Difference between gastric sleeve and endoscopic sleeve gastroplasty
Gastric sleeve surgery and endoscopic sleeve gastroplasty are both weight loss procedures, but they differ in terms of their invasiveness, procedure methods, and long-term effects. Here’s a comparison between the two:
- Gastric Sleeve Surgery (Sleeve Gastrectomy): This is a surgical procedure that involves removing a large portion of the stomach to create a smaller, sleeve-shaped stomach. It’s a major surgery that typically requires a hospital stay and is performed using minimally invasive techniques (laparoscopy).
- Endoscopic Sleeve Gastroplasty (ESG): ESG is a less invasive procedure that doesn’t require any incisions. It’s performed using an endoscope (a flexible tube with a camera) that is inserted through the mouth and into the stomach to place sutures or staples to create a smaller stomach volume.
- Procedure Method:
- Gastric Sleeve Surgery: The surgeon removes a significant portion of the stomach, leaving a sleeve-like tube. This reduces the stomach’s capacity, leading to earlier feelings of fullness and reduced food intake.
- Endoscopic Sleeve Gastroplasty: Sutures or staples are placed in the stomach to create pleats, effectively reducing the stomach’s capacity without removing any part of it. This results in similar effects as a gastric sleeve but without surgical removal of tissue.
- Recovery and Hospital Stay:
- Gastric Sleeve Surgery: Recovery time is generally longer, and patients may need to stay in the hospital for a few days.
- Endoscopic Sleeve Gastroplasty: Since it’s a less invasive procedure, the recovery time is usually shorter, and many patients can go home on the same day or the day after the procedure.
- Long-Term Effects:
- Gastric Sleeve Surgery: This surgery has a well-established track record for producing significant weight loss and improvement in weight-related health issues. It’s considered a more permanent alteration to the stomach’s anatomy.
- Endoscopic Sleeve Gastroplasty: ESG is a relatively newer procedure, and its long-term effects may not be as extensively studied. Some studies suggest that it can lead to significant weight loss and improvements in metabolic health, but the durability of these effects over the long term is still being researched.
- Risks and Complications:
- Both procedures carry risks associated with any medical intervention, including infection, bleeding, and adverse reactions to anesthesia.
- Gastric sleeve surgery involves the additional risks associated with major surgery, such as leaks at the staple line, vitamin and nutrient deficiencies, and potential long-term complications related to altered digestion.
- Endoscopic sleeve gastroplasty is less invasive, but there can be risks associated with the sutures or staples, such as migration or erosion.
- Eligibility for both procedures depends on factors such as body mass index (BMI), overall health, and previous weight loss attempts.
- ESG might be considered for individuals with a lower BMI who don’t qualify for more invasive surgeries.
It’s essential to consult with a medical professional to determine which procedure is best suited for an individual’s specific situation, taking into account factors such as health status, medical history, and weight loss goals.
Gastric sleeve surgery
A gastric sleeve, also known as sleeve gastrectomy, is a surgical procedure for weight loss and obesity management. It involves the removal of a large portion of the stomach, leaving behind a smaller, sleeve-shaped stomach that resembles a banana or sleeve.
During the surgery, a surgeon removes approximately 75-85% of the stomach, which significantly reduces its capacity to hold food. This leads to a reduced intake of food, a feeling of fullness with smaller meals, and a decrease in appetite due to hormonal changes in the body.
The gastric sleeve procedure helps with weight loss in several ways:
- Reduced Stomach Size: With a smaller stomach, patients feel full more quickly, leading to a decrease in food intake.
- Ghrelin Hormone Regulation: The part of the stomach that produces the hunger-stimulating hormone ghrelin is typically removed during the surgery. This can help reduce feelings of hunger and increase satiety.
- Restriction: Unlike gastric bypass surgery, which involves rerouting the digestive tract, the gastric sleeve procedure only involves reshaping the stomach. There is no malabsorption of nutrients, but the restriction on food intake helps patients consume fewer calories.
- Long-Term Weight Loss: The procedure can lead to significant weight loss and may improve or resolve obesity-related health conditions such as type 2 diabetes, hypertension, and sleep apnea.
- Lifestyle Changes: While the surgery provides a tool for weight loss, patients still need to make long-term changes to their diet and exercise habits to achieve and maintain successful weight loss.
It’s important to note that the gastric sleeve procedure is a major surgery and should be considered carefully. Candidates for this surgery typically have a body mass index (BMI) of 40 or higher, or a BMI of 35-39.9 with significant obesity-related health issues. The decision to undergo the surgery should be made in consultation with a healthcare provider after a thorough evaluation of the individual’s medical history, current health status, and lifestyle factors.
Endoscopic sleeve gastroplasty
Endoscopic sleeve gastroplasty (ESG) is a minimally invasive weight loss procedure that aims to reduce the size of the stomach using an endoscope, a flexible tube with a camera and other instruments attached to it. This procedure is also known as the “accordion procedure” because it involves creating folds or sutures within the stomach to reduce its volume, similar to how an accordion folds and unfolds.
ESG is typically performed on individuals who are overweight or have obesity and have not achieved successful weight loss through diet and exercise alone. It is considered an alternative to more invasive weight loss surgeries like gastric bypass or sleeve gastrectomy.
Here’s how the ESG procedure generally works:
- Preparation: Before the procedure, patients undergo a thorough evaluation, including medical history, physical examination, and possibly diagnostic tests. They may also receive counseling on lifestyle changes and dietary modifications.
- Procedure: During the ESG procedure, the patient is placed under sedation. The endoscope is inserted through the mouth and into the stomach. The endoscope allows the surgeon to visualize the inside of the stomach and perform the necessary steps to reduce its size.
- Creating Folds: The surgeon uses specialized instruments attached to the endoscope to create folds in the stomach tissue. These folds are created by placing sutures or stitches along the length of the stomach. The placement and tightness of these sutures determine the degree of reduction in stomach volume.
- Closure: Once the desired reduction in stomach size is achieved, the sutures are tightened and secured to hold the folds in place. This effectively restricts the stomach’s capacity, leading to earlier feelings of fullness and reduced food intake.
- Recovery: ESG is minimally invasive, so the recovery time is generally shorter compared to traditional surgical procedures. Patients usually go home on the same day as the procedure. However, there may be some post-procedure discomfort, and a specific diet plan is often recommended to facilitate healing and gradual reintroduction of foods.
- Long-Term Outcomes: The goal of ESG is to promote weight loss by limiting the amount of food a person can consume. Over time, as the stomach adjusts to its reduced size, individuals may experience weight loss. The degree of weight loss varies from person to person and is influenced by factors such as dietary habits, exercise, and overall commitment to lifestyle changes.
It’s important to note that while ESG is generally considered safer and less invasive than traditional bariatric surgery, it might not provide the same level of weight loss or long-term results. As with any medical procedure, there are potential risks and complications, including infection, bleeding, and unintended changes in stomach function.
If you’re considering undergoing ESG or any other weight loss procedure, it’s crucial to have a thorough discussion with your healthcare provider to determine the most appropriate option for your specific needs and medical history.