1555 - Endoscopic Sleeve Gastroplasty (ESG) for the treatment of patients with Class I and Class II obesity with comorbidities who have failed first-line treatments

Page last updated: 04 May 2021

Application Detail

Description of Medical Service

Endoscopic Sleeve Gastroplasty is an incisionless, minimally invasive procedure developed for bariatric treatment. ESG is delivered in a single endoscopic session using commercially available equipment. ESG reduces gastric capacity between 70% and 85% by creating a restrictive sleeve through a series of endoscopically placed full-thickness sutures. This imbrication of the greater curvature of the stomach is similar to but not identical to sleeve gastrectomy in shape. The gastroplasty is created using an endoscopic suturing device fitted to an endoscope. An oesophageal overtube is using during the procedure as well as a tissue helix device to ensure full-thickness bites. The procedure is performed under general anaesthesia with endotracheal intubation.

Description of Medical Condition

According to the Australian Institute of Health and Welfare, 63% of Australian adults were overweight or obese in 2014-15 [1]. Of this population, 28% are obese, equating to roughly six million Australians with a body mass index (BMI) of 30 and above. Current studies show that around 70% of obese individuals have at least one established morbidity, including but not limited to type-2 diabetes, heart disease, sleep apnoea, hypertension, stroke, and musculoskeletal diseases [2]. Obesity has also been linked to various cancers and it is estimated that 3.6% of all new cancers globally are attributable to overweight and obesity [3]. From an economic perspective, obese individuals have medical costs that are roughly 30% greater than their normal weight peers [4]. The latest PricewaterhouseCoopers report estimated that the direct and indirect costs of obesity in Australia is $8.65 billion, creating a large financial burden on Australia’s healthcare system as well as tying up valuable healthcare resources to treat this chronic disease [5].

Reason for Application

New MBS item

Medical Service Type


Previous Application Number

Not Applicable

Associated Documentation

Application Form

Application Form (Word 1220 KB)
Application Form (PDF 1509 KB)

Consultation Survey

Consultation Survey (Word 508 KB)
Consultation Survey (PDF 304 KB)

PICO Confirmation

Ratified PICO Confirmation (PDF 1706 KB)
Ratified PICO Confirmation (Word 283 KB)

Assessment Report


Public Summary Document

Public Summary Document (Word 229 KB)
Public Summary Document (PDF 590 KB)

Meetings for this Application


6-7 December 2018


10-11 October 2019


28-29 November 2019