A guide to minimally-invasive weight loss intervention with Endoscopic Sleeve Gastroplasty (ESG)

At Atlantic Gastroenterology, we celebrate those innovative, yet clinically-proven safe and effective diagnostic and therapeutic modalities. Often, these cutting-edge treatments and techniques are conservative in nature. As such, Endoscopic Sleeve Gastroplasty (ESG) is a great fit with and complement to the array of other advanced services administered by our Board-certified gastroenterologist, Dr. Alexander Shapsis, and available at our office in Brooklyn, New York.

Endoscopic Sleeve Gastroplasty in Brooklyn NY area

ESG explained

Endoscopic Sleeve Gastroplasty is considered to be a minimally-invasive alternative to conventional surgical Bariatric interventions, such as gastric bypass and sleeve gastrectomy, to support weight loss among patients afflicted by obesity. Instead of altering parts of the stomach with invasive resections and incisions, ESG is performed non-surgically by using a thin flexible tube (endoscope) which is equipped with a camera and a suturing device called Overstitch. The endoscope and device are introduced through the patient’s mouth. In doing so, external surgical cuts are avoided. We then use the suture device to reduce the size of the stomach, resulting in a tube or “sleeved” shape akin to what is achieved with traditional sleeve gastrectomy – only without scarring and associated demands on the body for healing and recovery.


Dr. Shapsis conducts a thorough medical evaluation before recommending treatment options. Appropriate candidates should be free of any GI or metabolic conditions as well as past stomach surgeries that could adversely affect the outcomes from ESG. It is also essential for patients to be committed to a healthy lifestyle. After all, ESG is not a “one and done” procedure. Rather, it is a stepping stone toward renewed health, self-confidence, and a positive outlook on life. Good candidates understand that adhering to a proper diet and exercise regimen and follow-up care and monitoring is a must to maintain weight loss and avoid potential complications.


As a non-surgical treatment, ESG is inherently linked to a variety of advantages over traditional surgical techniques. Notably, this process is associated with a significant reduction in the risk of infection or hernia. Additionally, patients typically recover much faster and require less “downtime.” Patient satisfaction is typically high; the lack of external incisions minimizes pain post-procedure and avoids  scarring. This latter feature has a profound, positive psychological effect on patients as they adjust to their new bodies.

Research findings published in the journal Endoscopy International Open also noted that, on average, ESG patients lost ~15 to 20% of their total body weight within 12 months of treatment. Furthermore, it was reported that patients maintained that weigh loss. The benefits extended to remarkable improvements in obesity-linked conditions, such as Type 2 diabetes, high blood pressure, and Obstructive Sleep Apnea. Improved body image, mental health status, and quality of life also accompanied these physical transformations.


Rarely, as a minimally-invasive alternative, ESG results in severe bleeding, infection, or perforation. These potential complications can require immediate medical attention or even surgery. ESG still requires the use of sedatives or anesthesia for comfort. So, there are small risks of adverse respiratory and other reactions.

Following treatment, patients may also feel nauseous, and experience pain or reflux complications. In rare cases, sutures can become loose with time. This complication requires more interventions or repeat procedures. Lastly, patients’ real weight loss may fall short of their goals, or weight may be regained following initial losses, however the risks were similar compared to those after Bariatric Surgery.

In Summary

ESG is transforming interventions for weight loss and the lives of patients who are committed to a healthy lifestyle and to ongoing follow-up care. Atlantic Gastroenterology is here for you on a journey to better health. Call 718 521-2840 with questions and to schedule a consultation with Dr. Shapsis at our office in Brooklyn, NY.

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New patients: 718 521-2840 Existing patients: 718 615-4001 EndoSlim Clinic: 1-877-SIZEOFF (1-877-749-3633)