Endoscopic Sleeve Gastroplasty

What is Endoscopic Sleeve Gastroplasty

Endoscopic sleeve gastroplasty is a weight loss (bariatric) procedure. It is done by inserting a long, flexible tube (endoscope) through the mouth and into the stomach.

Through the endoscope, the surgeon applies surgical staples or stitches (sutures) to make the stomach smaller. This procedure does not require any incisions.

You may need this procedure if you are very overweight and have not been able to lose enough weight with diet and exercise. Your health care provider may recommend this procedure if other types of bariatric surgery are not safe for you. You are likely to lose weight after this surgery because your stomach will be smaller. You will need to work closely with your health care providers to maintain a healthy weight.

Tell a health care provider about:

  • Any allergies you have.
  • All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
  • Any problems you or family members have had with anesthetic medicines.
  • Any blood disorders you have.
  • Any surgeries you have had.
  • Any medical conditions you have.
  • Whether you are pregnant or may be pregnant.
  • Any family history of stomach cancer.
  • Any stomach problems you have.
  • Any mental health problems you have.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

  • Stomach pain and nausea.
  • Infection.
  • Bleeding.
  • Allergic reactions to medicines or dyes.
  • Damage to the stomach or the part of the body that moves food from the mouth to the stomach (esophagus), such as a hole (perforation).
  • Stomach juices leaking outside of the stomach.
  • A blood clot that travels to a lung (pulmonary embolism).

What happens before the procedure?

Medicines

  • Ask your health care provider about:
    • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
    • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood.Do not take these medicines unless your health care provider tells you to take them.
    • Taking over-the-counter medicines, vitamins, herbs, and supplements.
  • You may be prescribed antibiotic medicine. If so, take the medicine as told by your health care provider.

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

  • Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

  • 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
  • 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
  • 6 hours before the procedure – stop drinking milk or drinks that contain milk.
  • 2 hours before the procedure – stop drinking clear liquids.

General instructions

  • You may need to meet with a diet and nutrition specialist (dietitian) and a mental health professional to make sure you can commit to maintaining a healthy diet and a healthy weight for years after this procedure.
  • Plan to have someone take you home from the hospital or clinic.
  • Plan to have a responsible adult care for you for at least 24 hours after you leave the hospital or clinic. This is important.

What happens during the procedure?

  • To lower your risk of infection, your health care team will wash or sanitize their hands.
  • An IV will be inserted into one of your veins.
  • You will be given one or more of the following:
    • A medicine to make you fall asleep (general anesthetic).
    • Antibiotics.
    • Anti-nausea medicine.
  • You will be positioned so that you are lying on your left side.
  • An endoscope will be passed through your mouth, down your esophagus, and into your stomach.
  • An air-like gas will be sent through the endoscope to expand (inflate) your stomach. This will give your surgeon a clearer view inside of your stomach and will make more room to do the procedure.
  • Your surgeon will use staples or sutures to make your stomach narrower and shorter. These will be applied using a tool at the end of the endoscope.
  • Your stomach will be washed out with an antibiotic solution.
  • The endoscope will be removed.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

  • Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until the medicines you were given have worn off.
  • You may continue to receive fluids and medicines through an IV. When you are able to drink clear fluids, your IV will be removed.
  • Do not drive for 24 hours if you were given a sedative during your procedure.

Summary

  • Endoscopic sleeve gastroplasty is a procedure to help you lose weight (bariatric procedure).
  • This procedure is done through a long, flexible tube (endoscope). No incisions are necessary.
  • During this procedure, the surgeon will use staples or stitches (sutures) to make your stomach shorter and narrower.
  • It will be important to work with your health care providers for years after this procedure to maintain a healthy weight through diet and exercise.

Care After Endoscopic Sleeve Gastroplasty

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After the procedure, it is common to:

  • Have a decreased appetite.
  • Feel full after eating less than you used to eat.
  • Have mild swelling or pressure in your abdomen (bloating).
  • Have nausea.

Follow these instructions at home:

Medicines

  • Take over-the-counter and prescription medicines only as told by your health care provider. You may be given:
    • Pain medicine.
    • Anti-nausea medicine.
    • Medicine to prevent heartburn.

Eating and drinking

  • Follow instructions from your health care provider about eating or drinking restrictions.
    • For a few weeks, your diet may be limited to only protein shakes.
    • After a few weeks, you may begin to eat a soft-food diet.
    • Eventually, you will move to a regular diet.
  • Drink enough fluid to keep your urine pale yellow. Ask your health care provider about the best way to plan your water drinking so you can avoid feeling full during meal time.
  • When you return to a regular diet, you will need to make sure you are getting the right amount of nutrients and calories. Work with your dietitian to make sure your diet gives you enough energy but does not cause you to gain weight.
  • Ask your health care provider if you should take a vitamin or mineral supplement.

Activity

  • Follow your exercise plan as told by your health care provider. Exercise is an important part of losing weight and staying at (maintaining) a healthy weight after surgery.

Return to your normal activities as told by your health care provider. Ask your health care provider what activities and exercises are safe for you.

General instructions

  • Do notdrive or use heavy machinery while taking prescription pain medicine.
  • Do notdrive for 24 hours if you were given a medicine to help you relax (sedative) during your procedure.
  • Keep all follow-up visits as told by your health care provider. This is important. You will need to return for imaging tests of your stomach a few weeks after surgery.

Contact a health care provider if:

  • You have chills or a fever.
  • You have pain or nausea that does not go away or get better with medicine.
  • You have frequent vomiting.
  • You have heartburn.
  • You have difficulty swallowing.

Get help right away if:

  • You have severe pain.
  • You are unable to swallow.
  • You have severe vomiting.
  • You vomit blood.
  • You have chest pain.
  • You have difficulty breathing.

Summary

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Do not drive or use heavy machinery while taking prescription pain medicine.
  • Follow instructions from your health care provider about eating or drinking restrictions.
  • Ask your health care provider what activities and exercises are safe for you.
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