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For individuals struggling with obesity, finding an effective solution to achieve significant weight loss and improve their overall health is often a top priority. Two popular weight loss procedures that have gained widespread attention are the traditional Gastric Sleeve and the Endoscopic Sleeve Gastrectomy, also known as an ESG for short. While both surgeries aim to help individuals shed excess pounds and improve their quality of life, they have distinct differences in terms of procedure, recovery, and long-term outcomes. At Streamline, not only do we offer traditional Gastric Sleeve surgery, but we also offer the less-invasive alternative – the Endoscopic Sleeve Gastrectomy.

In this blog, we will explore the key differences between the ESG and the Gastric Sleeve to help you make an informed decision if you’re considering weight loss surgery.


Understanding the procedures

Endoscopic Sleeve Gastrectomy (ESG)

Endoscopic Sleeve Gastrectomy is considered a less invasive alternative in comparison to traditional weight loss procedures such as Gastric Sleeve surgery. It may be suitable for individuals who are overweight/moderately obese and have tried other weight loss strategies, such as diet and exercise alone, and have not been successful.


Traditional Gastric Sleeve

The Gastric Sleeve is a surgical weight loss procedure that involves the permanent removal of a large portion of the stomach in order to help individuals lose weight and improve their health. It is a common and effective surgery option for those struggling with obesity and related health conditions. However, it is not without risks and potential complications, and individuals should undergo a thorough medical evaluation and engage in discussions with healthcare professionals to determine if it is the right option for their specific needs and circumstances.


A comparison between ESG and the Gastric Sleeve

Surgical approach


Endoscopic Sleeve Gastrectomy is a minimally invasive outpatient procedure that involves no stomach incisions. Using this approach, a tiny camera and instruments are introduced through the mouth and down the throat to reach the stomach. Using the endoscope, the surgeon creates small folds or sutures in the stomach while preserving the rest of it intact. This makes the procedure reversible, unlike the traditional Gastric Sleeve, which involves the physical removal of a portion of the stomach. This reduces its capacity and restricts food intake.


Gastric Sleeve

The Gastric Sleeve is a surgical procedure performed through keyhole surgery, involving the removal of 90% of the stomach. This alteration transforms the stomach into a narrow tube, approximately 1cm in diameter. This ultimately reduces the stomach’s capacity and results in significant weight loss.




The recovery period for the ESG is typically faster than the Gastric Sleeve. Most patients can return to their regular activities within a few days.


Gastric Sleeve

Recovery time for the Gastric Sleeve is longer and may require a hospital stay. Patients are gradually introduced to a liquid diet and then progress to soft and solid foods as their body heals. Patients typically need several weeks to resume normal activities.


Weight loss and effectiveness


Although ESG can lead to significant weight loss, the extent of weight loss may vary from person to person. It is considered effective for some individuals, especially those with moderate obesity.


Gastric Sleeve

The Gastric Sleeve is recognised for achieving substantial and enduring weight loss outcomes. It is frequently suggested for individuals struggling with severe obesity.


Complications and risks


Patients undergoing ESG may encounter mild nausea and abdominal discomfort for approximately a week following the procedure. Although ESG is generally considered safe with fewer complications than traditional Gastric Sleeve surgery, it is crucial to highlight that potential risks and complications do exist. It is recommended to have a comprehensive discussion about these aspects with a healthcare professional.


Gastric Sleeve

The Gastric Sleeve carries a range of potential complications, including infection, bleeding, leaks, and long-term nutritional deficiencies. The most serious complication is a leak from the staple line, which occurs in between 1 and 3% of patients.


Considerations for choosing the right procedure


Your BMI and overall health will play a crucial role in determining which procedure is right for you. The Gastric Sleeve is often recommended for individuals with a higher BMI or more severe obesity, whilst the ESG may be suitable for those with a lower BMI or a preference for less invasive surgery.


Recovery time

Consider how much time you can dedicate to recovery. The ESG offers a quicker recovery period, which may be appealing if you have work or other commitments that can’t be put on hold.


Long-term goals

Think about your long-term weight loss and health goals. If you’re looking for rapid and substantial weight loss with potentially greater health benefits, the Gastric Sleeve may be the better choice. However, if you prioritise a less invasive procedure with a quicker recovery, ESG might be suitable.


Both the ESG and the Gastric Sleeve are effective weight loss procedures, each with its own set of advantages and considerations. The right choice for you depends on your individual circumstances, including your BMI, recovery expectations, and long-term goals. Consulting a qualified healthcare professional is crucial to evaluate your unique circumstances and determine the most suitable weight loss procedure. Whether you opt for ESG or Gastric Sleeve, both can be life-changing tools in your journey toward a healthier, more fulfilling life.

Remember when considering either of these options it is important to seek advice from an expert weight loss clinical team. They will be able to advise you on your best treatment option, as well as any risks or complications. If you’re ready to take the next steps to achieving significant weight loss, call us on 0333 016 3030 or fill out the form below.

If you would like more information on the comparison between the Gastric Sleeve and the ESG please visit our other blog Endoscopic Gastric Sleeve Vs Traditional Gastric Sleeve.

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Call us to chat on: 0333 016 3030 (local rate) or fill in our contact form below.

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