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The stomach can be made smaller without surgery. This procedure is called endoscopic sleeve gastroplasty, or ESG. A flexible endoscope is passed through the mouth, down the esophagus, and into the stomach. A small camera allows the doctor to see the stomach lining from inside. Using a special suturing device, the doctor places a series of stitches, along the stomach wall. These stitches pull the stomach walls together, creating folds that shorten and narrow the stomach. As the sutures are tightened, the stomach becomes smaller and takes on a tube like shape. This reduces how much food the stomach can hold, and helps patients feel full sooner. Because no external incisions are needed, recovery is usually faster than with traditional bariatric surgery. Patients may lose significant weight when the procedure is combined with lifestyle changes.