Endoscopic Bariatric Revisions
Bariatric surgery is an incredible tool to help patients with weight loss as well as resolution of metabolic conditions such as diabetes, hypertension, high cholesterol and more. However, some patients can struggle with weight regain after these procedures or Dumping Syndrome after gastric bypass. Incisionless endoscopic revision procedures can help!
Bariatric Surgery Over Time
For some gastric bypass surgery patients, the stomach pouch and small bowel connection (anastomosis) created during gastric bypass surgery may stretch over time. This can reduce the feeling of satiety or fullness and allows patients to begin eating more, which can result in weight regain over time. It can also lead to dumping syndrome in bypass patients. Similarly, a gastric sleeve can enlarge over time whether due to it being created initially too big, stretching over time, or retained gastric fundus.
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Endoscopic revision provides patients who have stopped losing or are regaining weight with an incisionless procedure to restore their stomach to its original size so that weight loss can resume.
TORe Procedure
The TORe procedure (transoral outlet reduction) is performed through the mouth while the patient is under anesthesia. This eliminates external incisions required for most surgical procedures.
Using an endoscope, the surgeon is able to view the gastric pouch and connection (anastomosis) to the small intestine. With a suturing system, gastric bypass anatomy can be restored to its initial shape and size. The anastomosis is sutured to a normal bypass diameter and the gastric pouch itself can also be sutured smaller.
Often times this procedure can be completed in 15-30 minutes. After this non-invasive procedure, patients discharge home on the same day. ​
TORe Outcomes
Effectiveness in Weight Loss: Studies following patients who had TORe and found that they achieved a mean total body weight loss of approximately 10-15% of their total body weight. This weight loss amount can vary, but the procedure provides a substantial reduction in regained weight, helping patients return closer to their initial post-bypass low weight.
Sustained Results: In another study published in Gastrointestinal Endoscopy, researchers observed that patients who underwent TORe maintained their weight loss results over a two-year period, highlighting the procedure’s effectiveness as a long-term solution for weight regain.
Improved Satiety and Reduced Food Intake: Patients who undergo the TORe procedure often report increased satiety and decreased food intake, similar to the effects they experienced shortly after their original Gastric Bypass. By reducing the outlet size, TORe restores the restrictive component, which can be key for individuals who find themselves able to consume larger portions over time.
Dumping Syndrome: By revising the gastric bypass to its normal size and shape, the TORe procedure can also help with resolution of Dumping Syndrome in those struggling with the condition.
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Minimal Complications: Research has shown that TORe is generally well-tolerated, with a low risk of complications. Compared to revisional surgeries, TORe offers a much safer and less invasive approach with fewer risks and a shorter recovery time.
ReSleeve Procedure
For patient who have previously had a surgical sleeve, but struggle with weight gain sometimes this could be due to a stretched out stomach. Like the gastric bypass revision, the Re-Sleeve procedure is performed through the mouth with endoscopy. This is a non-surgical procedure without incisions!
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Using a suturing system it can be restored to its initial shape and size. This will help promote that new weight loss journey!
