the same day and return to work in 2-3 days.
• ESG is effective in helping patients lose almost 50% of their excess body weight within one year.
• ESG is effective in improving medical conditions like type 2 diabetes and high blood pressure for the majority of patients.

Learn More

Watch this Video

Frequently Asked Questions

Is ESG an FDA approved procedure?
Yes! The suturing device used to perform ESG is FDA approved to facilitate weight loss in adults with Body Mass Index (BMI) between 30-50 kg/m2.

How does ESG work?
The procedure reduces stomach capacity and slows gastric emptying. This translates into eating less, feeling full faster and staying full longer.

How is ESG different from traditional bariatric surgery?
ESG is less invasive than bariatric surgery since it is performed endoscopically, meaning there are no incisions or scars. Most patients can go home the same day and return to work in 2-3 days.

How much weight do patients lose?
In recent studies, patients undergoing ESG lost over 50% of their excess body weight and over 20% of their total body weight at one year.

What are some potential positive health impacts of ESG?
In a US randomized trial, 70% of patients with Type 2 Diabetes showed improvement in their diabetes and 64.3% of patients with hypertension showed improvement in their blood pressure. Other positive health impacts include improvement of cholesterol levels and improvement in sleep apnea.

How many ESG procedures have been done?
Over 250 publications and abstracts have reported outcomes in >10,000 patients receiving ESG in the US and worldwide.

Who is a candidate for ESG?
ESG is indicated for adults with Body Mass Index (BMI) between 30-50 kg/m2 who have not been able to lose weight or maintain weight loss through more conservative measures.

Are there any side effects to ESG?
All procedures have risk. Patients should talk with their doctor and understand all risks before having any procedure. That being said, major complications after ESG are extremely rare (< 1%).

Is ESG a permanent procedure?
Over time, there will be scarring and bridging tissue to maintain the reduced stomach size and sleeve-like shape. However, the procedure can be reversed by endoscopically cutting these bridges and removing sutures. In the event the sutures loosen and the sleeve-like shape stretches, retightening can be performed.

Is ESG covered by insurance? 
As of now, ESG is not covered by insurance. However, ESG is offered for self-paying patients with a reasonable and flexible plan.

For More Information 

• Learn more about Dr. Raghid Bitar
• Link to demonstrations (need to add photos/video)
• Contact information and next steps: FOR REFERRING PROVIDERs: Use EPIC to place a referral to Dr. Raghid Bitar (UNC general surgery / Siler City) and note that this is a referral for ESG.
• For Patients, please call 919-799-4050