Two procedures dominate the modern obesity treatment landscape: Endoscopic Sleeve Gastroplasty (ESG) and Laparoscopic Sleeve Gastrectomy (gastric sleeve). Both reduce stomach volume, yet they differ significantly in invasiveness, reversibility, recovery and long-term results.
What Is ESG?
ESG is performed entirely through the mouth using a flexible endoscope — no skin incisions. A suturing device reduces gastric volume by 70-80%. Performed in 60-90 minutes, most patients are discharged the same day.
- No incisions — no scarring
- Partially reversible
- Day-case procedure
- Low complication rate
- Return to activities in 1-2 weeks
What Is Gastric Sleeve?
LSG permanently removes approximately 75-80% of the stomach through small abdominal incisions, leaving a narrow tube-shaped stomach. It is one of the most widely performed bariatric surgeries globally.
- Permanent and highly effective
- Reduces hunger hormones (ghrelin)
- Requires 1-2 overnight hospital stays
- Irreversible
Key Differences
| Feature | ESG | Gastric Sleeve |
|---|---|---|
| Incisions | None | 3-5 small |
| Reversibility | Partial | Irreversible |
| Recovery | 1-2 weeks | 2-4 weeks |
| Weight loss (12mo) | 15-20% | 25-35% |
Which Is Right for You?
ESG suits patients with BMI 30-40 who prefer a non-surgical approach. Gastric sleeve is recommended for BMI 40+ or serious obesity comorbidities requiring greater, permanent weight loss.
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Op. Dr. Murat Ustun provides a comprehensive evaluation to find the most appropriate treatment for your individual needs.
Contact UsFAQ
Is ESG more painful than gastric sleeve?
ESG has no skin incisions and is generally associated with less discomfort. Gastric sleeve recovery is also well-tolerated but takes longer.
How long do ESG results last?
ESG weight loss can remain effective for up to 5 years with lifestyle changes and regular follow-up.