BALTIMORE, Md. — Patients with obesity who don’t want, or don’t qualify for, traditional bariatric surgery now have a new option at MedStar Health: endoscopic sleeve gastroplasty (ESG), a minimally invasive procedure that reshapes the stomach without any external incisions.
Christopher You, MD, a board-certified general and bariatric surgeon at MedStar Franklin Square Medical Center, performed the procedure for the first time at MedStar Health on August 21. The patient went home the same day.
During the roughly 90-minute procedure, performed under mild sedation, Dr. You threads a flexible tube with a small camera through the patient’s mouth and into the stomach, then uses a series of sutures to reduce the stomach’s size and reshape it into a smaller, tube-like pouch. Because the entire procedure is done through the mouth, there are no external cuts or scars, and unlike traditional bariatric surgery, no part of the stomach is removed.
“Endoscopic sleeve gastroplasty gives us another important tool in the treatment of obesity,” Dr. You said. “For appropriately selected patients, it can provide meaningful weight loss without the incisions or scars and without removing any part of the stomach, as with traditional bariatric surgery. It allows us to approach obesity treatment in a less invasive way while helping patients feel full sooner and eat less.”
More than one billion people worldwide are estimated to be living with obesity, according to global research cited by the World Obesity Federation, and the condition is linked to serious health risks including cardiovascular disease, type 2 diabetes, fatty liver disease, and sleep apnea. While bariatric surgery remains effective for many patients, some don’t want it or don’t qualify — a gap Dr. You said ESG is designed to help close.
Dr. You pointed to published clinical evidence behind the procedure. A randomized trial published in The Lancet, known as the MERIT trial, found ESG patients lost an average of 13.6% of their total body weight after one year, with the loss sustained at two years — compared with less than 1% weight loss among patients who received diet and exercise counseling alone. “Dr. You stressed that ESG is not experimental,” reflecting that the procedure is backed by peer-reviewed, multicenter research rather than being a novel or unproven technique.
Because there are no external incisions, most patients go home the same day and can resume routine activities within several days, though the procedure is not offered without evaluation — patients considering ESG undergo an assessment to determine whether it’s appropriate for them, and treatment is paired with nutritional counseling and lifestyle support.
“Obesity is a complex, chronic disease, and there is no single treatment that is right for everyone,” Dr. You said. “The addition of ESG expands the range of evidence-based options we can offer patients. It gives us another way to personalize treatment based on a patient’s health, goals, and preferences.”
The Center for Bariatric Surgery at MedStar Franklin Square is accredited by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP), a joint program of the American College of Surgeons and the American Society for Metabolic and Bariatric Surgery that sets national standards for bariatric care. Southern Maryland’s own MedStar St. Mary’s Hospital holds a similar bariatric accreditation, though ESG specifically was described in this announcement as newly available at MedStar Franklin Square, not confirmed as offered locally.
