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If you have been researching weight loss surgery options, you have likely come across both the Laparoscopic Sleeve Gastrectomy (LSG) and the Endoscopic Sleeve Gastroplasty (ESG). While both procedures reduce the stomach's capacity and help you feel full faster, they are fundamentally different in how they work, who they are best suited for, and what you can expect in terms of results.

This page will walk you through a clear, honest comparison so you can come to your consultation informed and ready to make the best decision for your body and your goals.

The Laparoscopic Sleeve Gastrectomy is the most commonly performed bariatric surgery in the United States. During the procedure, Dr. Rodriguez makes four to five small incisions in the abdomen and uses a laparoscope to remove approximately 75 to 80 percent of the stomach. What remains is a narrow, sleeve-shaped tube — roughly the size of a banana.

The portion of the stomach that is removed is also responsible for producing ghrelin, the hunger hormone. This is why patients report not only feeling full quickly, but also feeling significantly less hungry overall — often within days of surgery.

Because the sleeve is a permanent surgical alteration, it offers durable, long-term weight loss results that are difficult to reverse. It is our most commonly recommended procedure for patients with a BMI of 30 or higher, especially when obesity-related health conditions are present.

The Endoscopic Sleeve Gastroplasty is a newer, incision-free procedure in which a flexible endoscope is passed through the mouth into the stomach. Using a suturing device attached to the scope, Dr. Rodriguez folds the stomach in on itself and stitches it into a smaller, sleeve-like shape — without removing any tissue and without making a single cut in the abdomen.

Because the stomach is reduced in volume but not permanently removed, the ESG is technically reversible, though reversal is rarely performed. Recovery is faster than with a surgical sleeve, and most patients return to normal activity within a few days.

The ESG is an excellent option for patients who want a meaningful, medically supervised weight loss intervention but are not ready for or do not require traditional surgery — particularly those in the BMI 28 to 36 range.

There is no universal right answer — the best procedure is the one that matches your BMI, health history, weight loss goals, and lifestyle. Use this as a starting guide:

There is no universal right answer — the best procedure is the one that matches your BMI, health history, weight loss goals, and lifestyle. Use this as a starting guide:

You may be a better fit for the Sleeve (LSG) if...

• Your BMI is 36 or higher
• You have type 2 diabetes or pre-diabetes
• You have significant weight to lose (100 lbs+)
• You have sleep apnea or hypertension
• You want maximum, durable long-term weight loss

You may be a better fit for the ESG if...

• Your BMI is between 28 and 36
• You want to avoid any abdominal incisions
• You prefer a shorter recovery time
• You want a less invasive first step
• You are not a surgical candidate due to other health factors

We believe in transparent, all-inclusive pricing with no surprise bills. Our current procedure pricing:

•  ESG (Endoscopic Sleeve Gastroplasty): starting at $9,800

•  Gastric Sleeve (LSG): starting at $10,800

•  Mini Gastric Bypass: $12,500

•  Gastric Bypass (RNY): $13,500

All procedures include pre-operative nutritional and psychologic evaluation, surgery, and post-operative follow-up care. Most patients can finance through our available options — ask us at your consultation.

One of the things that sets Dr. Rodriguez apart is his specialization in minimally invasive, same-day bariatric surgery. Whether you choose the sleeve, the ESG or other procedures, you go home the same day of your procedure — not a week later. Our focused pre-operative process gets most patients surgery-ready in just 2 to 4 weeks, not months.

The best way to know which option fits your situation is a direct conversation with Dr. Rodriguez. In your consultation, we will review your BMI, medical history, weight loss goals, and any existing health conditions to give you a clear, personalized recommendation — with no pressure.

Call us at 561-829-7982 or use the contact form to schedule your consultation. We serve patients from Delray Beach, Boca Raton, and across the country.

Our programs focus on holistic health, including nutrition, exercise, and stress management. We aim to empower you with the tools and knowledge needed to maintain a balanced and healthy lifestyle.