Surgery

Intragastric Balloon & Endoscopic Sleeve Gastroplasty (ESG)

Why It’s Done (Indications) 

Non-surgical obesity management for individuals with a high BMI who haven't achieved target weight loss through diet and exercise alone, or who wish to avoid long-term injections of medications or traditional weight-loss surgery.

How to Prepare (Preparations)

• Medications: Inform your doctor about any blood thinners or diabetes medications, as they may need temporary adjustment.
• Comprehensive nutritional assessment and a clear liquid diet for 1–2 days before the procedure.
• Fasting overnight.

What Happens (Procedural Details)

• Intragastric Balloon: Under mild sedation, an uninflated soft silicone balloon is passed through the mouth into the stomach via an endoscope. Once inside, it is filled with sterile saline (about 500-700 mL), filling up stomach space to promote feeling full earlier.
• Endoscopic Sleeve Gastroplasty (ESG): Performed under general anesthesia. A specialized endoscopic stitching device is guided down the throat. The doctor places full-thickness sutures along the stomach wall, folding it inward to reduce stomach capacity by roughly 70% into a narrow tube shape.
   

Recovery (Postoperative Care)

• Nausea, vomiting, and stomach cramping are common during the first 3–5 days as the stomach adapts.
• Gradual dietary progression: need to have close collaboration with dietician, fluid diet for a month, progressing to pureed foods, soft solids, and eventually normal healthy portions.
• Intragastric balloons are removed endoscopically after 6 to 9 months.
   

Risks (Potential Complications)

• Severe vomiting on the 1st week after balloon placement (common).
• Early balloon deflation or bowel obstruction (rare).
• Bleeding, or suture breakdown (for ESG).