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Banner Wyoming Medical Center first in state to offer non-surgical Endoscopic Sleeve Gastroplasty (ESG) for weight loss

By Kristy Bleizeffer 1 week ago

Banner Wyoming Medical Center is the first in the state to offer Endoscopic Sleeve Gastroplasty, a non-surgical procedure for people who need to lose a significant amount of weight, but who don’t qualify for weight-loss surgery.

This outpatient procedure is performed endoscopically, with small, tubular instruments inserted down the throat and into the stomach. Patients typically go home on the same day of the procedure. No surgical incisions are required.

Julien Fahed, M.D., is a board-certified gastroenterologist specializing in advanced bariatric endoscopic procedures. He worked for more than a year to expand the bariatric program at WMC by offering new nonsurgical weight loss procedures including Gastric Balloon, Endoscopic Sleeve Gastroplasty, and others. Ours is the state’s only accredited bariatric center.

Below, Dr. Fahed answers common questions about ESG.

What Is Endoscopic Sleeve Gastroplasty (ESG)?

This is a relatively new procedure that has been gaining rapid popularity in the U.S. and worldwide. It is most known as ESG or Endosleeve. As the name suggests, it’s a procedure where a sleeve shaped stomach is created using an endoscope inserted down the throat. The goal is to make the stomach smaller and hence induce weight loss.

How Does Endoscopic Sleeve Gastroplasty (ESG) Compare To Laparoscopic Sleeve Gastrectomy (LSG)?

It’s important to mention here that the new ESG procedure is different from the well known gastric sleeve surgery or LSG. Both procedures share a lot of similarities such as trying to create a small sleeve shaped stomach however, there are few differences. The main one being the technique used. ESG is performed by introducing a single scope down the throat while LSG is performed by making a few small incisions in the abdomen.

Who Is A Good Candidate For ESG?

The ideal candidate for the ESG procedure is a patient with a Body Mass Index (BMI) of 30 to 40 where diet and exercise have been tried and failed. Other patients can still qualify for the ESG procedure on a case-by-case basis.

The U.S. Centers for Disease Control provide the following table regarding the standard BMI categories for adults. Determine your BMI using the CDC’s Body Mass Index Calculator.

  • Below 18.5 = Underweight
  • 18.5 – 24.9 = Normal
  • 25.0 – 29.9 = Overweight
  • 30.0 and Above = Obese

What Are The Health Benefits?

The C.D.C. defines obesity as someone with a B.M.I. of 30 or more. Obesity can put patients at risk for all sorts of different diseases including arthritis (sometimes requiring joint replacement), hypertension, diabetes, heart attacks, strokes, depression, anxiety, sleep apnea, cirrhosis, cancer and others.

The goal of non-surgical weight-loss procedures like ESG is to promote weight loss and gain health benefits 5 to 10 years down the road. If you are someone who has pre-diabetes or pre-hypertension, tools like this give you a chance to delay and maybe prevent those diseases from developing.

What Are The Risks Of ESG?

Just like any other endoscopic procedure, this procedure has rare risks for bleeding, infection, anesthesia complications and perforation. Specific risks for this procedure include injury to neighboring organs. Fortunately, all these risks mentioned are very rare. As part of recovery, patients may experience nausea and abdominal pain both of which will quickly resolve within three days.

How Is The Procedure Performed?

Patients typically go under general anesthesia. A flexible scope is introduced down the throat where multiple sutures are placed from the inside to plicate the folds of the stomach together. The sutures placed are intended to make the stomach lumen narrower and shorter.

How Does The Procedure Promote Weight Loss?

ESG is considered to be a restrictive procedure where patients experience satiety earlier during the meals. The procedure serves as a tool to help patients control their urges while going through a complete lifestyle change. Patients who go follow a comprehensive bariatric program after the procedure have better and durable weight loss results.

Like all weight-loss plans, surgeries and procedures, these are tools to help you pursue a healthier lifestyle. A commitment to healthy diet and exercise habits are required for long-term success.

Is Endoscopic Sleeve Gastroplasty Safe?

Overall, ESG is a safe procedure. Most patients expect to go home on the same day and back to work on day three.

What is the next step in learning more about ESG at Wyoming Medical Center?

To learn more about this procedure, call Dr. Fahed’s office at 307-233-2700 for a consultation. During the visit, you will know if ESG is the right procedure for you or if there are other better options more suitable to your situation. No referral is needed.

You can watch a video animation about the procedure and find information on other weight-loss procedures at

Professional headshot of

Julien Fahed M.D.

Julien Fahed, M.D., is a board-certified gastroenterologist specializing in advanced bariatric endoscopic procedures. He helped expand the Bariatric Program at Wyoming Medical Center by offering new non-surgical, weight-loss procedures including Gastric Balloon and Endoscopic Sleeve Gastroplasty. He also offers endoscopic revisions for previous Gastric Bypass and Gastric Sleeve surgeries.

To learn more about our non-surgical, endoscopic weight-loss procedures, schedule a consultation with Dr. Julien Fahed. Call (307) 233-2700.