Endoscopic Sleeve Gastroplasty (ESG) in Melbourne
Endoscopic sleeve gastroplasty (ESG) is a minimally invasive weight-loss procedure that reduces the size of your stomach without the need for surgery.
At Specialist Surgical Group, our Melbourne-based bariatric specialist performs ESG using an endoscope (a flexible tube with a camera and suturing device) passed through your mouth. No incisions are made on your body. The procedure reshapes your stomach from the inside by placing a series of stitches that reduce its volume by approximately 70-80%, helping you feel full sooner and eat smaller portions.
ESG sits between non-surgical options like gastric balloons and more invasive bariatric surgeries like the gastric band, gastric sleeve, or the gastric bypass. It’s typically performed as a day procedure under general anaesthesia.
We consult from our Essendon and Bundoora clinics, with procedures performed at accredited hospitals in Melbourne.
Call us today at (03) 9466 7338 to book a consultation.
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We are located in the heart of Essendon and Bundoora.
Is ESG right for you?
At Specialist Surgical Group, our Melbourne-based surgeon offers ESG to patients who meet specific criteria and are committed to making long-term lifestyle changes as part of their weight management journey.
ESG may be suitable if you:
- Have a BMI of 30 or higher with weight-related health conditions such as type 2 diabetes, high blood pressure, or sleep apnoea
- Have a BMI of 35 or higher and have tried other weight loss methods without lasting success
- Are looking for a less invasive alternative to traditional bariatric surgery
- Are committed to working with our multidisciplinary team for ongoing support
- Understand that success requires permanent changes to eating habits and physical activity levels
ESG may also be considered for patients with a BMI above 40 who are not suitable candidates for, or prefer to avoid, traditional bariatric surgery [2].
During your consultation, we will conduct a comprehensive health assessment, discuss your weight management goals, and determine if ESG is the most suitable option for you.
Potential benefits
- Minimally invasive, no incisions. ESG is performed entirely through the mouth using endoscopic technology, eliminating the need for external incisions or scars [1].
- Day procedure. Most patients return home the same day and resume daily activities more quickly than after traditional bariatric surgery [3].
- Effective weight loss. Clinical studies show an average total body weight loss of 15-20% within 12-18 months. For example, someone weighing 100kg might lose 15-20kg [1][4].
- Improvement in health conditions. The MERIT trial showed 80% of ESG patients experienced improvement in one or more metabolic conditions, including type 2 diabetes, high blood pressure, and high cholesterol [1].
- Stomach volume reduction. The suturing technique reduces the stomach’s capacity by approximately 70-80%, helping you feel full sooner and eat smaller portions [5].
- Potentially reversible. Unlike surgical sleeve gastrectomy, ESG does not remove any part of the stomach. The procedure may be adjustable or reversible if medically necessary [3].
- Shorter recovery. Most patients return to work within a week and resume normal activities within 1-2 weeks [3].
Potential risks
- Post-procedure discomfort. Nausea, abdominal pain, or cramping is common in the first 2-3 days and is typically managed with medication [1].
- Bleeding. Minor bleeding at the suture sites can occur during or after the procedure, though this is uncommon and usually resolves without intervention [5].
- Gastric perforation. In rare cases, the suturing device may cause a perforation (hole) in the stomach wall, which may require surgical repair. In the MERIT trial, serious adverse events occurred in only 2% of patients, with no deaths or need for surgical intervention [1].
- Variable long-term results. Individual responses to ESG vary. Some patients may experience a reduction in effectiveness over time, requiring additional intervention [4].
- Suture loosening. Over time, some sutures may loosen, potentially reducing the effectiveness of the procedure. If needed, a follow-up ESG can be performed to re-tighten the stomach [6].
- Lifestyle commitment. Long-term success depends on sustained dietary changes and regular exercise. Patients who do not maintain these changes may experience weight regain [1].
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(03) 9466 7338Meet our weight loss surgeons
Your ESG journey
The following steps provide a brief overview of your ESG journey. Individual experiences will vary based on your specific health circumstances.
1. Initial consultation and assessment
Your journey begins with a consultation with our bariatric surgeon. We’ll review your medical history, assess your BMI and weight-related health conditions, and discuss your weight-loss goals.
We’ll explain how ESG works, how it compares to surgical options like the gastric sleeve, and whether it’s the most suitable approach for your situation.
2. Pre-treatment preparation
In the days before your procedure, you’ll follow a liquid diet to prepare your stomach. We’ll review your current medications and provide instructions about fasting requirements.
Where appropriate, we’ll connect you with our dietitian to begin planning the dietary changes that will support your results during and after the procedure.
3. The surgery procedure
ESG is performed under general anaesthesia at an accredited Melbourne hospital, typically taking 60-90 minutes. You do not need to stay overnight.
Your surgeon passes an endoscope (a flexible tube with a camera and suturing device) through your mouth and into your stomach. No incisions are made on your body.
Using the suturing device, your surgeon places a series of stitches through the stomach wall, drawing the tissue together to create folds that reduce the stomach’s volume by approximately 70-80%.
The reshaped stomach holds less food, helping you feel full sooner. Unlike surgical sleeve gastrectomy, no part of the stomach is cut or removed.
4. Recovery
Most patients go home the same day. You may experience nausea, abdominal discomfort, or cramping for the first 2-3 days, which is managed with medication.
Most patients return to work within a week and resume normal activities within 1-2 weeks. You’ll start with liquids and gradually progress to soft foods, then regular meals in smaller portions over 3-4 weeks.
5. Supported weight loss period
In the months following your procedure, you’ll work closely with our team to maximise your results. Regular follow-up appointments track your progress and allow us to address any concerns.
Our dietitian provides personalised nutritional guidance, and our team offers support to help you build the eating and exercise habits that drive long-term success.
Most patients lose 15-20% of their total body weight within 12-18 months.
6. Long-term follow-up
We schedule ongoing appointments to monitor your progress, provide nutritional guidance, and address any concerns.
If additional intervention is needed, ESG can potentially be revised or, if appropriate, converted to traditional bariatric surgery via our revision bariatric surgery service. Our team remains available to support you as your needs evolve.
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(03) 9466 7338Endoscopic Sleeve Gastroplasty FAQ
ESG in Australia typically costs between $8,000 and $15,000. Some private health funds may provide partial coverage for bariatric procedures, though coverage varies by insurer and policy.
Medicare does not currently provide rebates for ESG, as the procedure does not have a dedicated Medicare Benefits Schedule item number [7]. We’ll provide a detailed quote and explain your coverage options during your consultation.
Most patients lose 15-20% of their total body weight within 12-18 months. For example, someone weighing 100kg might lose 15-20kg. The MERIT trial, a landmark randomised controlled study, reported an average total body weight loss of 13.6% at 12 months, with weight loss maintained at 2 years [1].
Results from larger observational studies and high-volume centres have reported even higher weight loss, with total body weight loss of up to 20% at 12 months [4]. Your success depends heavily on following dietary guidelines and staying active.
You’ll have general anaesthesia during the procedure, so you won’t feel anything. Afterwards, expect nausea and abdominal discomfort for the first 2-3 days, similar to stomach upset. Most patients return to work within a week and normal activities within 1-2 weeks [3].
You’ll start with clear liquids for the first few days, then progress to pureed foods, soft foods, and finally regular textures over 4-6 weeks. In the long run, you’ll eat smaller portions of protein-rich foods. Our dietitian provides detailed meal plans and ongoing support throughout your journey.
ESG may be suitable if you have a BMI of 30 or higher and health conditions, or a BMI of 35 or higher and have tried other weight-loss methods. If you have a very high BMI or complex medical conditions, traditional bariatric surgery might be more appropriate. A comprehensive assessment will determine the best option for you [2].
If ESG does not achieve adequate weight loss or complications arise, several options are available. The stomach can be re-sutured in a follow-up ESG procedure to restore restriction [6]. Alternatively, ESG can be converted into a surgical procedure, such as gastric sleeve or gastric bypass surgery [4]. Our revision bariatric surgery team will assess your individual circumstances and guide you toward the most appropriate next step. You do not need to have had your original ESG with us.
ESG is less invasive, with no external incisions and a shorter recovery, but may achieve modest weight loss compared to surgical sleeve gastrectomy. ESG is potentially reversible, while sleeve surgery permanently removes part of your stomach. We’ll help you understand which option best suits your goals and circumstances, including whether a gastric band, gastric balloon, mini gastric bypass, or a surgical sleeve might be more appropriate.
Unlike traditional bariatric surgery, ESG typically doesn’t cause significant nutrient absorption issues. However, most patients benefit from taking a daily multivitamin, especially when eating smaller portions. Your medical team will monitor your levels and recommend appropriate supplements if needed.
Medical disclaimer
The information on this page is for general educational purposes only. It does not constitute medical advice, diagnosis, or treatment recommendations, and does not create a doctor-patient relationship. Individual circumstances vary significantly, and nothing on this page should be used as a substitute for personalised advice from a qualified medical professional.
If you have concerns about your health, please seek medical attention promptly. To discuss your specific condition and treatment options with our team, please book a consultation by calling us at (03) 9466 7338.
References
[1] Abu Dayyeh BK, Bazerbachi F, Vargas EJ, et al. Endoscopic sleeve gastroplasty for treatment of class 1 and 2 obesity (MERIT): a prospective, multicentre, randomised trial. Lancet. 2022;400(10350):441-451. https://doi.org/10.1016/S0140-6736(22)01258-2
[2] Eisenberg D, Shikora SA, Aarts E, et al. 2022 American Society for Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO): Indications for Metabolic and Bariatric Surgery. Surg Obes Relat Dis. 2022;18(12):1345-1356. https://doi.org/10.1016/j.soard.2022.08.013
[3] Hedjoudje A, Abu Dayyeh BK, Cheskin LJ, et al. Efficacy and Safety of Endoscopic Sleeve Gastroplasty: A Systematic Review and Meta-Analysis. Clin Gastroenterol Hepatol. 2020;18(5):1043-1053.e4. https://doi.org/10.1016/j.cgh.2019.08.022
[4] Fehervari M, Fadel MG, Alghazawi LOK, et al. Medium-term weight loss and comorbidity remission after ESG: systematic review and meta-analysis. Obes Surg. 2023;33:3527-3538. https://doi.org/10.1007/s11695-023-06855-7
[5] Maselli DB, Hoff AC, Kucera A, et al. Endoscopic sleeve gastroplasty in class III obesity: Efficacy, safety, and durability outcomes in 404 consecutive patients. World J Gastrointest Endosc. 2023;15(7):469-479. https://doi.org/10.4253/wjge.v15.i7.469
[6] Bhandari M, Mathur W, Neto MG, et al. Endoscopic Sleeve Gastroplasty: 6-Year Outcomes in 1,377 Patients. Obes Surg. 2026. https://doi.org/10.1007/s11695-026-08505-8
[7] Australian Government Department of Health. Medicare Benefits Schedule. https://www.mbsonline.gov.au/internet/mbsonline/publishing.nsf/Content/Downloads