Endoscopic Bariatrics Treatment & Procedures at Apollo Hospitals

Overview

Endoscopic bariatrics is an innovative field of weight management that utilises minimally invasive techniques to help patients achieve significant weight loss without traditional surgery. This advanced approach bridges the gap between lifestyle interventions and bariatric surgery, offering effective solutions for individuals struggling with obesity who may not qualify for or prefer not to undergo surgical procedures.

At Apollo Hospitals, our comprehensive endoscopic bariatrics programme addresses weight management through various non-surgical and minimally invasive procedures, including:

• Endoscopic Sleeve Gastroplasty (ESG) - a procedure that reduces stomach volume by creating internal sutures
• Intragastric Balloon Systems - temporary devices placed in the stomach to create a feeling of fullness
• Endoscopic Gastric Plication - a technique that folds and sutures stomach tissue to reduce capacity
• Duodenal Liners - devices that bypass a portion of the small intestine to reduce calorie absorption
• Aspiration Therapy - a system that allows controlled removal of a portion of food after meals
• Primary Obesity Surgery Endoluminal (POSE) - creation of plications in the stomach fundus
• Transoral Gastroplasty - endoscopic creation of a restrictive sleeve in the stomach

These procedures are performed entirely through the mouth using flexible endoscopes and specialised instruments, eliminating the need for external incisions. Most can be completed in an outpatient setting with significantly shorter recovery times than traditional weight loss surgery.

Our endoscopic bariatrics approach provides a valuable treatment option for patients with BMIs between 30-40 who haven't achieved success with lifestyle modifications alone but may not be candidates for or prefer not to undergo more invasive surgical options. This integrated programme combines advanced procedural techniques with comprehensive lifestyle support to help patients achieve and maintain meaningful weight loss.

Our Expertise: Why Choose Apollo

Apollo Hospitals stands at the forefront of endoscopic bariatrics in India, offering unparalleled expertise in non-surgical and minimally invasive weight loss procedures. When you choose Apollo for your weight management journey, you benefit from:

Comprehensive Procedural Excellence

• Full spectrum of endoscopic weight loss options tailored to individual needs
• High procedural success rates exceeding international benchmarks
• Pioneering techniques including the latest innovations in endoscopic bariatrics
• Specialised expertise in managing complex and high-BMI cases
• Advanced revision procedures for patients who have regained weight
• Minimally invasive approach resulting in faster recovery and fewer complications
• Evidence-based protocols ensuring optimal outcomes and safety

Multidisciplinary Approach

• Integrated weight management team including gastroenterologists, dietitians, and psychologists
• Thorough pre-procedure assessment identifying the most appropriate intervention
• Personalised treatment planning considering medical history, weight goals, and lifestyle factors
• Collaborative care coordination throughout your weight loss journey
• Comprehensive psychological support addressing emotional aspects of weight management
• Nutritional expertise providing sustainable dietary guidance
• Lifestyle modification coaching supporting long-term success

Advanced Technology and Facilities

• State-of-the-art endoscopic equipment enabling precise procedures
• High-definition imaging systems enhancing visualisation during interventions
• Dedicated endoscopy suites designed specifically for bariatric procedures
• Advanced monitoring capabilities ensuring patient safety
• Latest-generation bariatric devices including balloons and suturing systems
• Comfortable recovery environments with specialised care teams
• Purpose-built facilities accommodating the needs of higher-weight patients

Patient-Centred Experience

• Transparent communication about expected outcomes and limitations
• Detailed pre-procedure education ensuring informed decision-making
• Compassionate care approach recognising the emotional aspects of weight management
• Private consultation settings respecting patient dignity and confidentiality
• Flexible scheduling options accommodating work and family commitments
• Ongoing support resources including group meetings and digital tools
• Lifelong follow-up programmes maintaining connection with the care team

Research and Innovation

• Participation in clinical trials evaluating emerging technologies
• Continuous procedural refinement improving techniques and outcomes
• Academic collaborations with international centres of excellence
• Regular publication in peer-reviewed medical journals
• Contributions to development of new bariatric devices and methods
• Outcomes tracking and analysis guiding quality improvement
• Fellowship training programmes developing the next generation of specialists

Our commitment to excellence in endoscopic bariatrics reflects our understanding that effective weight management requires more than just procedures—it demands comprehensive support, advanced technology, and an experienced team dedicated to your success. At Apollo Hospitals, we provide this integrated approach to help you achieve meaningful, sustainable weight loss and improved health.

Treatment Options for Endoscopic Bariatrics

Apollo Hospitals offers a comprehensive range of endoscopic bariatric procedures, each designed to address specific patient needs and weight management goals:

Primary Endoscopic Procedures

Endoscopic Sleeve Gastroplasty (ESG)

• Non-surgical reduction of stomach volume through endoscopic suturing
• Creation of a sleeve-shaped restriction that limits food intake
• Outpatient procedure typically completed in 60-90 minutes
• Average weight loss of 15-20% of total body weight within 12-18 months
• Preservation of normal stomach function and nutrient absorption
• Fully reversible if medically necessary
• Ideal for patients with BMI 30-40 seeking significant weight loss without surgery
• Lower risk profile compared to surgical alternatives

Intragastric Balloon Systems

• Temporary placement of a soft balloon within the stomach
• Space-occupying device creating earlier satiety with smaller meals
• Simple procedure performed under mild sedation in about 20-30 minutes
• Various balloon types available, including single, dual, and adjustable options
• Typically remains in place for 6-12 months depending on the system
• Average weight loss of 10-15% of total body weight during balloon placement
• Excellent option for patients requiring short-term weight loss
• Often used as a bridge therapy before more definitive procedures

Endoscopic Gastric Plication

• Reduction of stomach capacity through internal folding and suturing
• Creation of multiple tissue folds to restrict stomach volume
• Fully endoscopic procedure lasting approximately 60 minutes
• Potential weight loss of 15-18% of total body weight
• No stapling or removal of stomach tissue
• Maintained stomach function with normal digestive processes
• Lower complication rate than surgical alternatives
• Suitable for patients seeking a durable option with minimal invasiveness

Transoral Gastroplasty (TOGA)

• Creation of a narrow sleeve in the stomach using specialised devices
• Reduction of functional stomach capacity by approximately 80%
• Stapled restriction creating a smaller passageway for food
• Outpatient procedure with same-day discharge
• Expected weight loss of 15-20% of total body weight
• Preserved stomach integrity with no permanent alteration
• Potential for procedure revision if needed
• Appropriate for patients with BMI 35-40 seeking significant restriction

Advanced Metabolic Procedures

Duodenal Mucosal Resurfacing

• Targeted thermal ablation of duodenal mucosa
• Modification of gut signalling to improve metabolic health
• Particularly effective for patients with type 2 diabetes
• Procedure duration of approximately 60 minutes
• Modest weight loss (7-10% of total body weight) with significant metabolic benefits
• Improvement in blood glucose levels and insulin sensitivity
• Reduction in diabetic medication requirements
• Often combined with weight loss medications for enhanced results

Duodenal Sleeve Liner

• Flexible, thin-walled tube placed in the small intestine
• Creates a barrier between food and the intestinal wall
• Mimics the intestinal bypass component of gastric bypass surgery
• Implanted endoscopically in approximately 30-45 minutes
• Typically remains in place for 6-12 months
• Average weight loss of 15-20% of total body weight
• Significant improvement in glucose metabolism
• Ideal for obese patients with type 2 diabetes

Aspiration Therapy

• Minimally invasive device allowing partial removal of stomach contents after meals
• Small tube placement connecting the stomach to an external port
• Controlled aspiration of approximately 30% of food intake
• Quick outpatient procedure taking about 30 minutes
• Potential for long-term use with significant weight loss
• Average reduction of 15-20% of total body weight
• Regular monitoring and ongoing lifestyle support
• Option for patients requiring significant, sustained weight loss

Revision and Combination Therapies

Post-Surgical Revision Procedures

• Endoscopic techniques to address weight regain after bariatric surgery
• Suture placement to reduce enlarged gastric pouches
• Revision of gastrojejunal anastomosis
• Outlet reduction procedures for dilated connections
• Sclerotherapy to reduce stoma diameter
• Non-surgical approach to surgical complications
• Recovery of weight loss without reoperation
• Alternative to complex surgical revisions

Combination Therapy Programmes

• Integrating multiple endoscopic approaches for enhanced results
• Sequential procedures based on weight loss progress
• Customised combination of restrictive and metabolic techniques
• Stepped approach beginning with less invasive options
• Comprehensive medication management alongside procedures
• Intensive lifestyle modification support
• Personalised protocol development for complex cases
• Optimisation of outcomes through multimodal strategies

Each procedure is performed by our highly specialised team in a state-of-the-art endoscopy suite equipped specifically for bariatric interventions. All patients undergo comprehensive evaluation to determine the most appropriate option based on their medical history, body mass index, comorbidities, and weight loss goals. Treatment plans are developed collaboratively with input from gastroenterologists, dietitians, psychologists, and the patient themselves to ensure the best possible outcomes.

State-of-the-Art Technology

Apollo Hospitals integrates cutting-edge technology into our endoscopic bariatrics programme, enhancing procedural safety, precision, and effectiveness:

Advanced Endoscopic Systems

• High-definition endoscopes providing crystal-clear visualisation of internal structures
• Dual-channel therapeutic endoscopes allowing simultaneous use of multiple instruments
• 3D endoscopic imaging enhancing depth perception during complex procedures
• Near-infrared imaging capabilities for tissue characterisation
• Carbon dioxide insufflation systems reducing post-procedural discomfort
• Water jet-assisted endoscopes for improved tissue cleaning and visualisation
• Specialised large-diameter endoscopes designed specifically for bariatric procedures
• Ultra-thin gastroscopes for improved patient comfort during diagnostic assessments

Endoscopic Suturing and Plication Platforms

• Apollo OverStitch™ endoscopic suturing system enabling precise tissue approximation
• Incisionless Operating Platform (IOP) for full-thickness plications
• Endoscopic stapling devices creating durable gastric restrictions
• Tissue helix technology for secure tissue acquisition before suturing
• Automated suture tensioning systems ensuring optimal tissue approximation
• Multi-stitch deployment capabilities for efficient procedure completion
• Specialised suture materials designed for long-term gastric applications
• Endoscopic clip applicators for supplementary tissue securement

Intragastric Balloon Technologies

• Fluid-filled balloon systems with adjustable volumes for optimal tolerance
• Gas-filled lightweight balloons reducing side effects and improving comfort
• Multi-balloon systems distributing pressure more evenly in the stomach
• Balloon composition materials resistant to gastric acid degradation
• Advanced placement and removal tools ensuring procedural safety
• Next-generation balloon shapes designed to reduce migration risk
• Swallowable capsule balloons requiring no endoscopy for placement in select cases
• Programmable balloon deflation mechanisms for scheduled removal

Advanced Imaging and Monitoring Systems

• Endoscopic ultrasound integration for tissue layer visualisation
• Fluoroscopic guidance capabilities for precise device positioning
• Real-time procedure recording systems for quality review and education
• Vital sign monitoring platforms specifically calibrated for bariatric patients
• Body composition analysis technology providing detailed metabolic assessment
• 3D body scanning systems for objective measurement of body shape changes
• Continuous glucose monitoring integration for metabolic outcome tracking
• Digital image archiving for before-and-after comparisons

Digital Health Technology

• Apollo Hospitals website providing patient support and monitoring capabilities
• Remote patient monitoring platforms tracking weight and vital signs
• Digital food journaling tools integrated with nutritionist review
• Virtual support group platforms connecting patients for shared experiences
• Telehealth follow-up capabilities enabling convenient post-procedure care
• Patient education portals with multimedia learning resources
• Procedure simulation technology for patient education and consent
• Wearable activity trackers synced with patient records for progress monitoring

Specialised Procedural Equipment

• Custom bariatric procedure tables accommodating higher weight capacities
• Ergonomic procedure rooms designed for optimal workflow
• Advanced sedation delivery systems ensuring patient comfort
• Rapid recovery monitoring stations with specialised observation capabilities
• Emergency response equipment specifically designed for bariatric patients
• Dedicated fluoroscopy suites for procedures requiring imaging guidance
• Specialised patient transport solutions ensuring dignity and safety
• Bariatric-specific recovery furniture for post-procedure comfort

This technological infrastructure supports our endoscopic bariatrics specialists in delivering precise, effective procedures with optimal safety profiles. Our commitment to technological advancement reflects Apollo Hospitals' dedication to providing world-class care through innovation and excellence in medical technology.

Team of Experts

The excellence of Apollo Hospitals' endoscopic bariatrics programme is built upon our multidisciplinary team of specialists, each bringing unique expertise to create comprehensive care for patients seeking weight loss solutions:

• Interventional Gastroenterologists
• Bariatric Medicine Physicians
• Nutritional Support Team
• Psychological Support Specialists
• Exercise Physiology Team
• Support Staff

This collaborative team approach ensures that patients receive comprehensive care addressing all aspects of their weight management journey. Regular multidisciplinary case conferences allow our specialists to combine their expertise, creating personalised treatment plans that optimise outcomes for each individual. The seamless coordination between team members provides a supportive environment where patients feel guided and empowered throughout their weight loss experience.

Frequently Asked Questions

About Endoscopic Bariatric Procedures

What is endoscopic bariatrics and how is it different from bariatric surgery?

Endoscopic bariatrics refers to minimally invasive weight loss procedures performed entirely through the mouth using flexible endoscopes and specialised instruments. Unlike traditional bariatric surgery, these procedures require no external incisions, general anaesthesia is often unnecessary, and most can be performed as outpatient procedures.

Key differences include:

• Shorter procedure times (typically 30-90 minutes)
• Faster recovery (days versus weeks)
• Lower complication rates
• Reduced pain and discomfort
• Preservation of normal anatomical structure
• Often reversible or adjustable
• Viable option for patients with BMI 30-40

While surgical options typically result in greater weight loss, endoscopic procedures offer a valuable alternative for patients seeking significant results with less invasiveness or as an early intervention before considering surgery.

Which endoscopic bariatric procedure is right for me?

The most appropriate procedure depends on several factors:

• Your current BMI and weight loss goals
• Medical history and presence of comorbidities
• Previous weight loss attempts
• Anatomical considerations
• Lifestyle and eating habits
• Personal preferences regarding permanence vs. temporary intervention

During your comprehensive consultation at Apollo Hospitals, our specialists will:

• Review your complete medical history
• Perform physical examination and necessary diagnostic tests
• Discuss your weight loss goals and expectations
• Explain all suitable options with their benefits and limitations
• Create a personalised recommendation based on your specific profile

This collaborative process ensures you receive the procedure that offers the best balance of effectiveness, safety, and alignment with your personal needs.

How much weight can I expect to lose with endoscopic bariatric procedures?

Weight loss results vary by procedure and individual factors but typically fall within these ranges:

• Endoscopic Sleeve Gastroplasty (ESG): 15-20% of total body weight within 12-18 months
• Intragastric Balloon: 10-15% of total body weight during placement (6-12 months)
• Endoscopic Gastric Plication: 15-18% of total body weight over 12-18 months
• Aspiration Therapy: 15-20% of total body weight with continued use
• Duodenal Sleeve Liner: 15-20% of total body weight during placement

For context, a 100 kg individual might expect to lose approximately:

• 15-20 kg with ESG
• 10-15 kg with an intragastric balloon
• 15-18 kg with gastric plication

Individual results depend on multiple factors including adherence to dietary guidelines, exercise commitment, starting weight, metabolic factors, and attendance at follow-up appointments. Our comprehensive programme provides the support needed to help you achieve optimal results.

What happens during an endoscopic bariatric procedure?

While each procedure varies in its specific techniques, most follow this general process:

• Preparation: You'll follow specific pre-procedure instructions, typically including dietary restrictions for 24-48 hours
• Arrival: Check-in at our specialised endoscopy unit
• Sedation: Administration of conscious sedation or in some cases, general anaesthesia
• Procedure: An endoscope is passed through your mouth into the stomach
• Intervention: Depending on your procedure, this might involve suturing, balloon placement, sleeve creation, or device implantation
• Completion: The endoscope is removed, and you're transferred to recovery
• Recovery: Monitoring in our recovery area for 1-3 hours
• Discharge: Most patients return home the same day with specific care instructions

Our team provides detailed procedural education with visual aids before your appointment, ensuring you understand exactly what to expect at each step.

Is endoscopic bariatrics painful?

Endoscopic bariatric procedures typically involve minimal pain compared to surgical alternatives:

• During the procedure, you'll be under sedation and won't experience discomfort
• Immediately after, mild to moderate throat soreness is common but manageable
• Some patients experience temporary nausea or abdominal discomfort for 24-72 hours
• Most patients require only over-the-counter pain relief medications
• Significant pain is uncommon and may indicate an issue requiring medical attention

Our pain management protocols are tailored to each procedure and include preventative medications, clear post-procedure guidelines, and prompt access to medical advice if discomfort exceeds expected levels. Most patients report returning to normal activities within 1-3 days, with minimal reliance on pain medication.

What is the recovery process like?

Recovery from endoscopic bariatric procedures is typically straightforward:

• Immediate recovery (1-3 days):
  • Liquid diet progression following procedure-specific protocols
  • Mild throat soreness and potential nausea
  • Limited physical activity recommendation
  • Regular hydration with small, frequent sips
• Short-term recovery (4-14 days):
  • Gradual diet progression from liquids to pureed foods to soft foods
  • Return to normal daily activities within 1-3 days
  • Return to work within 1-5 days (procedure-dependent)
  • Beginning of lifestyle modification programme
• Long-term adjustment (2-6 weeks):
  • Transition to regular healthy eating patterns
  • Introduction of regular physical activity
  • Adaptation to new portion sizes and eating habits
  • Regular follow-up appointments with the multidisciplinary team

Throughout the recovery process, our team provides close monitoring, dietary guidance, and support through in-person appointments, ensuring any concerns are addressed promptly.

Will I need to change my diet and lifestyle after an endoscopic bariatric procedure?

Yes, dietary and lifestyle changes are essential components of successful outcomes:

• Dietary changes include:
  • Smaller, more frequent meals aligned with reduced stomach capacity
  • Emphasis on protein-rich foods to preserve muscle mass
  • Mindful eating practices, including thorough chewing and slow eating
  • Structured meal planning under nutritionist guidance
  • Limitation of high-calorie liquids that can undermine weight loss
  • Specific supplementation regimen based on your procedure
  • Gradual progression through dietary stages following your procedure
• Lifestyle modifications include:
  • Regular physical activity starting with walking and progressing to more structured exercise
  • Stress management techniques to prevent emotional eating
  • Adequate hydration but separate from mealtimes
  • Mindfulness practices around eating behaviours
  • Regular sleep habits supporting metabolic health
  • Participation in support groups or counselling sessions
  • Regular monitoring of weight and health markers

Our comprehensive programme provides education, support, and accountability in making these changes sustainable. Patients who fully embrace these modifications typically achieve significantly better results than those who rely solely on the procedure itself.

Can I regain weight after an endoscopic bariatric procedure?

Weight regain is possible after any weight loss intervention. Several factors influence long-term outcomes:

• Factors that support weight maintenance:
  • Consistent follow-up with the bariatric team
  • Adherence to recommended dietary guidelines
  • Regular physical activity (150+ minutes weekly)
  • Participation in support groups
  • Regular self-monitoring of weight and habits
  • Addressing emotional aspects of eating
  • Management of medical conditions that may affect weight
• Common reasons for weight regain:
  • Return to previous eating patterns, especially high-calorie foods and beverages
  • Gradual increase in portion sizes
  • Decline in physical activity levels
  • Untreated psychological factors related to eating
  • Development of "work-around" eating behaviours that circumvent the procedure's effects
  • Hormonal or metabolic adaptations

Apollo's programme specifically addresses weight maintenance with long-term follow-up protocols, refresher dietary counselling, behavioural strategies, and when appropriate, consideration of revision procedures or adjunctive treatments if significant regain occurs.

Practical Considerations

Is endoscopic bariatrics covered by insurance?

Insurance coverage for endoscopic bariatric procedures varies:

• Some insurers have begun covering specific procedures like ESG, particularly for patients with obesity-related conditions
• Coverage is more likely for patients with higher BMIs or significant comorbidities
• Documentation of previous supervised weight loss attempts often strengthens coverage cases
• Medical necessity letters from referring physicians can support coverage requests

Our financial counsellors at Apollo Hospitals can:

• Verify your insurance benefits before scheduling
• Provide detailed procedure codes for pre-authorization requests
• Assist with appeals if coverage is initially denied
• Explain financing options and payment plans if procedures aren't covered
• Connect eligible patients with available assistance programmes

We believe financial considerations shouldn't prevent access to effective treatment and work diligently to find solutions for each patient's situation.

How do I start the process at Apollo Hospitals?

Beginning your endoscopic bariatrics journey involves these simple steps:

• Initial contact: Schedule a consultation through:
  • Our website request form
  • Phone contact with our bariatric coordinator
  • Referral from your physician
• Pre-consultation questionnaire: Complete a comprehensive health assessment before your appointment
• Initial consultation: Meet with our bariatric specialist to discuss:
  • Your weight history and previous weight loss attempts
  • Medical conditions and medications
  • Weight loss goals and expectations
  • Potential procedure options
• Multidisciplinary evaluation: Assessments with:
  • Dietitian for nutritional evaluation
  • Psychologist for behavioural assessment
  • Additional specialists if needed based on medical history
• Procedure selection and preparation: Collaborative decision-making and preparation for your chosen intervention
• Procedure scheduling: Convenient booking with pre-procedure instructions

This streamlined process typically takes 2-4 weeks from initial contact to procedure, depending on insurance requirements and any necessary medical preparations.

Contact Our Endoscopic Bariatrics Team

Take the first step towards effective weight management by contacting our specialised Endoscopic Bariatrics department:

• Email:
• Online:
• Locations:
  • Delhi
  • Mumbai
  • Chennai
  • Bangalore
  • Hyderabad
  • Kolkata
  • [Other locations]

For a complimentary initial assessment or to attend one of our regularly scheduled information seminars about weight loss options, please contact our bariatric coordinators.

Begin Your Weight Loss Journey Today

Managing weight effectively can transform your health and quality of life. At Apollo Hospitals, our comprehensive endoscopic bariatrics programme offers innovative, minimally invasive solutions for individuals seeking significant weight loss without traditional surgery.

Our multidisciplinary team combines advanced endoscopic procedures with personalised nutritional guidance, psychological support, and ongoing follow-up to help you achieve and maintain meaningful weight loss. Whether you're concerned about obesity-related health conditions or seeking to improve your overall wellbeing, our patient-centred approach provides the support and expertise you need.

Non-surgical weight loss solutions with proven results.