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Bariatric Revision

About

Bariatric revision, also known as transoral gastric outlet reduction, is a non-surgical procedure specifically designed to improve quality of life for patients who have regained weight after a gastric bypass procedure.

Who It’s For

Bariatric revision is for patients who have previously had a gastric bypass procedure, and who are now experiencing problems from that procedure, such as having trouble with digesting food or regaining weight.

How The Procedure Works

This brief, non-invasive procedure is performed on an outpatient basis. Under mild sedation, an endoscopic suturing system is used to reduce the size of the gastrojejunal anastomosis to its original size (the size it was immediately after gastric bypass). After the procedure, patients will feel “full” in a timely fashion again, which helps them to eat less.

Why The Procedure Is Important

Gastric bypass is still the first-line surgery when it comes to weight loss procedures. However, over time, the hole (gastrojejunal anastomosis, or “outlet”) becomes larger, which causes patients not to feel “full” while eating. Because patients do not feel full, they continue to eat past the point where they should, which contributes to weight gain after the surgery. This mild procedure of bariatric revision uses endoscopy to bring the hole down to its correct size.

FAQ

WHO IS ELIGIBLE FOR BARIATRIC REVISION?

This procedure is designed for patients who have had a gastric bypass procedure and are experiencing problems post-procedure (weight gain, trouble digesting food, not feeling full, etc.)

WHO IS NOT ELIGIBLE FOR BARIATRIC REVISION?

Bariatric revision is only for those who have had gastric bypass surgery.

HOW LONG DOES THE PROCEDURE TAKE?

The procedure is performed in an outpatient setting and takes less than 30 minutes to perform. The entire appointment will take several hours. Patients are discharged home the same day.

WHAT ARE THE RISKS OF THE PROCEDURE?

Because bariatric revision is a minimally invasive endoscopic procedure, the risks of complication are extremely low. Patients may feel sore or uncomfortable immediately after the procedure.

HOW MUCH WEIGHT WILL I LOSE AGAIN?

Bariatric revision is predominately used to eliminate weight gain post-gastric bypass. Most patients will lose an average of 10% of their total body weight. This is not the same amount of weight that was lost after the original bypass. However, the weight that you lose after Endoscopic Bariatric Revision is typically sustained for many years (current studies show weight loss for more than 5 years). This means any further weight gain has been halted.

HOW DO I KEEP THE WEIGHT OFF AFTER BARIATRIC REVISION?

Similar to gastric bypass surgery, patients are urged to adopt healthier eating habits after undergoing the procedure. Eating slowly and avoiding over-eating eating are keys to long-term success.

WHAT EVALUATION IS REQUIRED BEFORE THIS PROCEDURE?

We will perform a standard upper endoscopy to assess your pouch and outlet. This is primarily to confirm that your outlet is enlarged. In some cases, the outlet may not be enlarged and weight gain may have been from other factors.

I GAINED WEIGHT AFTER A SLEEVE GASTRECTOMY. AM I A CANDIDATE FOR BARIATRIC REVISION?

Yes. While endoscopic revision is most commonly used to fix a Roux-en-y gastric bypass, we can also correct a sleeve gastrectomy. This involves suturing the sleeve to make it small again. This will help to restore fullness after eating. Contact us to learn if you may be a candidate.

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