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Endoscopic Sleeve Gastroplasty (Accordion)

Endoscopic Sleeve Gastroplasty (Accordion)

Endoscopic sleeve gastroplasty (ESG), also called the accordion procedure, is a relatively new weight loss procedure that reduces the size of your stomach. The procedure uses an endoscopic suturing device, with no need for surgery. Endoscopic sleeve gastroplasty may be an option for people who are obese and have not been able to lose weight through diet and exercise. However, the long-term success also depends on your commitment to living a healthier lifestyle.

At The Institute of Gastroenterology at Sheba Medical Center in Israel, multidisciplinary experts will assess your suitability for endoscopic sleeve gastroplasty. If you are a qualified candidate, we will perform this procedure with state-of-the-art equipment and provide comprehensive follow-up care.


How does Endoscopic Sleeve Gastroplasty work?

Before the procedure:

Once our team determines that you qualify for endoscopic sleeve gastroplasty, we will instruct you on how to prepare for the procedure. You may require various exams and tests before the surgery, and you may need to start an exercise program, follow certain diet restrictions and/or stop taking certain medication.

During the procedure:

1. ESG is performed in the hospital under general anesthesia.
2. Your doctor will insert an endoscope – a flexible tube with a camera and an attached suturing device – down your throat and into the stomach. The miniature camera provides the doctor with a view of the inside of your stomach, thereby eliminating the need to make any incisions in your abdomen.
3. The doctor will use the endoscope to place approximately 12 sutures in your stomach. These sutures alter the shape of your stomach so that it becomes tube-shaped. As a result, the amount of food that you can ingest and the amount of calories that your body absorbs are both restricted.
4. The entire procedure takes approximately an hour and a half.

After the procedure:

  • You will not be permitted to eat for eight hours
  • Once you are allowed to eat, you will need to follow a liquid diet for the first week
  • About two weeks after the ESG, you will be able to eat semi-solid foods, and then progress to following a normal, healthy diet

What does ESG treat?

Endoscopic sleeve gastroplasty can lead to significant weight loss and can be an effective tool for treating obesity.

What are the possible side effects?

As a minimally invasive procedure, endoscopic sleeve gastroplasty has a lower risk of operative complications than other weight loss surgeries. Some patients have reported pain and nausea that last for a few days after the procedure.

Who is a candidate for this therapy?

Usually, endoscopic sleeve gastroplasty is done only after you’ve tried to lose weight through diet and exercise, but have not been successful with long-term weight loss.

To qualify for endoscopic sleeve gastroplasty, you need to:

  • Have a body mass index (BMI) of 35-40, tried conventional diet treatment and failed;
  • Have a BMI of 30-35 with an obesity-related comorbidity, tried conservative treatment and failed;
  • Be willing to participate in a medically supervised weight loss program and make permanent changes to your lifestyle;
  • Be 18 years of age or older.

Meet The Team

Shomron Ben-Horin
Prof. Shomron Ben-Horin
Director of the Institute of Gastroenterology
Prof. Ben-Horin specializes in gastroenterology, he has published over 200 original articles, books, and chapters in medical literature. Prof. Ben-Horin is a full professor at the Sackler of Medicine, Tel- Aviv University, a member of the Scientific Scientific Council of the Crohn’s and Colitis Association (ECCO), and also chair of the Department of Inflammatory Bowel Diseases of the Israeli Gastrointestinal Association, Associate Professor, First Hospital of Sun-Yitsan University, Guangzhou, China.
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Sheba Medical Center provides innovative, personalized medical care to patients from around the world. We are the largest, most comprehensive hospital in the Middle East and dedicated to providing advanced and compassionate medicine for everyone.

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