Endoscopic Sleeve Gastroplasty (ESG)

Why ESG?

ESG has become much more popular than conventional weight loss surgeries due to its minimally invasive nature. Using an endoscope means the skin does not need to be cut and opened, leaving no external scars. Similarly, the recovery process is quicker, and most patients do not need an overnight stay in hospital. This makes in attractive and safe alternative to more invasive bariatric surgery.

ESG and other weight loss surgeries are usually considered once a patient has exhausted other methods to lose weight. However only a fraction of NHS patients (less than 5%) are eligible for weight loss surgery according to NICE guidelines (as a BMI of >35 and type 2 diabetes diagnosis is needed) and less than 1% of eligible people ever actually access bariatric surgery on the NHS.

European Guidance formally recognised ESG as an appropriate procedure for patients with a BMI of 30+. This is why many obesity patients, particularly those with a BMI less than 35, seek treatment privately.

A recent study (the MERIT study) found the ESG procedure to be five times more effective than lifestyle changes alone. It tracked the obesity outcomes of patients who received a diet, fitness and lifestyle programme alone and those who received the programme and ESG.  Those who had the ESG procedure lost 49% of their body weight on average vs. just 4% in the control group. ESG patients also demonstrated improvements in diabetes, hypertension, non-alcoholic fatty liver disease (NAFLD) and metabolic syndrome compared to controls, as well as improvement in gastroesophageal reflux disease (GORD).

Patient Testimonial

After having a hysterectomy and going into surgical menopause, Sue was determined to be ‘fit at fifty’. She was recently married, but had no confidence and was frustrated with her appearance. “I like my food and I did like a drink, but overall I was quite healthy. I ate well most of the time, I exercised regularly, I saw a PT and did high intensity exercise like weight lifting. I didn’t have any health issues, but I was significantly overweight for my height. Even looking at my wedding pictures upset me as I didn’t like the way I looked and I wouldn’t put on a swimming costume ever.”

Sue was just over 5ft and weighed 13 ½ stone putting her BMI at 36. She was fit and had no health issues, but had seen her GP many times about ways to manage her weight. She tried prescription weight loss medication, mail order slimming supplements and even went to a private doctor for £200 a month slimming injections: “The drugs work a bit while you’re on them, but there are always side effects and they didn’t give me permanent or significant weight loss. I blamed the menopause, but I was the one putting the food in my mouth. I started to think about weight loss surgery. I had a gut feeling that I didn’t want a body part cut off and taken away like in gastric bypass surgery. I came across a newer and safer technique called ESG – Endoscopic Sleeve Gastroscopy.”

ESG is a minimally invasive alternative to gastric surgery. Performed via a ‘camera down the throat’ technique means no incisions (or scars) on the abdomen and the stomach isn’t cut off or taken away. Instead a special device sews a line of stitches across the middle of the stomach, reducing its volume. “The doctor was very frank with me, he said that I had to do the work. If I continued to overeat then the stitches would stretch and I could find myself undoing any weight loss. I knew I had to commit to overhaul my lifestyle.”

Sue paid £10,000 to have the surgery privately. Having no health issues, like diabetes, meant she would be highly unlikely to meet NHS criteria. “The procedure was very simple. I went to the hospital (the Cleveland Clinic in London) in the morning, went down for anaesthesia and woke up an hour or so later. I had no marks or scarring on my body, just an IV drip in for the rest of the day. The recovery is very easy. I went home the next day which was a Thursday and I had the Friday off; I was back at work Monday morning.”

Sue noticed a difference in her clothes feeling too loose after just 4 weeks. The reduced size of her stomach meant she felt satisfied and full after small meals. “It forces you to eat smaller portions and your brain gets the message your full. You could ignore it and keep eating what tastes good, but you would feel uncomfortable so you don’t. I still had treats, but it would be one biscuit to get the taste, not four.”

Sue lost a stone easily in the first 8 weeks and remembered asking her doctor if she could break the no alcohol guidance. “Have a glass of champagne? You can have a bottle,” he had joked as he couldn’t believe how different I looked at my check up.

Studies have shown that the average gastric procedure patient loses 15% of their body weight over 6 months, but just 12 weeks after the procedure and Sue has already lost 20% of her body weight, quickly slimming down to 11 stone: “I was a size 18 in most shops, so I was thrilled to wear a size 12 Karen Millen dress to a wedding. It’s such a nice feeling to be able to go in any High Street shop and find clothes in my size that look good on me. My skin feels great and have more energy. I don’t feel sluggish anymore, I’ve changed my life

Sue’s BMI is currently 28 and she will only need to lose 7 more pounds for her BMI to be 25, which at over 50 years old is pretty incredible. “I’ve decided that to help me stay focused on the last leg of my weight loss journey, I am planning to renew my wedding vows on our holiday to Tanzania next year. I’ll be having a photo shoot on the day and replacing my wedding day picture as soon as I get home!”

Sue had the ESG procedure with Dr Rehan Haidry at the Cleveland Clinic, London

Susan Pye, 51, Wiltshire, Engineer

Before and After

After

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