Fig. 1
Gastric sleeve
Home the same day, for most
Endoscopic Sleeve Gastroplasty (ESG) in Toronto
ESG: a smaller stomach, from the inside
Endoscopic sleeve gastroplasty folds the stomach into a narrower shape with stitches placed through the mouth. No incisions, nothing removed, and most people go home the same day.
- 0incisions
- 0removed
- Same dayhome, for most
Where the work happens
A sleeve is done through five small incisions in the upper belly. ESG reaches the stomach through the mouth and esophagus, so the skin is never opened.
About the gastric sleeveThrough the scope, step by step
Scroll to follow the endoscope: through the mouth, stitches placed from inside, each row tightened. Scroll back to see any step again.
Fig. 2, ESG - 01
Your stomach today
ESG reshapes the stomach from the inside. Nothing is removed and there are no incisions.
- 02
Through the mouth
Under anesthesia, a flexible endoscope passes through the mouth and esophagus into the stomach.
- 03
Stitches from inside
A suturing device places full-thickness stitches in rows along the greater curve.
- 04
Cinched into a sleeve shape
Each row is tightened. The stomach folds into a narrow tube, about 70% smaller in volume.
- 05
No cuts, no scars
The endoscope comes out the way it went in. Most people go home the same day.
- 06
Smaller, same path
Food follows the natural route through a smaller stomach, so most people feel full sooner.
A simplified 3D illustration for education, built from anatomical proportions. Your surgeon explains what applies to you.
The day of your ESG
One visit, from arrival to home. Your nurse and the anesthesia team stay with you throughout.
- 01
Arrive
Check in, meet your nurse and the anesthesia team.
- 02
Anesthesia
You sleep through the procedure under general anesthesia.
- 03
The procedure
A flexible endoscope, stitches from the inside, no incisions.
- 04
Recovery
A few hours with a recovery nurse while you wake up.
- 05
Home
Most people go home the same day, with a clear plan for the first weeks.
The first weeks. You start with liquids and move to soft and then regular foods in stages, guided by your dietitian. Some people feel nausea or cramping for the first days; your team helps you manage it.
Aftercare at 360 SleeveIs ESG for me?
ESG is commonly discussed for adults who fit these descriptions. Dr. Gamme makes the decision with you at your consultation.
- 01A BMI of about 30 to 40The range where ESG is most often discussed.
- 02You would rather avoid incisionsNothing is cut and nothing is removed.
- 03Surgery is not right for you yetOr you are not ready for it. ESG is a different path, not a lesser one.
Performs ESG at 360 Sleeve
Dr. Gary Gamme
MD, MPH, FRCSC, FACS, DABOM
A bariatric and advanced endoscopic surgeon. He holds a Master of Public Health from Harvard and trained in advanced endoscopy in Miami and in bariatric surgery in Ottawa.
- FRCSC
- Fellow of the Royal College of Surgeons of Canada
- FACS
- Fellow of the American College of Surgeons
- DABOM
- Diplomate of the American Board of Obesity Medicine
360 SleeveESG, all-in price
- Your procedureDr. Gary Gamme and the endoscopy teamIncluded
- AnesthesiaWith monitoring throughoutIncluded
- The facilityProcedure room, recovery room and nursingIncluded
- TaxesIncluded in the priceIncluded
Total, taxes included$16,000
$16,000, all in
Taxes included. The aftercare included with ESG is confirmed at your consultation. OHIP does not cover ESG at 360 Sleeve.
$516a month at an example 9.9% APR
Financing through Beautifi or Medicard, 6 months to 6 years, no prepayment fees. The lender sets your rate after approval.
Questions about ESG
What people ask before choosing ESG. Dr. Gamme goes through all of it with you, for your situation.
Still wondering? , or ask the assistant in the corner.
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01Is ESG surgery?
ESG is an endoscopic procedure. It is done from the inside, through the mouth, under general anesthesia. There are no incisions on the belly and no scars.
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02Is anything removed?
No. Stitches fold the stomach into a narrower shape. Nothing is cut out, and food follows its natural route.
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03How does recovery go?
Most people go home the same day. Some feel nausea or cramping for the first days, which your team helps you manage. You start with liquids and move on to other foods in stages, guided by your dietitian.
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04When can I go back to work?
Many people return to light work within a few days to a week. Your team tells you what applies to you and your job.
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05How is ESG different from a sleeve?
A sleeve removes about 80% of the stomach through small incisions. ESG makes the stomach smaller from the inside with stitches. The sleeve is usually discussed at higher BMIs; ESG most often between about 30 and 40.
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06Who performs ESG at 360 Sleeve?
Dr. Gary Gamme, a bariatric and endoscopic surgeon with fellowship training in advanced endoscopy and bariatric surgery.
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07Is ESG permanent?
ESG is meant to last. Nothing is removed, and the stitches stay in place. Over time, some stitches can loosen and the stomach can slowly stretch again, so your eating habits and follow-ups matter. Your surgeon explains what to expect in your case.
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08Can ESG be reversed?
Because nothing is cut out, ESG is often described as potentially reversible, but it is rarely undone. If needed, ESG can be repeated, or another procedure such as a gastric sleeve can be done later. Your surgeon goes through the options with you.
Your first step is a conversation
A free consultation, in person in North York or online. Meet the team, ask anything and leave with a clear plan and price.
(416) 360-7360 sleeve@clinic360.com 1131A Leslie St #300, Toronto, ON M3C 3L8