Abstract
Endoscopic sleeve gastroplasty (ESG) is an incisionless gastric remodeling procedure for the management of obesity which leads to a reduction in the size of the gastric lumen, prolongs gastric emptying, and changes in hormonal mechanisms that alter satiation. While a variety of suture patterns have been explored and technique may vary between endoscopists, the basic steps of ESG include (1) diagnostic esophagogastroduodenoscopy, (2) consideration of mucosal marking to guide suture placement, (3) placement of running sutures from distal to proximal along the greater curvature with intermittent reinforcement stitches. While this manuscript will predominantly focus on the technical aspects of performing the ESG procedure, knowledge of the cognitive components of bariatric endoscopy are critical to the success of this procedure in clinical practice.
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