Endoscopic Sleeve Gastroplasty

Endoscopic Sleeve Gastroplasty, also referred to as ESG, is a durable and minimally invasive weight loss option. This innovative procedure uses an endoscope inserted through the mouth to reduce the size of the stomach, to promote weight loss without any external incisions.

Benefits of Endoscopic Sleeve Gastroplasty

To perform the Endoscopic Sleeve Gastroplasty, our doctors insert an endoscope, which is a flexible tube with a camera attached, into the mouth down into the stomach. We then use an endoscopic suturing device to reduce the size of the stomach. When the stomach is smaller, there is less capacity for food allowing for the patient to feel fuller while consuming less. The patient will lose weight as less calories are consumed.

  • On average, patients reduce excess body weight by over 50% in one year*
  • May help improve comorbid conditions such as Type 2 Diabetes, sleep apnea, hypertension, high cholesterol, and joint pain
  • Quicker recovery, patients resume normal activities the next day
  • Involves no external sutures and no external scarring
  • Less postoperative pain, indicates reduced need for painkillers compared to traditional surgical weight loss procedures

How Does ESG Work?

Endoscopic Sleeve Gastroplasty is similar to a traditional gastric sleeve surgery because it reduces the stomach size to restrict the amount of food a patient can eat. However, unlike a surgical sleeve procedure, the Endoscopic Sleeve Gastroplasty is performed without any incisions and part of the stomach is not removed. This incision-less procedure is considered a “durable” (rather than permanent) procedure. Sutures can break or pull through the tissue due to overeating, vomiting or gastric motility.


Endoscopic Sleeve Gastroplasty or ESG

The endoscopic sleeve gastroplasty, also known as the ESG, is an effective and minimally invasive weight loss option.

Dr. Yu Explains ESG Procedure

In this short video, Dr. Sherman Yu discusses the Endoscopic Sleeve Gastroplasty, or ESG.

Dr. Sherman Yu Featured on ABC13 to Discuss ESG

Dr. Yu joins Cynthia Cisneros on Saturday Extra to discuss non-invasive Endoscopic Sleeve Gastroplasty.

From the Operating Room - Dr. Yu & The ESG

Dr. Yu talks about the Endoscopic Sleeve Gastroplasty in the operating room.

Investing in Endoscopic Sleeve Gastroplasty

When you invest in the Endoscopic Sleeve Gastroplasty, you’re investing in yourself. The Endoscopic Gastric Sleeve procedure can be financed with payments as low as $279 per month.

While the endoscopic gastric sleeve is not covered by insurance, we partner with a variety of medical financing lenders that specialize in competitive interest rates and fast approvals. Apply for financing via phone or online with one of our participating lenders.

*Price is subject to change. Monthly payment is based on purchase price alone, excluding taxes and interest. Patients must qualify via an approved independent medical lender. Loan offers are given by independent lenders based on approved credit and not everyone will qualify.

Self Pay Package

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*Estimated monthly payment for those who qualify. Pricing is subject to change.

Am I a Candidate for Endoscopic Sleeve Gastroplasty?

If you have struggled to lose weight through diet and exercise, and you are seeking a non-surgical option to lose a significant amount of weight, you might be a candidate for the Endoscopic Sleeve Gastroplasty (ESG). During a consultation, our experienced surgeons will discuss your weight loss goals and evaluate your health to determine the best option for you.

Traveling to Houston for Endoscopic Sleeve Gastroplasty

We welcome patients from across the country, many who visit us for the Endoscopic Sleeve Gastroplasty. Our team is dedicated to helping each patient find weight loss success and our board certified bariatric surgeons Dr. Yu and Dr. Scarborough have performed more than 7,000 bariatric procedures.

Endoscopic Sleeve Gastroplasty is an ideal bariatric procedure for traveling patients because our surgeons are experienced in performing ESG and it has a short recovery time compared to other surgical weight loss procedures. ESG is a non-surgical procedure that uses an endoscopic suturing device to reduce the size of the stomach and helps patients lose weight by reducing the amount of food they consume. Patients may resume regular activities and routines within 24 to 48 hours, making it possible to complete the procedure and recovery in less than one week.*

After ESG: Keep the Weight Off

ESG is a tool for weight loss and part of a complete lifestyle change needed to maintain long term weight loss. While the procedure can successfully help patients lose weight, additional positive lifestyle changes need to be made in order to develop healthy habits. Our experienced surgeons and staff provide support to make your new lifestyle an empowering journey!

Healthy Lifestyle Changes That Help Promote and Maintain Weight Loss

  • MEAL PLANNING Our experienced dietitians provide meal plans for post-procedure patients and share healthy recipes to help you stay on track.
  • EXERCISE Find a fitness routine you enjoy and can commit to doing consistently.
  • SUPPORT Attend support groups to stay motivated.
  • STAY INSPIRED Connect with us on Instagram as a resource for inspiration, healthy recipes, and weight loss tips. Remember we are always here for you! Call us to schedule an appointment with one of our doctors if your weight loss stalls.

Pre-Surgery: Liquid Diet

1 Week Before Surgery


Protein Supplements (3 to 5 servings daily, 60-150 grams of protein daily)
Choose supplements with >20g of protein, <10 grams of fat, <10 grams of sugar, <250 calories per serving

  • Ready to Drink options: Premier Protein, Muscle Milk, Unjury, Iconic
  • Protein Powder options (mixed with ice, water/low fat milk/unsweetened nut milk, no fruit/vegetables): Bariatric Advantage High Protein Meal Replacement, Isopure, Orgain
  • Avoid: smoothies, food

Clear Liquids (+64oz daily)
Choose products with <50calories, <10g sugar per 8oz serving

  • Water with lemon, Crystal Light, G2/GZero, Proper, MiO
  • Decaf tea/coffee, herbal tea with sugar substitute
  • Sugar free gelatin/ice pops
  • Broth (store bought, homemade)
  • Avoid: any carbonated beverages, fruit/vegetable juice, soup

Post-Surgery Diet

Day 1-2 
+48-64oz Clear Liquids

  • Sip on clear liquids (same clear liquid options as pre-op): Crystal Light, G2, GZero, Mio, sugar free gelatin/ice pops, broth
  • Do not drink: carbonated beverages, caffeine, protein shakes
  • Avoid: drinking through straws, vitamins and do not eat any food.

Day 3-14 (2 weeks)
Full/Thick Liquids

  • Start slowly taking Bariatric vitamins
  • +48-64oz clear liquids
  • +40-60 grams of protein from 1-3 Protein Supplements (Ready to Drink, or protein shakes made with protein powder and water/low fat milk/unsweetened nut milk)
  • Smooth (strained) and thick, low fat soups (no rice/noodles, meats, vegetable pieces)
  • Smooth, low fat, low sugar Greek yogurt
  • Smooth, sugar free pudding

Day 15-28 (weeks 3 and 4)
Pureed Foods

  • +48-64oz clear liquids
  • +40-60 grams of protein from 1 – 3 servings of Protein Supplements (Ready to Drink, or protein shakes made with protein powder and water/low fat milk/unsweetened nut milk)
  • Protein foods: Mashed scrambled eggs, mashed white fish/tuna, finely minced ground turkey, cottage cheese
  • High fiber foods: Mashed beans, mashed fruits (bananas, raspberries, pears, etc), mashed vegetables (carrots, peas, cauliflower, avocado, etc.)
  • Plain, instant hot cereals

Weeks 5 and 6
Chopped Soft Solid Foods

  • +48-64oz clear liquids
  • +40-60 grams of protein from 1 – 3 servings of Protein Supplements (Ready to Drink, or protein shakes made with protein powder and water/low fat milk/unsweetened nut milk)
  • Protein foods: soft, tender meats (skinless, dark meat chicken, pot roast/roast beef, baked fish), eggs, low fat cheese, low fat deli slices
  • High fiber foods: beans, soft cooked vegetables, peeled fruits, high fiber crackers/breakfast cereals
  • Avoid bread, pasta, rice and tortillas for 6 months after surgery.

Week 7 and beyond
Chopped Solid Foods (Maintenance Phase)

  • +48-64oz clear liquids
  • +60-80 grams of protein from 1 – 3 servings of Protein Supplements (Ready to Drink, or protein shakes made with protein powder and water/low fat milk/unsweetened nut milk)
  • Protein foods: chopped meats, eggs, low fat cheese, deli meats
  • High fiber foods: beans, chopped and shredded raw/cooked vegetables, chopped fruits with skin-on, high fiber crackers/breakfast cereals

Am I a Candidate?

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1 Clinical Gastroenterology and Hepatology January 2017 Volume 15, Issue 1, Pages 37–43.e1

*Individual Results May Vary

The TLC Surgery Doctors have either authored or reviewed and approved this content.

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