Endosleeve (Endoscopic Sleeve Gastroplasty)

Find out more about whether an Endosleeve procedure might be right for you.

Dr Balalis is the only doctor in Adelaide currently performing Endosleeve procedures for patients. To find out if an Endosleeve procedure is right for you, find out more in the below Endosleeve procedure information.

If you’d like to discuss Endosleeve or other surgical and non-surgical weight loss options, contact us anytime to schedule an appointment with a member of the team.


Endoscopic Sleeve Gastroplasty is more commonly known as an endosleeve procedure, ESG or an accordion procedure.

While the name suggests it is similar to Gastric Sleeve surgery, it is actually quite different. Gastric Sleeve surgery and Endosleeve do share similar risk profiles, however an Endosleeve procedure avoids stapling or removing part of the stomach, the procedure takes less time to perform, and works to aid weight loss in a different way.

An Endosleeve procedure is an endoscopic and incision-less procedure that reduces the size of the stomach and helps to diminish hunger cravings. It is considered an alternative to surgery as it is a non-surgical procedure.

To perform an Endosleeve procedure , Dr Balalis passes a flexible four-channel tube and small endoscope through a patient’s mouth, into the oesophagus and then stomach. This is done under anaesthesia.

Using an endoscopic suturing device, internal stitches are placed inside the stomach to lessen its volume by about 40-50%. The procedure also shortens and re-shapes the stomach to help it empty into the intestines slower. This helps you to feel fuller longer.



Guidelines for an Endosleeve procedure include:

  • Age >18
  • BMI 30-50
  • Patient who has tried other avenues without success
  • No alcohol or drug dependency
  • No untreated acute psychiatric disorders
  • No eating disorders
  • Is committed to a healthy lifestyle and lifelong care

To calculate your BMI, visit our BMI calculator.

Endosleeve or Endoscopic Sleeve Gastrectomy is also an alternative to more invasive bariatric surgeries and can be part of a plan to reduce the risk of weight-related illness such as high blood pressure, diabetes, fatty liver disease, sleep apnea or heart disease.

Endosleeve may not be suitable for people with conditions including large hiatus hernia, gastritis, bleeding disorders or gastric ulcer or lesions.

If you think you may benefit from an Endosleeve procedure, please contact us to schedule an appointment to discuss your options.

Note: These are guidelines. Every person is different, and individual circumstances must be discussed with a medical professional.


People who receive an Endosleeve or Endoscopic Sleeve Gastroplasty lose approximately 15%-20% of their total body weight at 12-24-months. [1]


The most common side effects of an Endosleeve include nausea and mild pain following the procedure.

As with any surgical procedure, complications may occur with an Endosleeve and should be discussed with a trained medical professional.

Contact us to schedule an appointment to discuss the options available and what’s right for you.



[1] Dayyeh et al (28 July, 2022). Endoscopic sleeve gastroplasty for treatment of class 1 and 2 obesity (MERIT): a prospective, multicentre, randomised trial. Available at: https://pubmed.ncbi.nlm.nih.gov/35908555/ (Accessed: 22 December, 2022).




How long will recovery take after an Endosleeve procedure?

Since no incisions are made with an Endosleeve most patients can return to their normal activities within a few days. While recovery depends on each individual’s circumstances, it is recommended that you plan for at least three days of inactivity following the procedure.

Are there any diet restrictions following an Endosleeve procedure?

An Endosleeve is a restrictive procedure meaning it will limit the amount of food that you can eat. Life-long vitamin/mineral supplementation as well as protein supplementation is also necessary due to decreased intake of food as well as limited absorption of nutrients.

Our expert dieticians will prepare post-procedure nutrition plan for you and continue to monitor your progress as part of our post-procedure support service, Post-Care-Success.

Is the Endosleeve a permanent procedure?

An Endosleeve uses permanent stitches that do not dissolve; however, these can be removed at a later date if required.

It is possible for the stitches to break over time if under too much tension, however this does not necessarily lead to reversal of the Endosleeve or weight gain.

Endosleeve and pregnancy?

If you are planning to get pregnant in the future, this should be discussed with Dr Balalis at your initial consultation.

It is normally advised that patients avoid pregnancy for at least six months following an Endosleeve procedure.

Can I have an Endosleeve following a Gastric Bypass?

While an Endosleeve procedure is not suitable following a Gastric Bypass, it is possible to have a Transoral Outlet Reduction (TORe) using an overstitch device.

 If you have previously had a Gastric Bypass and would like to discuss a Transoral Outlet Reduction, please request an appointment to discuss your options with Dr Balalis.

Can I have an Endosleeve following a Gastric Balloon?

Research has shown that people who’ve had a gastric balloon do less well following an Endosleeve in terms of weight loss.

 If you have had a gastric balloon and feel like you need additional support, please request an appointment to discuss your options with Dr Balalis.


Can I have an Endosleeve following a Lap Band?

Research has shown that people who’ve had a Lap Band do less well following an Endosleeve in terms of weight loss.

 If you have had a Lap Band and feel like you need additional support, please request an appointment to discuss your options with Dr Balalis.

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