What is E-ESG?

Endomina Endoscopic Sleeve Gastroplasty (ESG) is an advanced endoscopy procedure that changes the stomach from a pouch shape to a sleeve shape.

It uses a special endoscopic device called the Endomina system and it is completed via the mouth. It is a non-surgical procedure; this means no incisions through the abdomen to reach the stomach.

E-ESG is a new weight loss procedure for obesity in the UK, however it is an established procedure in the USA where many procedures have been safely performed. It is a lower risk option than bariatric surgery.

Dr Haidry is one of the few doctors in Europe experienced in performing E-ESG.

Questions and Appointments

For any enquiries about conditions, tests or treatments, please feel free to call Dr Rehan Haidry’s medical secretary.

Why ESG?

People with a higher BMI (classed as having obesity) and suffering from related metabolic diseases, like type 2 diabetes or heart disease, may find that dietary changes and prescribed medication do not help them enough to reach their desired health. Procedures like E-ESG can help a person to achieve long term or permanent weight loss, which supports better overall metabolic health.

E-ESG reduces the number of calories a person consumes, as the stomach volume is reduced. Patients report feeling full and satisfied after a small meal, whereas before they would have felt hungry and not satisfied.

Endoscopic procedures have become much more popular than conventional weight loss surgeries due to their minimally invasive nature. Using an endoscope means the skin does not need to be cut and opened, leaving no external scars and making the recovery process is quicker. There is also no risk of ‘leaks’ (holes left after surgery which stomach contents might leak out of) which can happen during bariatric surgery. Endoscopic alternatives have become much more popular as most patients only need one overnight stay in hospital, some may be discharged same day. This all makes E-ESG an attractive and safe alternative to more invasive bariatric surgery.

NICE who provide guidance to the NHS now recommend ESG as a treatment for obesity (read about the updated NICE guidance here). However less than 1% of eligible people ever actually access bariatric surgery on the NHS and even less will have ESG or E-ESG as far fewer NHS doctors are trained to perform them. This is why many obesity patients, particularly those with a BMI less than 35, seek treatment privately.



E-ESG and ESG are similar procedures. Both take around 45 minutes – half the time of conventional bariatric surgeries – and the stomach is reached via endoscope (tube down the throat of a sedated patient). The stomach stitched away is not cut or removed, which makes it lower risk and with less chance of complications.

E-ESG and ESG deliver similar expected weight loss of around 30-40% of their total body weight. However, for best results patients must be committed to permanent healthy lifestyle changes like smaller portions, healthier food choices and regular exercise.

E-ESG uses the Endomina stitching device which ‘fences off’ half of the stomach. It uses a unique suture technique which leaves 7-9 robust sutures in place. The only difference between the two techniques is ESG stitches the stomach ‘mucosa to mucosa’ (this is the inner lining of the stomach) while E-ESG stitches the stomach ‘serosa to serosa’ (this is the outer layer of the stomach). This makes it potentially more durable and in theory less likely to ‘stretch’ over time. However long-term studies are needed to prove this.

Dr Haidry can discuss both options with you.

The E-ESG procedure is currently available at the Cleveland Clinic Hospital in London. The Cleveland clinic offers E-ESG alongside a multi-disciplinary support programme (with psychologist, dietitians and surgeons involved in patient’s care). The centre is closely aligned with the Cleveland Clinic in Ohio, one of the biggest centres in the world for obesity procedures, including E-ESG.


Get In Touch

For any enquiries about conditions, tests or treatments, please feel free to call Dr Rehan Haidry’s medical secretary Debra Hyams on:

Tel: 0203 423 7609  |  Email: rhaidrymedsec@ccf.org