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98 James Street, Suite 103, Edison, NJ 08820

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Endoscopic sleeve gastroplasty

A lighter life.
A stronger you.

A new chapter in your weight-loss journey.

ESG reshapes your stomach from the inside, without abdominal incisions or removal of stomach tissue. Explore a personalized path forward with Dr. Anish Nihalani.

Explore my options
Discover ESG
Anish Nihalani, MD, FACS, FASMBSBoard-certified surgeon · Bariatric fellowship training
Illustrative lifestyle model enjoying a sunny garden walk
More room for the life
you want to live.
Illustrative lifestyle image. Not a patient result.
No abdominal incisions
No stomach tissue removed
Care beyond the procedure

Understand the procedure

A smaller stomach.
A thoughtful approach.

The endoscopic sleeve is also called endoscopic sleeve gastroplasty or endoscopic suture gastroplasty.

A flexible camera and suturing device pass through the mouth. Internal stitches bring the stomach walls together, creating a smaller space for food. This can help you feel satisfied with smaller portions.2

ESG is performed under general anesthesia. It preserves stomach tissue and does not reroute the intestines. Your plan pairs the procedure with nutrition, movement and follow-up care.

Find out whether ESG may fit your goals
THE ESG APPROACH01 / 03
ESG schematic showing the preserved gastric outlet and duodenumAnterior schematic: the esophagus enters the stomach, which continues through the pylorus into the C-shaped duodenum and then the jejunum. Sutures are illustrated in the gastric body, away from the outlet. The digestive route remains continuous in all three stages.EsophagusFundusStomachPylorusDuodenumContinues to jejunumSimplified anterior schematic. Not to scale.


The endoscope enters through the mouth. The stomach remains connected to the duodenum through the pylorus.4

A view from inside the stomach

See what tightening changes.

Internal sutures draw stomach folds together. These illustrated views show the change in the gastric lumen.5

01

Before tightening

Illustrated view inside the gastric body showing placed but loose sutures beside a wider lumen
Sutures have been placed, but remain loose. The gastric walls have not yet been drawn together.
02

After tightening

Illustrated view after tightening showing gathered gastric folds, secured sutures and a smaller open remaining lumen
Tightened sutures gather the tissue into folds. A smaller, open gastric channel remains visible.

Illustrated intraluminal views, not patient endoscopy photographs. Orientation and suture pattern vary. The pylorus and duodenum are shown in the external anatomy above.

Your goals. Your options.

Could ESG be
right for you?

If weight loss has felt like a cycle of starting over, it may be time for a different conversation.

ESG may be an option for adults with a BMI of 30 or higher who have struggled to sustain weight loss and are ready to commit to ongoing lifestyle changes.3

  • You want to understand an endoscopic option.
  • You are ready for a structured plan and follow-up.
  • You want a physician to help compare your choices.

Your history, stomach anatomy and health conditions matter. BMI alone cannot determine eligibility.

A starting point for the conversation

Know your BMI.

Use your height and weight to calculate your body mass index.

Height


For adults. This calculation stays in your browser.

Evidence, with perspective

Meaningful progress.
Realistic expectations.

Research helps guide the conversation. Your care plan makes it personal.

13.6%

Average total body weight loss
at 52 weeks

In the MERIT randomized trial, participants receiving ESG plus lifestyle changes lost an average of 13.6% of their starting weight.1

Read the published study

Study average, not a prediction or a result from this practice. Individual outcomes vary. Long-term nutrition and follow-up remain essential.

Dr. Anish Nihalani, board-certified surgeon

Meet your surgeon

Expertise you can trust.
Care that knows you.

Anish Nihalani, MD, FACS, FASMBS

The right treatment starts with understanding the person.

Dr. Nihalani is a board-certified surgeon with fellowship training in bariatric surgery at the University Medical Center of Princeton. His practice brings together endoscopic, medical and surgical weight-management options, so you can have a thoughtful conversation about the path that fits your health and goals.

More about Dr. Nihalani

A plan, not just a procedure

Support for the
whole journey.

From your first questions to your next chapter.

01

Talk it through.

Review your goals, history and previous treatments. Compare ESG, medication and surgical options.

02

Build your plan.

Discuss candidacy, preparation, costs and the nutrition changes that go with treatment.

03

Take the next step.

If ESG is appropriate, receive individualized instructions for the procedure and recovery.

04

Keep moving forward.

Follow a guided diet progression and continue follow-up to support your long-term goals.

Clarity before commitment

Good questions.
Clear answers.

Bring every question. We will help you understand your options.

Speak with our team Compare all weight-loss options
How is ESG different from surgical gastric sleeve?
ESG reduces stomach capacity with internal sutures. Surgical sleeve gastrectomy removes part of the stomach through abdominal incisions. They are different procedures with different benefits, risks and expected outcomes.2
How much weight might I lose?
Results vary. The MERIT trial reported 13.6% average total body weight loss at 52 weeks with ESG plus lifestyle changes. Your response depends on many factors, including nutrition and follow-up.1
What is recovery like?
Many patients leave the facility the same day. Nausea and abdominal discomfort may occur early on. You will follow a staged diet and individualized instructions about returning to work and exercise.3
What are the risks?
ESG has risks, including bleeding, infection, stomach injury or leakage, and complications from anesthesia. Additional treatment or hospitalization may be needed. Your consultation includes an individualized discussion of risks and alternatives.3
Can ESG fit alongside weight-loss medication?
Ask about the full range of treatments, including GLP-1 medications. Dr. Nihalani will review your history and response to treatment before discussing whether medication, an endoscopic procedure, surgery or a combination may fit your needs.
What if I have had weight-loss surgery before?
Weight regain deserves a fresh evaluation. Endoscopic revision may be an option for selected patients, but it is a different assessment from primary ESG. Your existing anatomy and previous operation determine the options to discuss.3
Will insurance cover ESG?
Coverage varies, and ESG may require self-pay. Consultation benefits can differ from procedure coverage. Ask our team to review your benefits and provide a cost estimate before you decide.2

Start with a conversation

Your next chapter
starts here.

Explore ESG with a physician who can help you see the full picture.

Book my consultation 732-662-5888Ask about endoscopic sleeve gastroplasty.
Edison
98 James Street, Suite 103
Edison, NJ 08820
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Clark
28 Gibson Blvd
Clark, NJ 07066
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Personal attention, close to home.

Convenient consultations for patients across Middlesex and Union Counties.

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Medical information & research sources
  1. Abu Dayyeh BK et al. MERIT trial. The Lancet. 2022;400:441–451. ESG plus lifestyle changes in adults with class 1 or 2 obesity.
  2. Mayo Clinic: Endoscopic sleeve gastroplasty. Procedure overview and coverage considerations.
  3. Johns Hopkins Medicine: Endoscopic Sleeve Gastroplasty. Candidacy, recovery, revision and risks.
  4. OpenStax Anatomy and Physiology 2e: The Stomach and The Small and Large Intestines. Gastric outlet and duodenal anatomy.
  5. Endoscopic sleeve gastroplasty: the cable technique. VideoGIE. 2021. A published intraluminal technical demonstration. The drawings here illustrate general tissue folding and lumen reduction; they do not prescribe one suture pattern.

This page is general education, not a determination of candidacy. A clinical evaluation is required. Results and recovery vary. The lifestyle photograph is an AI-created illustration; it does not depict a patient or treatment outcome.

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