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Procedures

Six options.
One honest recommendation.

We offer endoscopic and surgical procedures under one roof, so the recommendation you get is based on what suits you, not on the one procedure a clinic happens to offer.

Do you qualify?EndoscopicSurgicalCompare side by side
A guide, not a diagnosis

Do you qualify?

BMI 27 to 35

You may be a candidate for an endoscopic sleeve (ESG, with related health conditions below BMI 30) or an intragastric balloon, a temporary first step. Medication-based care through WeightSimple is another option.

See ESGSee the balloon
BMI 30 to 40

You may be a candidate for an endoscopic sleeve (ESG), with no external incisions, or for any of our surgical options: sleeve gastrectomy, gastric bypass, or SADI.

See ESGSee surgical options
BMI 35 and above

Surgical options such as sleeve gastrectomy or gastric bypass may be appropriate, especially with conditions like type 2 diabetes. ESG is still an option, and a GLP-1 medication may be added if you want greater weight loss.

See ESGSee sleeve gastrectomySee gastric bypass
BMI 40 and above

SADI and gastric bypass are often discussed. Sleeve gastrectomy (LSG) and ESG, with or without a GLP-1 medication, are still options. We may recommend medically supervised weight loss before surgery to improve safety.

See SADISee sleeve gastrectomySee ESG
Previous gastric bypass or mini bypass

If weight has returned after a gastric bypass or mini bypass, TORe tightens the stretched connection endoscopically. Other revision options are discussed at consultation.

See TORe

Candidacy depends on more than BMI. Your surgeon reviews your full health history before recommending any procedure.

Endoscopic

Through the mouth, no external incisions.

Illustration of Endoscopic Sleeve Gastroplasty
ESG
Endoscopic, no incisions

Endoscopic Sleeve Gastroplasty

An endoscope passed through the mouth places sutures that fold the stomach and reduce its volume by roughly 70%. Nothing is cut or removed, and there are no external incisions. The procedure takes about 60 to 90 minutes.

Often suits
BMI 27* to 50, prefers to avoid surgery
Recovery
Back to desk work in 1 to 3 days
Typical loss
15 to 20% of body weight
Price
$16,000 to $17,000

* At BMI 27 to 30, ESG is considered when there are related health conditions. Our team will assess these and discuss them with you.

About ESGDiscuss this option
Illustration of Transoral Outlet Reduction
TORe
Endoscopic, no incisions

Transoral Outlet Reduction

For patients whose weight has returned after a gastric bypass or mini bypass. Sutures placed endoscopically tighten the stretched connection between the stomach pouch and small intestine, restoring some of the bypass's original restriction.

Often suits
Weight regain after gastric bypass or mini bypass
Recovery
About 1 to 2 days
Typical loss
7 to 10% of body weight
Price
$12,000 to $13,000
About TOReDiscuss this option
Illustration of Intragastric Balloon
Balloon
Endoscopic, no incisions

Intragastric Balloon

A soft balloon is placed in the stomach through the mouth and filled so smaller meals feel filling. It is removed after about six months, while the habits built during that time carry on.

Often suits
BMI 27 to 35, wants a temporary first step
Recovery
Usually same day
Typical loss
5 to 7% of body weight
Price
$8,000 to $9,000
About the balloonDiscuss this option
Surgical

Keyhole surgery, small incisions.

Illustration of Laparoscopic Sleeve Gastrectomy
LSG
Surgical, keyhole

Laparoscopic Sleeve Gastrectomy

About 80% of the stomach is removed through small keyhole incisions, leaving a narrow sleeve that limits intake and lowers hunger-hormone levels.

Often suits
BMI 30 and above
Recovery
About 2 to 4 weeks
Typical loss
25 to 30% of body weight
Price
$15,000 to $16,000
About LSGDiscuss this option
Illustration of Roux-en-Y Gastric Bypass
RYGB
Surgical, keyhole

Roux-en-Y Gastric Bypass

A small stomach pouch is created and connected directly to the small intestine, reducing both how much you eat and how much is absorbed.

Often suits
BMI 35 and above
Recovery
2 to 4 weeks
Typical loss
30 to 40% of body weight
Price
$16,000
About RYGBDiscuss this option
Illustration of a duodenal switch, standing in for SADI
SADI
Surgical, keyhole

Single Anastomosis Duodeno-Ileal Bypass

Combines a sleeve gastrectomy with a single intestinal bypass connection. It is a simplified form of the duodenal switch, and requires lifelong nutritional follow-up.

Often suits
BMI 35 and above
Recovery
Several weeks
Typical loss
35 to 45% of body weight
Price
$20,000 to $22,000
About SADIDiscuss this option

Weight-loss ranges are typical total body weight loss reported in published literature, not SmartSleeveMD outcomes data. Individual results vary.

Side by side

Compare all six.

Showing 6 procedures

Comparison of the six procedures
FeatureESGEndoscopic Sleeve GastroplastyTOReTransoral Outlet ReductionBalloonIntragastric BalloonLSGLaparoscopic Sleeve GastrectomyRYGBRoux-en-Y Gastric BypassSADISingle Anastomosis Duodeno-Ileal Bypass
How it's doneThrough the mouth, sutures fold the stomachThrough the mouth, sutures tighten the bypass outletThrough the mouth, a balloon occupies stomach spaceKeyhole surgery, part of the stomach removedKeyhole surgery, small pouch connected to the intestineKeyhole surgery, sleeve plus one intestinal connection
IncisionsNoneNoneNoneSmall, 0.5 to 1.5 cmSmall, 0.5 to 1.5 cmSmall, 0.5 to 1.5 cm
RecoveryBack to desk work in 1 to 3 daysAbout 1 to 2 daysUsually same dayAbout 2 to 4 weeks2 to 4 weeksSeveral weeks
PermanenceLong-term, can be revisedLong-termTemporary, removed at about 6 monthsPermanentPermanentPermanent
Often suitsBMI 27* to 50 (*27 to 30 with related health conditions)Weight regain after gastric bypassBMI 27 to 35, wants a temporary first stepBMI 30 and aboveBMI 35 and aboveBMI 35 and above
Typical weight loss15 to 20%7 to 10%5 to 7%25 to 30%30 to 40%35 to 45%
Price$16,000 to $17,000$12,000 to $13,000$8,000 to $9,000$15,000 to $16,000$16,000$20,000 to $22,000
ESGEndoscopic Sleeve Gastroplasty
Endoscopic, no incisions
How it's done
Through the mouth, sutures fold the stomach
Incisions
None
Recovery
Back to desk work in 1 to 3 days
Permanence
Long-term, can be revised
Often suits
BMI 27* to 50 (*27 to 30 with related health conditions)
Typical weight loss
15 to 20%
Price
$16,000 to $17,000
TOReTransoral Outlet Reduction
Endoscopic, no incisions
How it's done
Through the mouth, sutures tighten the bypass outlet
Incisions
None
Recovery
About 1 to 2 days
Permanence
Long-term
Often suits
Weight regain after gastric bypass
Typical weight loss
7 to 10%
Price
$12,000 to $13,000
BalloonIntragastric Balloon
Endoscopic, no incisions
How it's done
Through the mouth, a balloon occupies stomach space
Incisions
None
Recovery
Usually same day
Permanence
Temporary, removed at about 6 months
Often suits
BMI 27 to 35, wants a temporary first step
Typical weight loss
5 to 7%
Price
$8,000 to $9,000
LSGLaparoscopic Sleeve Gastrectomy
Surgical, keyhole incisions
How it's done
Keyhole surgery, part of the stomach removed
Incisions
Small, 0.5 to 1.5 cm
Recovery
About 2 to 4 weeks
Permanence
Permanent
Often suits
BMI 30 and above
Typical weight loss
25 to 30%
Price
$15,000 to $16,000
RYGBRoux-en-Y Gastric Bypass
Surgical, keyhole incisions
How it's done
Keyhole surgery, small pouch connected to the intestine
Incisions
Small, 0.5 to 1.5 cm
Recovery
2 to 4 weeks
Permanence
Permanent
Often suits
BMI 35 and above
Typical weight loss
30 to 40%
Price
$16,000
SADISingle Anastomosis Duodeno-Ileal Bypass
Surgical, keyhole incisions
How it's done
Keyhole surgery, sleeve plus one intestinal connection
Incisions
Small, 0.5 to 1.5 cm
Recovery
Several weeks
Permanence
Permanent
Often suits
BMI 35 and above
Typical weight loss
35 to 45%
Price
$20,000 to $22,000

Weight-loss ranges are typical total body weight loss reported in published literature, not SmartSleeveMD outcomes data. Individual results vary. Prices are ranges; you'll get an exact quote at consultation.

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