Surgical Sleeve (Laparoscopic Sleeve Gastrectomy)
LSG is the most prevalent weight loss surgery in Australia. It removes a substantial portion of the stomach, creating a sleeve shape, and also reduces ghrelin (the hunger hormone).
Advantages
- High efficacy
- Established safety profile
- Widespread surgical expertise
Disadvantages
- Permanent and irreversible
- 1–3% serious complication rate (bleeding, staple line leaks)
- May worsen or cause gastro-oesophageal reflux disease (GORD)
Endoscopic Sleeve Gastroplasty (ESG)
ESG is a minimally invasive procedure using the Overstitch device, performed entirely through the mouth. It has a decade of research with encouraging results.
Why ESG? The Unmet Need
Fewer than 2% of eligible candidates pursue surgical options due to:
- Concerns about permanence
- Surgical access limitations
- Complication anxiety
- Reluctance about recovery time
- Borderline BMI (30–35) not meeting surgical thresholds
ESG bridges the gap between medical and surgical approaches for these patients.
Treatment Selection Factors
- Anatomical modification acceptance
- Required weight loss magnitude
- Recovery expectations
- Pre-existing reflux history
- Surgical history complexity
Guidelines by BMI Class
- Class 1 (BMI 30–35): Weight loss drugs or ESG alone
- BMI 35+: ESG combined with pharmaceuticals, or standalone surgery
A sequential or phased approach is reasonable. One size doesn't fit all - Dr Fazal will work with you to find the right approach.
How to Book
Request an appointment with Dr Fazal today to discuss which approach is right for you. You will need a referral letter from your GP.