Endoscopic Sleeve Gastroplasty (ESG)

What ESG involves

Endoscopic sleeve gastroplasty reduces the stomach by about 70% without any incision. Under general anaesthesia, an endoscope carrying a suturing device (Apollo OverStitch) is passed through the mouth and a series of full-thickness stitches folds the stomach into a narrow sleeve. The procedure takes 60–90 minutes; there are no external scars, the stomach is not cut, and the anatomy is preserved, which is why it is regarded as reversible and the risk profile is closer to an endoscopy than to surgery.

Expected weight loss is 15–20% of total body weight at 12 months in the published trials — less than a surgical sleeve (25–30%) but substantially more than a gastric balloon, and durable at five years in the majority of patients who keep up dietary follow-up.

Who is eligible

BMI 30–40 (occasionally higher for patients who decline or cannot have surgery), age 18–65, no large hiatus hernia or previous gastric surgery. It suits patients who want a meaningful, lasting result but not a surgical operation, or who have a BMI too low for surgery. A gastroscopy on arrival confirms suitability.

Why Istanbul, and why through us

ESG costs £8,000–12,000 privately in the UK and €9,000–13,000 in Germany. Our partner bariatric endoscopy team performs it regularly in a JCI-accredited hospital with the same Apollo system, at a third of the price, and because recovery is fast the whole trip is four nights.

You deal with one coordinator, one hospital and one medical team from the first message to the last follow-up. Every price is itemised in writing before you pay a deposit, and the written quote does not change unless you change the plan. Flights are never included.

Recovery and follow-up

One night in hospital, then the hotel; most patients fly home on day four. Nausea and cramping for two to three days are normal. Liquids for two weeks, puree for two, then a structured diet. Work from day three to five. The dietitian follows you remotely at one, three, six and twelve months — the result depends on it.

Cost of ESG in Turkey

The published price includes the procedure, gastroscopy, one hospital night, hotel, transfers and twelve months of remote dietitian follow-up. Flights are never included.

Distinguish gastroplasty from sleeve gastrectomy

Ask the clinician to explain precisely which procedure is proposed. Ask how endoscopic sleeve gastroplasty differs from surgical sleeve gastrectomy, and request the exact name in your consent documents.

If you arrived through an advertisement for “non-surgical sleeve,” ask what that description does and does not mean. It should not become a promise that the procedure has no material risks, needs no anaesthesia or requires no clinical follow-up.

Compare the options before choosing a label

Explain your previous treatment experience and what you are seeking from another intervention. Ask the team to compare the proposed endoscopic treatment with appropriate medical or surgical alternatives and no intervention for now.

A comparison should address more than weight change. Ask about risks, the support programme, possible further treatment and the uncertainty around results. Do not decide from a claim that one approach is always easier or safer.

Confirm the service and the actual price

The current catalogue figure is labelled as a market benchmark. It is not evidence of a confirmed partner offer. Ask for a named clinician, facility and written quote before you book.

Ask what the estimate covers: assessment, procedure, anaesthesia or sedation where applicable, hospital arrangements, accommodation and follow-up. Flights are not included. If another treatment is suggested after examination, request a separate explanation and updated quote.

Plan beyond the procedure day

Ask what dietary guidance and clinical review are recommended afterwards, who supplies them and what happens once you return home.

Request clear instructions about whom to contact for a concern and how urgent assessment is arranged. A remote message is not the same as an examination. Do not use another patient's timetable as your own discharge plan.

Is ESG a reversible version of sleeve surgery?

Ask the specialist to explain the exact procedure, limitations and any possible future interventions. Do not assume reversibility from a marketing description.

Does the online figure confirm availability?

No benchmark establishes a named provider or bookable package. Confirm both before paying.

What should my consultation answer?

Why the treatment is being considered for you, which alternatives are relevant, what risks matter and how follow-up will work.

Look for an assessment service, not only a suturing device

Use NICE's ESG guidance to discuss assessment and monitoring with the specialist. It is UK guidance, not verification of a Turkish facility. Ask who assesses your medical history, nutritional needs and readiness for follow-up, who performs the endoscopy and how to verify the named team and premises.

Explain previous stomach procedures, reflux symptoms, current medicines and earlier weight-management treatment. Ask which of these could change the recommendation or require further assessment. A photograph and a BMI figure cannot answer every clinical question. Ask the specialist to explain eligibility after assessment rather than relying on an age or BMI range alone.

Make the alternatives comparison specific to your priorities

If avoiding abdominal incisions is your priority, ask what endoscopic treatment still involves: anaesthesia, internal sutures, recovery restrictions and possible additional treatment. If your priority is long-term weight management, ask how the support programme and alternatives fit your health history rather than comparing headline percentages from different studies.

Ask whether continued medical weight management, a gastric balloon, sleeve gastrectomy, or postponing an intervention is relevant. These links explain options; they do not establish that you qualify for them. Request the reason for the recommendation and the reason another approach was not selected.

Plan the first trip and the months afterwards separately

The ESG catalogue entry is a market benchmark with a one-night hospital notation. Ask for the actual accommodation and duration of dietary support rather than inferring them from this entry. Request a current partner quote that separates hospital care, hotel accommodation, clinical reviews and dietary support. Flights are excluded.

Before travel, ask for written instructions on eating and drinking, medicines, expected symptoms and the symptoms that require urgent assessment. Confirm how you will reach a clinician outside a scheduled appointment and where you would be examined after returning home. Do not treat the absence of an external wound as evidence that you are ready to work, exercise or fly.

What if I cannot attend the recommended follow-up?

Raise this before booking. Ask which appointments can be remote, which need local examination or testing and who receives the results. An intervention should not be selected on the assumption that follow-up can be skipped.