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Endoscopic Sleeve Gastroplasty (Accordion) Procedure

Endoscopic sleeve gastroplasty, also known as the accordian procedure, is a weight loss procedure that uses an endoscopic suturing device to reduce the size of your stomach. The procedure recreates what would occur at a surgical sleeve gastrectomy though without the need for surgery. This procedure is ideal for those with a body mass index of 30 or more and for those where diet and exercise alone have not worked. Because the procedure is minimally invasive, there is a reduced risk of complications. Like other weight loss programs, however, a commitment to a healthier lifestyle will help to ensure long-term success and permanent weight loss.

In addition to weight loss, endoscopic sleeve gastroplasty can also lower your blood sugar and potentially address other serious weight-related problems.

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How It's Performed

Vivek Kumbhari, director of bariatric endoscopy for Johns Hopkins, answers questions about the endoscopic sleeve gastroplasty procedure, including what it involves and how it is different from weight loss surgery.

View more videos about our other non-surgical weight loss services.

What to Expect:

Endoscopic sleeve gastroplasty (ESG) is performed in the hospital under general anesthesia. Before your procedure, you will need to follow specific preparation instructions, which you will discuss with your doctor in advance.

During ESG:

  • The procedure is done using an endoscope, a flexible tube with a camera and an endoscopic suturing device attached, and it will be inserted down your throat into the stomach.
  • The tiny camera allows the doctor operating the endoscope to see and operate inside your stomach without making incisions in your abdomen.
  • Using the endoscope, the doctor places approximately 12 sutures in the stomach. The sutures change the structure of your stomach, leaving it shaped like a tube. This restricts the amount of calories your body absorbs and the amount of food you can eat.

The accordian procedure takes approximately 90 minutes, and the majority of patients go home the same day. Some patients might require a short admission to the hospital for a day or less for observation after the procedure.

After ESG:

  • You will not be allowed to eat for eight hours.
  • After the initial eight hours, you will be allowed to start a liquid diet, which you will continue for one week.
  • Approximately two weeks after the procedure, you will move on to semisolid foods, and then to a normal, healthy diet.

To qualify for the endoscopic sleeve gastroplasty procedure, you should:

  • Be 18 or older
  • Have a body mass index (BMI) of 30 or higher
  • Be willing to participate in a medically supervised weight loss program

To learn more or to schedule a consultation, call 410-583-LOSE (5673).