Non-surgical weight loss option now available in Alberta

EDMONTON - Albertans now have access to non-surgical treatment for obesity - a minimally invasive weight-loss procedure performed by bariatric surgery and gastroenterology teams at the Royal Alexandra Hospital.

Endoscopic sleeve gastroplasty (ESG) reduces the stomach size by suturing it internally. The surgical team inserts a thin flexible tube with a camera down the mouth to reach the stomach. They then use tools through the endoscope to stitch the stomach from the inside to reduce the size of the organ. The procedure typically takes about 90 minutes.

"This procedure is a significant advancement in the field of weight-loss surgery, especially for patients who don't qualify for traditional bariatric surgery or prefer a less invasive option," says Dr. Noah Switzer, upper gastrointestinal and bariatric surgeon. "Rather than having a complex surgery requiring extensive recovery, patients have access to technology that requires no cuts or incisions that allows them to go home the same or next day."

For years, Mary-Ann Thurber felt hesitant about the risks associated with bariatric surgery as a long-term weight management treatment. The 65-year-old patient in the Edmonton Adult Bariatric Specialty Surgery Clinic at the hospital found short-term success with appetite suppression medication. She was offered the new procedure as an alternative treatment option.

"Since having the procedure in February, I am sleeping better, I have more energy and ultimately feel better equipped and motivated to manage my weight without the help of appetite suppression medication," says Thurber. "I’m so grateful this option was available for me in Edmonton."

Like bariatric surgery, the new procedure makes patients feel full with less food, leading to weight loss and improvement in weight-related conditions such as diabetes, high blood pressure and sleep apnea.

"Unlike a laparoscopic sleeve gastrectomy, where upwards of 80 per cent of the stomach is removed, ESG uses an endoscopic suturing device to fold and stitch the stomach tissue into a smaller shape, keeping the entire organ in place," says Dr. Kirles Bishay, gastroenterologist at the hospital. "Thanks to new technology, we can reduce the size of the stomach without removing any part of the stomach, meaning ESG patients have a lower risk of surgery and quicker recovery."

Thurber stopped taking her appetite suppression medication shortly before the ESG procedure and is expected to continue to see some weight loss post-procedure, without the ongoing support of medication.

In the past five years, more patients are finding success with weight management with the increase of glucagon-like peptide-1 (GLP-1) prescribed medications on the market; however, stopping the medication can often lead to weight regain.

"There are benefits and risks associated with any medication," says Dr. Switzer. "ESG should help get patients off lifetime weight management medication and give them a sustainable tool to achieve better health and weight outcomes."

The endoscopic device, which allows surgeons to suture the stomach from the inside, was approved by Health Canada in February 2024. The endoscopic procedure is jointly performed by a surgeon and gastroenterologist through the Edmonton Adult Bariatric Specialty Surgery Clinic at the Royal Alex, which is the only facility in Alberta where the procedure is performed. Since first performing the procedure in December, the team has completed eight procedures, making the Royal Alex now home to the largest ESG program in Western Canada.

A referral to the Edmonton Adult Bariatric Specialty Surgery Clinic at the Royal Alex by a physician, nurse practitioner, or specialist is required for adults who struggle with obesity and meet clinic criteria. This clinic is a bariatric surgical clinic only. In preparing for bariatric surgery, medical and psychological interventions are provided to patients to ensure they are successful pre and post-surgery.

Alberta Health Services provides a range of healthcare services for more than five million adults and children living in Alberta. Our mission is to provide excellent, patient-focused healthcare that is accessible and sustainable for all Albertans. Our current focus is on reducing emergency department wait times, increasing access to surgeries, and improving patient flow.