About Apollo Endosleeve

Apollo Endoscopic Sleeve Gastroplasty (ESG) is a new and promising obesity treatment that gives people a safer and more effective option than the existing weight loss methods. The main advantage of ESG is that it does not involve surgery, so people have lower risks and faster recovery. ESG is a novel weight-loss procedure that shrinks the stomach using a device that stitches it from inside without any cuts. This procedure may be suitable for you if you are very overweight — with a body mass index of 30 or more — and have not been able to lose weight with diet and exercise.

ESG helps you lose a lot of weight by making you eat less. And the procedure is minimally invasive, lowering the chance of complications from surgery.

Like other weight-loss procedures, ESG demands dedication to a healthier lifestyle. You need to adopt lasting healthy changes to your diet and exercise regularly to make sure ESG works for you in the long run.

Why it’s done?

ESG is done to help you lose weight and possibly reduce your risk of serious health problems related to weight, such as:

Gastroesophageal reflux disease Heart disease and stroke High blood pressure Sleep apnea Type 2 diabetes ESG and other weight-loss procedures or surgeries are usually done only after you have tried to lose weight by improving your diet and exercise habits. ESG is less risky and invasive than other types of bariatric surgery.


Who it’s for?

ESG is often an option for people who do not qualify for other bariatric surgeries. The procedure is available to people who have a body mass index (BMI) above 30 and have not been successful in losing weight with other methods.

But ESG is not for everyone who is overweight. A screening process helps doctors determine if the procedure might be helpful for you. And you must be ready to commit to healthy lifestyle changes, regular medical check-ups and behavioral therapy.

ESG is not suitable for anyone who has bleeding in the digestive tract, a hiatal hernia bigger than 3 centimeters or who has had previous stomach surgery.

The operation itself

The ESG procedure is done using a device called an Overstitch; a device that goes into the stomach through the mouth and allows us to put several sutures (stitches) inside the stomach to reduce its size by up to 80%.

The procedure takes about an hour to complete and we do it under general anaesthetic for your comfort. But unlike surgery, we do not need to make any cuts to reach the stomach, which lowers the risk to you and speeds up your recovery.

Weight loss with the ESG

The weight loss results with ESG are impressive. At first we were seeing weight loss similar to that of gastric band at 50-60% excess weight loss after 2 years, but the latest results are more promising. The Longitudinal Compression technique used is now achieving over 50% excess loss in the first 6 months, which is comparable to surgical sleeve and gastric bypass.

We always remind patients that we need to wait to see long term results, 5 years or more, to be confident about the long-term benefits of the procedure, but the fact that we are seeing over 50% at 6 months and generally 60% at 2 years is very positive. It is too soon to tell, but we hope that the technique used will promote lasting weight loss as well as good results for the short term.

As with all weight loss procedures, there is a small proportion (about 10-20%) for whom the procedure does not work and for whom it is better to consider a surgical procedure.


Endoscopic sleeve gastroplasty has a good safety record in early studies. You may have some pain and nausea for a few days after the procedure. These symptoms can be treated with pain and nausea drugs. Most people recover after two days.

Also, endoscopic sleeve gastroplasty is not meant to be a temporary procedure, but it can be undone. In some cases, it can be changed to bariatric surgery.

Since the procedure is new and not widely used, there are still questions about how well it works and what risks it has in the long term.

How you prepare?

If you are eligible for endoscopic sleeve gastroplasty, your health care team will tell you how to get ready for your procedure. You may have to do some lab tests and exams before surgery. You may have to follow some rules about eating, drinking and taking medications. You may also have to start an exercise program.

It’s useful to plan for your recovery before the procedure. For example, get some help at home if you think you’ll need it. Recovery from endoscopic sleeve gastroplasty usually takes only a day or two.

What you can expect?

Endoscopic sleeve gastroplasty is done in the endoscopy unit as an outpatient procedure. You’ll be under general anesthesia for the procedure, so you’ll be asleep.

The procedure is done with an endoscope, a flexible tube with a camera and a device that stitches your stomach from inside. The endoscope goes down your throat into your stomach. The small camera lets the doctor who controls the endoscope (endoscopist) see and work inside your stomach without cutting your belly.

With the endoscope, the doctor puts about 12 sutures in your stomach. The sutures make your stomach smaller and tube-shaped. This limits how many calories your body takes in.

The procedure lasts about 90 minutes. After the endoscopic sleeve gastroplasty, you’ll wake up in a recovery room, where medical staff checks you for any problems.

Most people go home the same day after waking up from anesthesia. Some people may have to stay in the hospital for one day or less for observation after the procedure.

After Apollo endoscopic sleeve gastroplasty

After the procedure, you usually can’t eat for about eight hours. Then, you can start a liquid diet, which you have to keep for at least two weeks. After four weeks, you can move on to semi-solid foods, and then to a normal healthy diet.

You’ll also have medical visits and see a nutritionist and a psychologist often after your procedure.


If you undergo endoscopic sleeve gastroplasty, you can expect to lose a lot of weight. But your lifestyle habits also affect how much weight you lose.

The results of this procedure are very encouraging. One study showed that people with an average BMI of about 38 lost an average of 39 pounds (17.8 kilograms) in 6 months. After a year, they lost 42 pounds (19 kilograms).

Another study showed that people with an average BMI of about 45 lost an average of 73 pounds (33 kilograms) in the first 6 months.

Losing a lot of weight with endoscopic sleeve gastroplasty can also help you with health problems that are linked to being overweight, such as:

Gastroesophageal reflux disease Heart disease or stroke High blood pressure Severe sleep apnea Type 2 diabetes Our evidence suggests that you can lose about 15-18% of your initial weight (usually half of your extra weight) in 12-18 months*. This procedure is still new, so we don’t have long-term results yet.

The chart below shows the published results from a study of 248 ESG patients. It shows the average total body weight loss (TBWL) as a percentage of the initial weight. We also show how much weight this means for different initial weights.

To sum up, the published data shows that you can lose more than half of your extra weight in 24 months. This is similar to the weight loss with a gastric band, but the new technique can give results like surgical sleeve and bypass.

A paper published in Gastrointestinal Endoscopy (GIE) – https://doi.org/10.1016/j.gie.2018.12.012 – reported the results of Endoscopic Sleeve Gastroplasty (ESG) in 1,000 patients from King Saud University, Riyadh, Saudi Arabia. This was the first study to treat such a large number of patients with ESG, a minimally invasive procedure for obesity and related diseases. The paper showed that ESG cured all cases of high blood pressure and improved 70% of cases of type 2 diabetes. The paper also confirmed that ESG was safe, well-tolerated, and effective. Moreover, patients lost 64.7% of their excess weight after 18 months, which was similar to the outcomes of other surgical options for obesity.

Other advantages of the ESG

The ESG is done by inserting a device that stitches the stomach through the mouth using an endoscope. This means that there is no need for surgery, which involves cutting or stapling, leaving scars and wounds. Therefore patients recover faster and have lower chances and levels of post-operative problems.

Research also indicates that ESG has a low rate of complications. One study reported that only 2.4% of the patients had post-operative issues (AlQuatani et al December 2018).

What happens when weight-loss surgery fails?

You may not lose enough weight or you may gain weight back after any kind of weight-loss procedure, even if the procedure is done correctly. This can happen if you don’t stick to the suggested lifestyle changes. To prevent weight gain, you have to adopt healthy habits in your eating and exercise regularly and actively.

How much does the ESG cost?

The cost of an ESG can vary based on location and medical history but it is very close to that of the surgical sleeve. This is because the hospital, surgeon and anaesthetist fees are the same. Our current price is £5750 and have no competition regarding the expertise and affordability!