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Endoscopic Sleeve Gastroplasty (ESG)
in Toronto

Non-Surgical Weight Loss Procedure for Long-Term Weight Management

Endoscopic Sleeve Gastroplasty (ESG) is a minimally invasive weight loss procedure that reduces the size of the stomach without surgery or external incisions. Using an endoscope inserted through the mouth, the stomach is reshaped with internal sutures to help patients feel full sooner and eat smaller portions.

At 360 Sleeve, our team provides comprehensive weight loss solutions and personalized guidance to help you determine whether ESG, Gastric Sleeve Surgery, or another treatment is the right fit for your goals.

ESG Surgery in Toronto

What Is Endoscopic Sleeve Gastroplasty (ESG)?

Endoscopic Sleeve Gastroplasty is a non-surgical weight loss procedure that reduces the stomach’s capacity by placing a series of internal sutures through an endoscope.

Unlike gastric sleeve surgery, no portion of the stomach is removed. The procedure is performed through the mouth, eliminating the need for abdominal incisions.

By creating a smaller stomach pouch, ESG helps:

  • Reduce hunger
  • Increase feelings of fullness
  • Decrease portion sizes
  • Support long-term weight loss
  • Improve obesity-related health conditions

How Does ESG Work?

During the procedure, a flexible endoscope equipped with a suturing device is passed through the mouth into the stomach. A series of stitches are placed to fold and reduce the stomach’s size by approximately 70%.

Because no surgical incisions are required, patients typically experience a faster recovery compared to traditional bariatric surgery.

Who Is a Candidate for ESG?

You may be a candidate if you:

  • Have a BMI of 30 or higher
  • Have struggled to lose weight through diet and exercise alone
  • Prefer a less invasive option than surgery
  • Are committed to long-term lifestyle changes
  • Are looking for a procedure with minimal downtime

The best way to determine candidacy is through a consultation with our bariatric team.

Benefits of ESG

Minimally Invasive
No external incisions or surgical scars.

Outpatient Procedure
Most patients return home the same day.

Faster Recovery
Recovery is generally quicker than traditional weight loss surgery.

Significant Weight Loss
Patients can achieve meaningful weight loss when combined with healthy lifestyle changes.

Improved Health

Weight loss may help improve conditions such as:

  • Type 2 diabetes
  • High blood pressure
  • Sleep apnea
  • Joint pain
  • Metabolic syndrome

What Results Can I Expect?

Weight loss results vary from patient to patient.

Most patients begin noticing weight loss within the first few weeks after ESG. Success depends heavily on maintaining healthy eating habits, physical activity, and ongoing follow-up care.

Patients who actively participate in lifestyle changes typically achieve the best long-term results.

Recovery After ESG Procedure

Because ESG does not require surgical incisions, recovery is generally faster than traditional bariatric surgery.

Most patients can expect:

  • Mild nausea or stomach discomfort for several days
    Return to light activities within a few days
  • Gradual progression through a post-procedure diet
  • Return to normal routines within approximately one week

Our team provides detailed dietary guidance and support throughout recovery.

ESG vs Gastric Sleeve Surgery

ESG

Endoscopic Sleeve Gastroplasty
  • No external incisions
  • No portion of the stomach is removed
  • Performed using an endoscope through the mouth
  • Faster recovery and less downtime
  • Moderate weight loss results
  • Limited hormonal changes
  • Typically suitable for lower BMI patients
  • Can be a less invasive option for some patients
  • May be revised or converted to surgery later

Sleeve Surgery

Laparoscopic Sleeve Gastrectomy
  • Performed laparoscopically through small incisions
  • Approximately 80% of the stomach is removed
  • Surgical procedure performed under general anesthesia
  • Longer recovery period
  • Greater and more durable weight loss results
  • Significant hormonal and metabolic benefits
  • Suitable for a wider range of BMI levels
  • Considered the gold standard of bariatric surgery
  • Long-term proven outcomes and durability

Which Procedure is Right For Me?

ESG may be a good option for patients seeking a less invasive weight loss procedure with minimal downtime. Gastric Sleeve Surgery generally offers greater long-term weight loss, stronger metabolic improvements, and more durable results. During your consultation, our team will help determine which approach best aligns with your health goals, BMI, and medical history.

How Much Does ESG cost?

The cost of Endoscopic Sleeve Gastroplasty (ESG) at 360 Sleeve is $16,000. This includes the ESG procedure as well as access to our comprehensive 2-Year Aftercare Program, designed to support your long-term weight loss success through ongoing guidance and follow-up care.

Because ESG is performed in a private clinic setting, it is not covered by OHIP. However, many patients choose ESG as a minimally invasive alternative to weight loss surgery, offering meaningful weight loss without external incisions or a hospital stay.

During your consultation, our team will review the procedure, expected results, recovery, and financing options to help you determine whether ESG is the right weight loss solution for your goals.

Looking for the cost of ESG in Toronto? Contact 360 Sleeve to learn more about Endoscopic Sleeve Gastroplasty, financing options, and whether you may be a candidate for this minimally invasive weight loss procedure.

Meet Dr. Gamme

Meet Dr. Gamme

Dr. Gamme is a bariatric surgeon specializing in Endoscopic Sleeve Gastroplasty (ESG), a minimally invasive weight loss procedure performed without external incisions. Using advanced endoscopic techniques, he helps patients achieve meaningful weight loss with less downtime than traditional bariatric surgery.

At 360 Sleeve, Dr. Gamme takes a personalized approach to care, helping patients determine whether ESG is the right solution for their weight loss goals while providing ongoing support for long-term success.

Why Choose 360 Sleeve?

Canada’s Leader in Weight Loss Care

  • Over 5,000 weight loss procedures performed
  • Experienced bariatric surgeons and obesity specialists
  • Comprehensive pre- and post-procedure support
  • Personalized treatment plans
  • Financing options available
  • Long-term follow-up care

Whether you’re considering ESG, Gastric Sleeve Surgery, or SADI-S, our team is committed to helping you achieve lasting results safely and confidently.

Have Questions About ESG?

Explore our FAQ to learn all about long-term weight loss.

We address your most pressing questions and provide you with the information you’ll need to make informed decisions about this weight loss procedure.

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Dr. Gary Gamme - Sleeve Surgeon at 360 Sleeve

Meet Your ESG Doctor

Dr. Gary Gamme, specializing in Endoscopic Sleeve Gastroplasty

Considering Bariatric Surgery?

If you have struggled to achieve lasting results through diet, exercise, or medically supervised weight-loss programs, bariatric surgery may be worth exploring with a qualified specialist.

Our team evaluates each patient individually to determine whether gastric sleeve surgery or another bariatric procedure may be appropriate based on their health history and treatment goals.

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Start Your New Life Today

Are you ready to transform your weight, your health, and your life? Take the next step by contacting us now.

Meet Dr. Irshad

Dedicated to surgical innovation. Driven to provide unparalleled care.

Dr. Irshad’s Approach

Dr. Kashif Irshad (MD, MSc, FRCSC) is a highly skilled and compassionate gastric sleeve surgeon. He’s also one of Canada’s pioneers in the field of bariatric surgery, with over 15 years of experience transforming the lives of countless individuals struggling with weight management.

Through his commitment to excellence, innovation, and patient-centred care, Dr. Irshad has earned a well-deserved reputation as a trusted leader in the field of bariatric surgery.

He combines an extensive knowledge with a deep understanding of the physical, emotional, and psychological aspects of obesity.

You can expect Dr. Irshad to approach your journey with empathy and compassion – he recognizes that weight loss is not simply about shedding pounds, but about empowering individuals to lead healthier, more fulfilling lives.

Dr. Irshad’s Background

  • Chief of the Division of Thoracic and Foregut Surgery at William Osler Health System.
  • Completed over 3000 surgeries on the stomach and has mentored surgeons across the country on his techniques. 
  • Obtained his medical degree in 1998 at McGill University, where he also completed his formal training in General Surgery.
  • Completed his Master of Science in Experimental Surgery during his residency.
  • Trained in Thoracic Surgery at McMaster University.
  • Completed a prestigious fellowship at the University of Pittsburgh Medical Centre, where he trained under world-renowned bariatric and esophageal surgeons.
  • Pioneered the Sleeve Gastrectomy at William Osler Health System in 2009.
  • Has since brought his unique skill set to Clinic 360 where he has performed thousands of gastric operations including complex Bariatric revisions.
  • Published extensively on gastric and esophageal surgery.
  • Published the first Canadian series of Minimally Invasive Esophagectomies and presented his results at a national meeting in 2009. 
  • A member of the American Board of Obesity Medicine.

Select Publications

Irshad, K., Hazrati, A., Merchant, N., Auzad, A. & Pereira, S. (2023). A retrospective study assessing the effects of bariatric surgery on comorbid conditions and quality of life in obese individuals. Obesity Medicine.