Is Endoscopic Sleeve Gastroplasty Permanent?

Weight loss is about more than just appearance. Your overall physical and mental health can be at stake. Dr. Steven Batash and the staff at Batash Endoscopic Weight Loss Center in Rego Park, NY offer a proven treatment called Suture Sculpt endoscopic sleeve gastroplasty (ESG) as part of a healthy weight management strategy.

Is Suture Sculpt Permanent?

Perhaps one of the biggest advantages of ESG is that it is both permanent and reversible. This is an important consideration for many patients. The ESG treatment protocol is designed to last. The permanent sutures used in the treatment have been chosen for their ability to stay intact inside the body and provide the tube-shaped restriction of the stomach volume indefinitely.

Tests have shown the durability of the sutures after five years. This is good news for patients who change their lifestyles to fit their new physiology.

ESG May Be Reversible

The same endoscopic treatment used to insert the sutures may be used to remove them and allow the stomach to return to its original shape and volume. Generally, ESG reversal is neither indicated nor desired. However, it is significant that reversal is possible. Unforeseen circumstances may drive patients to seek a reversal treatment, so this potential provides an advantage for ESG over other treatments such as LSG.

What Is Suture Sculpt Endoscopic Sleeve Gastroplasty?

Obesity has been a major and growing epidemic in the United States and large portions of the world for decades. The health challenges brought on by obesity, including metabolic syndrome and type-2 diabetes, shorten lives and reduce the quality of life.

The advent of bariatric surgeries and treatments has provided a new avenue of hope for patients who have repeatedly been frustrated by attempts to lose excess weight. But not all bariatric treatments and treatments are alike. Endoscopic sleeve gastroplasty is a relatively new and unique treatment that is definitely worth considering.

The Treatment

Endoscopic sleeve gastroplasty treatments are non-surgical and minimally invasive. Patients are placed under general anesthesia and a suturing instrument is inserted into the stomach through the mouth and throat. The endoscopist reduces the size of the stomach by gathering the sides together in an “accordion effect.”

Permanent sutures are used to allow the newly resized stomach to remain at a reduced volume indefinitely. There are no incisions and no wounds, so patients recover quickly and begin reaping the benefits of treatment almost immediately.

How Suture Sculpt Works

Shrinking the size of the stomach increases feelings of fullness and reduces the sense of hunger. When patients feel full, they eat less and their body begins to use fat for energy. They lose weight. Losing weight has an increasingly positive effect on a wide range of diseases and health problems, such as type-2 diabetes, hypertension, and other comorbidities related to obesity.

ESG typically shrinks the size of the stomach by more than 60%. Because this is a non-surgical treatment, no stomach or organ material is removed from the body. This is a big plus in terms of reduction of surgical complications, normal nutrient absorption, and the possibility of a reversal treatment.

The non-surgical nature of ESG also significantly reduces recovery time. Normal gastric bypass surgeries can require weeks of rest and recovery time, if not longer. The ESG treatment is routinely done in 90 minutes and patients often feel fully recovered in a matter of days.

Prep and Recovery

The team at Batash Endoscopic Weight Loss Center will ensure each patient is fully prepared for their treatment. Patients can expect to accomplish lab tests in the days or weeks leading up to the treatment. They can also expect to follow appropriate dietary restrictions and possible changes to their medication regime immediately before their treatment appointment.
All weight loss treatments are part of a larger health and lifestyle strategy, and ESG is no exception. Expect to be asked to begin (or continue) a regular, reasonable exercise routine before treatment. Patients are placed under general anesthesia during the treatment so they are required to have a means of travel back home after outpatient release.
Suture Sculpt endoscopic sleeve gastroplasty is a minimally invasive treatment. There are no incisions to heal. Furthermore, the risk of post-operative complications such as infection is significantly reduced.
Patients will awaken from general anesthesia in a recovery room where caring medical staff will monitor them for an appropriate amount of time. Most patients go home the same day, often within a couple of hours. Most patients should experience a relatively rapid return to normal daily activity. Individual recovery times vary, but many patients feel fully recovered within just a couple of days.
Post-Treatment Medical Care
Many patients report no discomfort after treatment. Dr. Batash and the staff will provide post-treatment care that is effective and safe should patients need any follow-up visits.
Post-Treatment Home Care
Expect to be on a liquid-only diet for a period of time, normally about two weeks. Most patients transition to a semi-solid diet at that time, and then return to a healthy, normal diet. Return to normal physical activity happens quickly for most patients.

Do I Qualify?

Although minimally invasive and non-surgical, patients should meet a set of general criteria before pursuing the treatment. Patients should have a body mass index (BMI) greater than 30. In addition, patients should have attempted weight-loss unsuccessfully using other methods, preferably under the supervision of a physician.

Some conditions, such as gastrointestinal bleeding, may preclude patients from being eligible for the treatment. A screening process will help patients determine if ESG is right for them.

What to Expect After

Most patients return to work and are out exercising and living their normal lives within a day or two of the treatment. Patients will initially have dietary restrictions after treatment. As they progress from an all-liquid diet to semi-solid foods, and eventually to a normal diet, they’ll definitely notice that their eating habits will need to change. Because the treatment shrinks the stomach immediately, patients will feel fuller quicker.

Although the treatment does not interfere with the body’s ability to absorb nutrients, their lower calorie intake may impact the amount of certain vitamins and minerals patients are able to take in. Patients may be asked to begin or change their vitamin supplement routine to adapt to their new habits.

Weight Loss Results

The Suture Sculpt treatment must be part of a larger lifestyle improvement program aimed at weight loss and improved health. Commitment to dietary changes and increases in physical exercise are integral to achieving the weight loss and health benefits patients are seeking. There will be few if any physical restrictions place on most patients after the treatment, so they can begin getting healthy and safe exercise almost immediately.

Patients with typical weight loss profiles lose about 15% of their total body weight in the first six months after the treatment. For a person weighing 200 pounds, this equates to about 30 pounds. After one year, typical weight loss achieved has been about 18% of total body weight or 36 pounds for a 200-pound person. After two years, sustained weight loss has been around 24% or 48 pounds for the 200-pound original weight.

In terms of excess weight loss, ESG patients can expect to lose upwards of 60% of their excess weight (measured as the difference between their current weight and their ideal body weight). These results reflect a stable and achievable pace of weight loss. Some patients, particularly those who routinely follow dietary guidance and exercise routines, experience more than 18% weight loss in the first twelve months.

ESG and Type-2 Diabetes

Bariatric treatments are highly effective in treating type-2 diabetes. Studies have routinely shown rapid remission of type-2 diabetes symptoms and other comorbidities in patients who have undergone bariatric surgeries. ESG has a very similar impact on patients with type-2 diabetes. Studies have shown that over 70% of patients are in complete remission of type-2 diabetes within three months of an ESG treatment.

How Is Suture Sculpt Different from Other Weight Loss treatments?

Intragastric Balloon
Intragastric balloon treatments, such as the Orbera system, are non-invasive and non-surgical and promote rapid weight-loss through reducing the available stomach volume. The deflated balloon is placed in the stomach endoscopically (through the throat) and filled with a saline solution. The inflated balloon takes up stomach volume. Patients feel full while eating much faster, and caloric intake is reduced. The balloon is removed after six months.
The main difference between ESG and intragastric balloon therapy is that ESG is a permanent treatment (but reversible in many cases). The stitches are designed to be permanent, and the stomach size can be reduced indefinitely for ESG patients. The balloon, however, must be removed from intragastric balloon therapy patients. This risks a return to normal eating and subsequent weight gain before new habits of eating and exercise can take hold permanently.
Laparoscopic Sleeve Gastrectomy
Laparoscopic sleeve gastrectomy (LSG) involves the removal of a significant portion of the stomach via a surgical camera and instrument inserted through an incision in the abdominal wall. Once the treatment is finished and the tissue is removed, it is not reversible. Recovery time for this surgical treatment can be as long as 3 weeks. The LSG treatment can result in weight loss as high as 80% of excess weight.
While LSG can potentially achieve a loss of up to 80% of excess weight, ESG is still very effective (up to 60%) for patients who follow the recommended lifestyle changes that accompany the therapy. Because the ESG treatment is non-invasive and non-surgical, recovery time is significantly shorter in just a few days.

Is endoscopic sleeve gastroplasty reversible?

Yes, it is possible to reverse the ESG, but generally, the reversal of the procedure is neither indicated nor desired. However, it is significant that endoscopic sleeve gastroplasty reversal is possible, unlike the similar surgical gastric sleeve.

A reversal of ESG would be performed using the same endoscopic procedure that was used to insert the sutures. The sutures would be removed, and the stomach would be free to return to its original shape and volume.

In the unlikely event that unforeseen circumstances may drive patients to seek a reversal treatment, the reversal potential provides an advantage for ESG over other treatments such as laparoscopic gastric sleeve.


The actual price of the treatment will vary according to patient requirements, but the range is between $9,000 and $11,000. At this time, most insurance companies do not cover this relatively new treatment. Our clinic’s relationship with CareCredit provides financing options for patients requiring means to pay for the treatment. We are happy to assist. We know health is priceless, and we are committed to helping our patients find the means to secure the healthcare they need.

Why Choose Batash Endoscopic Weight Loss Centers?

Dr. Steven Batash and our professional medical staff at the Batash Endoscopic Weight Loss Centers are ready to consult with you and help you decide if ESG is right for you. Our clinics proudly provide expert, world-class medical care, and we specialize in ESG and other non-surgical weight-loss treatments for everyone in the NYC area. Contact Batash Medical today to learn more or get started.

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