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Endoscopic sleeve gastroplasty (ESG), a novel, incisionless, minimally invasive procedure, is developed as a non-surgical alternative for the management of obesity. It is a transoral gastroplasty procedure that utilizes a full-thickness endoscopic suturing system (OverStitch; Apollo Endosurgery) for the reduction of gastric volume by approximately 70%. In this procedure, sutures are placed in two rows along the greater curvature of the stomach, from the anterior wall to the greater curvature to the posterior wall, resulting in a gastric cavity that forms a tubular sleeve along the lesser curvature, with the closing of the greater curvature via plications from the gastroesophageal junction to the prepyloric antrum (1).

Endoscopic sleeve gastroplasty for obesity: A multicenter study of 248 patients with 24 months follow-up