Lebanon (961) 76 377 376 | info@advancedbmi.com

Endoscopic Sleeve Gastroplasty

Endoscopic sleeve gastroplasty is a relatively new weight-loss method that reduces the size of the stomach.

This procedure reduces the stomach size by the use of an endoscopic stitching device. Endoscopic sleeve gastroplasty is also less-invasive because there is no need for surgery. This weight-loss procedure may be an option for people who are significantly overweight and have not been successful in losing weight through dieting and exercising. Anyone with a BMI of 30 or more is usually considered as being “significantly overweight”.

Endoscopic sleeve gastroplasty is considered very effective and it usually leads to extensive weight-loss. It helps one lose weight because after the size of the stomach is reduced, the amount of food one can eat is also limited. One major advantage of this procedure is that it does not involve surgery. This means that the risk of complications is also reduced.

However, like with all other weight-loss procedures, endoscopic sleeve gastroplasty is not a “magic solution” or a “quick fix” to lose weight. For this procedure to be effective, you must adopt and commit to a total lifestyle change. In order to ensure the long-term effectiveness of endoscopic sleeve gastroplasty, you will need to adopt a healthier diet and exercise regularly after the procedure.

Why is it done?
Obesity and excess weight are linked to serious health issues that include: high blood pressure, type 2 diabetes, stroke, heart disease, sleep apnea and gastroesophageal reflux disease.

Even with a strict diet and exercise, some people are still not able to lose weight successfully. Endoscopic sleeve gastroplasty is a procedure that is performed to help people suffering from overweight or obesity to lose the excess weight and potentially reduce the risk of developing serious health problems that are linked to excess weight.

All weight-loss procedures including the endoscopic sleeve gastroplasty are performed after the patient has tried to lose weight using diet and exercise without success. Compared to bariatric surgery or other weight loss procedures; endoscopic sleeve gastroplasty is less invasive because it does not involve surgery; the risk of operative complications is also significantly reduced.

Who is it for?

Normally, endoscopic sleeve gastroplasty is a weight-loss option for overweight or obese people who are not considered candidates for other bariatric procedures or surgery. This is an option for people who have tried other weight-loss methods like combining dieting and exercise but have not been successful either in achieving significant weight loss or maintaining the weight loss.

However; not everyone who is overweight is considered a candidate for an endoscopic sleeve gastroplasty. Dr Safa usually perform a screening process to determine whether or not this procedure can be suitable for you. One must also commit to maintaining a healthy diet, exercising regularly, regular medical follow-ups and behavioral therapy participations.

Endoscopic Sleeve Gastroplasty is basically inappropriate for anyone who has had a prior stomach surgery, a hiatal hernia that is larger than 3 centimeters or a gastrointestinal bleeding. An endoscopic sleeve gastroplasty procedure may also not be covered by your health insurance because it Is still considered to be a fairly new procedure.

What are the Risks?

Early studies on endoscopic sleeve gastroplasty have shown a favorable safety profile and most people usually feel better in about two days. Some people can develop some pain and/or nausea a few days after an endoscopic sleeve gastroplasty procedure. However; these symptoms are usually not severe and can be managed using nausea and pain medications.

While this procedure is not designed to be a temporary solution; it usually can be reversed. In some cases; endoscopic sleeve gastroplasty can also be converted to bariatric or weight-loss surgery.

Given that endoscopic sleeve gastroplasty is still a new procedure that is not in wide use, there are still questions regarding its risks and its long-term effectiveness.

What can you expect?

While endoscopic sleeve gastroplasty is done as an outpatient procedure in the endoscopy unit; it requires general anesthesia. This means that you will be unconscious during the procedure. However, this procedure is usually performed in about 90 minutes.

To perform this procedure, Dr Safa will use an endoscope, which is a flexible tube which is attached to an endoscopic stitching device and a camera. Dr Safa will insert the endoscope into the stomach through your throat. The tiny camera attached to the endoscope allows Dr Safa and the endoscopist to see inside the stomach and operate without making any incisions on your abdomen.

Dr Safa uses the endoscope to make about 12 stitches in the stomach, changing the structure of your stomach. After the procedure, the stomach will be shaped like a tube which limits the amount of food you can take at one time. This also reduces your calorie intake.

Once the procedure has been performed, you will wake up from sedation in a recovery room where Dr Safa team will monitor you and ensure that there are no complications. Most people are usually discharged on the same day, once the anesthesia wears off. Other people may remain in the hospital for a few hours or overnight, to be observed after the procedure.


Dr Nagi Safa Interview

How can you prepare?

After you have been screened and considered to be eligible for an endoscopic sleeve gastroplasty, Dr Safa will provide you specific instructions regarding your preparation for the procedure. Usually, you will be required to undergo various lab tests before the procedure is performed. You may also be given restrictions on what you can drink or eat and which medications you can take. Dr Safa may also require that you begin exercising.

Basically, recovering from an endoscopic sleeve gastroplasty procedure usually takes one or two days. It is important to plan for recovery and ensure that you have enough days off, or someone to help you at home.

After an Endoscopic Sleeve Gastroplasty

Basically, you will not be allowed to eat or drink for some hours, after which our nutritionist will recommend a diet that is tailored for you. You will usually be started on a liquid diet for about two weeks, after which you will be put on semi-solid food and then proceed to eating regular food. In about a month, you will have transitioned to a regular diet.

After an endoscopic sleeve gastroplasty; you will be required to show up for frequent follow-ups on your procedure, with both a nutritionist and a psychologist.


After an endoscopic sleeve gastroplasty, you may achieve significant weight loss. However; the amount of weight loss achieved after the procedure usually depends on your commitment to changing your lifestyle habits. Adopting a strict diet and regular exercising regularly and consistently is very important in ensuring that the procedure is effective over the long-term.

Even so, studies on the effectiveness of endoscopic sleeve gastroplasty have shown impressive results. A recent study which involved a group of people with an average body mass index of around 38 found that after six months, an average weight loss of 17 kilograms was achieved. After 12 months, the weight loss achieved was about 19 Kilograms on average.

In another study involving people with an average Body Mass Index of 45; endoscopic sleeve gastroplasty resulted in an average weight loss of 33 Kilograms within the first six months.

Like other weight loss procedures and surgeries used to achieve significant weight loss, an endoscopic sleeve gastroplasty can potentially improve health conditions that are usually linked to excess weight or obesity. Examples of such conditions include:

  • High blood pressure
  • Heart Disease
  • Stroke
  • Gastroesophageal reflux disease
  • Type 2 diabetes
  • Severe sleep apnea
When weight-loss Surgery Isn’t Effective

Some people fail to lose enough weight or even lose weight and regain the weight lost after any type of bariatric procedure or surgery even if the weight loss procedure itself was performed perfectly and works as it should. The lack of significant weight loss or weight regain can and will usually occur when one does not follow the lifestyle changes recommended by the doctor, nutritionist and psychologist.

To ensure that you lose enough weight and maintain the weight loss after an endoscopic sleeve gastroplasty, you must commit to a permanent lifestyle change that includes following the recommended diet and exercising regularly and consistently.

If you are candidate for Weight Loss Surgery, and wish to know which surgery is best for you, fill out the Patient Questionnaire, and our team will help you decide.

Check this to compare the four main types of weight loss surgery.