Endoscopic Sleeve Gastroplasty (ESG)

GI Surgical Specialists is Southwest Florida’s first practice to offer an Endoscopic Bariatric program. Our highly specialized surgeons perform endoscopic primary (ESG, Gastric Balloon) and revisional (TORe) bariatric procedures


“I decided to research weight loss procedures and became interested in the Endoscopic Sleeve Gastroplasty (ESG). With only a couple days of recovery time, no incisions and the risks for complications being low, versus other procedures, I knew this was the procedure for me. In my case ZERO pain the day after the ESG. By day two I was back to normal routine at home.

Thankful I decided to visit Dr. Siegal and the team at GI surgical specialist. The overall experience was very pleasant. Highly recommend the Endoscopic Sleeve Gastroplasty with Dr. Siegal”


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Endoscopic Sleeve Gastroplasty (ESG) is a purely endoscopic procedure with no incisions or stomach stapling that reconstructs your stomach into a smaller chamber. ESG can shrink the stomach size by 70-80% and patients can expect to lose between 15-20% of their total body weight. It is an outpatient procedure that offers significant weight loss results with lower risks of complications and shorter recovery time. A large study was able to demonstrate excellent weight loss and resolution of medical comorbidities.

Endoscopic Sleeve Gastroplasty (ESG)

The recovery time after ESG is shorter than for bariatric surgical procedures so patients can return to their normal routine much faster. You can be back to your normal routine in a matter of a few days after the procedure.

How Is ESG Performed?

ESG is performed using an endoscope placed through the mouth that works in conjunction with a suturing device.  The large portion of the stomach is sutured, or plicated, creating a much smaller chamber for food to be stored (see image above). This makes patients feel full faster and slows down gastric motility.

Who Is ESG For?

The ESG procedure is performed on patients looking to kick-start their weight loss journey. Generally, this procedure can be done on patients with a BMI ranging from 27-50. Dietary changes and lifestyle modifications will need to be made in order for sustained weight loss in the long term.  This procedure can often be “adjusted” in the long term to re-instill the feeling of restriction that the patient felt immediately following their initial procedure if needed.

Is ESG covered by Insurance?

ESG is a newly FDA-approved procedure. New procedures are rarely embraced quickly by insurance companies, but Medicare has created a code that may allow it to be reimbursed in the near future. For now, it is a self-pay procedure.  Come talk to us about kickstarting your weight loss with a non-surgical procedure!

ESG Diet and Vitamin Instructions

ESG Diet Book

ESG Diet Book (Spanish)

ESG nutrition

Bariatric Vitamins

Multivitamin Comparison Chart