How does ESG compare to VSG? Endoscopic sleeve vs. surgical sleeve: key similarities and differences

[@kbkesq]

Great explanation. No question ESG is the less invasive procedure. Less downsides.

[@carriepickett2687]

That is frustrating insurance will not cover ESG the same as VSG, because depending on a patient's needs and life restrictions the choice should be between the doctor and patient. I appreciate the clarity of this video because the decrease of ghrelin hunger hormones for VSG is appealing, but also the recovery time for ESG makes that option very attractive.

[@sunshinebeauty7951]

Thank you so much for clarifying the difference between the two, in Australia it doesn’t seem like ESG is very popular and is definitely outside of the private health network. I enjoyed knowing the difference between the two mechanisms, they really are completely different procedures.

[@maryymendes]

What about vitamins and care after surgery? What are the main differences? I have searched about it and don't find any profounder analysis on the matter. Thanks.

[@DrMcGowanMD]

After VSG, it is recommend to stay on a multivitamin long-term. There is no current evidence to suggest that this is necessary with ESG. Our assumption is that it is not necessary, given that absorption is not altered and motility is decreased, not increased. However, we do recommend that our ESG patients take a complete multivitamin (or bariatric multivitamin) until they are consistently maintaining a balanced diet, which is typically within 3 months of the procedure.

[@Trudy-Lee1]

Thanks for sharing this. Very informative. I subbed.

[@suep.1875]

Why doesn't insurance cover ESG and how expensive is this? I really appreciate your explanations!

[@DrMcGowanMD]

It’s in the works. Probably 3-5 years away. There are many steps to obtaining insurance coverage for a procedure including a randomized trial (done), FDA authorization (done), assignment of a procedural CPT code (in process; 2 years turnaround), then Medicare valuation. Average cost is between $10k and $15k nationally

[@carriepickett2687]

@@DrMcGowanMD I very much appreciate this video and I have been debating whether to pay for the ESG or have insurance cover a VSG, because of my limited availability for recovery I am leaning towards ESG despite the cost. Your video states you can return to activity, does this general description of activities include weightlifting like powerlifting? What are the implications for wearing a tight belt when performing a deadlift set? I assume things should be fine.

[@flovoices4u294]

Great video. VSG is a "refluxogenic" procedure. Until best practices are agreed upon and standardization of technique is implemented, this is a huge flaw in this surgery IMO. Even the best surgeons still seem to have a 14-15% rate of de novo GERD post-surgery. No bueno for me. The risk vs benefit is not there until a person is around a Class 3. IMO ;).

[@shootit4now626]

Thank you very much. ❤

[@JC-ce8uw]

Esg for people prone to keloids and acid reflux?

[@carmenperez6055]

What about those stitches on the endoscopic sleeve?

[@DrMcGowanMD]

The sutures are non-dissolvable, polypropylene material. They remain in the stomach wall after the procedure, initially serving as scaffolding to allow the stomach to heal in the sleeve-like shape.

[@cgirls.3676]

Is the ESG performed under general Anesthesia?

[@DrMcGowanMD]

Yes, it is

[@aaliyahford502]

Genuine question.. why do I have to be overweight first to qualify for an endoscopic sleeve?

[@Godislove789]

How much is endoscopic sleeve? And is it reversible?