Gastric Bypass Revision
What is the Gastric Bypass Revision?
Gastric bypass is one of the best-known weight loss surgeries that consists of creating a stomach bag directly connected to the small intestine. Over time, that pouch at its connection point to the intestine (better known as the “outlet”) can get bigger. As a result, the patient returns to eating larger portions, leading to regaining the weight that had already been lost. Most gastric bypass patients can regain up to 30% of the weight they lost. But, only 1 in 5 patients will return to the weight with which they started treatment.
Gastric bypass endoscopic revision, also known as transoral outlet reduction, is an outpatient procedure without cuts or scars in which the pouch and outlet are adjusted to their original size. The result of this procedure is a feeling of optimal fullness, giving way to the ability to lose the weight that has been regained. Because the procedure is non-surgical, recovery is fairly quick and most patients can return to normal activities within 2-3 days.
How Does the Procedure Work?
The revision endoscopic gastric bypass procedure does not require incisions, cuts, or a long recovery time. It is a treatment that lasts approximately 15 minutes and is performed under sedation. The Innova Weight Loss team will use an endoscopic suture system, which is basically a device mounted on a flexible endoscope, which is passed into the stomach through the mouth. This state-of-the-art tool will tighten the pouch and stomach outlet and restore it to its original or smaller size.
Who Is It for?
Revision endoscopic gastric bypass is suitable for patients who have already undergone gastric bypass over a period of more than two years. Such patients initially achieved weight loss but reached a point where they have regained weight and have noticed that now they must eat larger portions. Definitely, this procedure is ideal for patients who are motivated and want to get back on track with weight loss with a “second chance” at their bypass.
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How Much Weight Will You Lose?
A patient with an endoscopic bariatric revision can lose an average between 10-15% of body weight. Although not the same amount of weight loss as the original gastric bypass, an endoscopic revision allows patients to lose weight substantially, and more importantly keep it off in the long term. Several studies have shown that weight loss after this procedure can be maintained for up to five years or more following the recommendations of the team of professionals.
Frequently Asked Questions
Endoscopic bariatric revision is a non-invasive technique used to restore a gastric bypass to its original size or smaller. A few years after gastric bypass surgery, the size of the pouch may begin to increase. As well as the connection between the pouch and the small intestine (known as the anastomosis or commonly called the outlet) can also begin to enlarge. The result of this is a larger food intake than the patient has been used to, leading to unwanted weight gain. With the endoscopic bariatric revision, the anastomosis or outlet can be tightened or restored to the size that was initially left and in this way help you lose the weight you had regained.
This procedure is designed for patients who have undergone a gastric bypass procedure and after a while have regained some of the weight they lost and have noticed that they now need to eat more to feel full.
Bariatric revision is aimed at those patients who have had previous gastric bypass surgery. If the patient has regained weight after gastric bypass for other conditions than bag dilation or leakage, it is unlikely that he or she is a candidate.
If you have developed ulcers or complications after gastric bypass, you may not be a candidate. If you use tobacco constantly, you are not eligible for the procedure.
Surgical revision is a complex procedure, in which the gastric pouch is made smaller or the bypass is modified by surgery. Due to its complexity, surgical revision has a complication risk of up to 30%.
Instead, endoscopic bariatric revision is performed endoscopically, with a suture system (Overstitch) mounted on the end of an endoscope. This fast and safe procedure has a maximum complication risk of 1%.
The endoscopic bariatric revision procedure is performed without incisions or cuts, recovery is very fast. The procedure is performed the same day and most patients return to normal activities in 2 to 3 days.
This procedure is performed on an outpatient basis and takes less than 30 minutes. The patient will be sedated during the procedure. After the procedure, you will go to the recovery area for a maximum of two hours, and immediately afterward you will be able to return home.
Some patients, for the most part, will experience a feeling of indigestion, nausea, and possibly slight pain or pressure in the upper abdomen. The risk of a serious complication, such as infection, bleeding, or stomach injury, is less than 1%.
Most patients can lose up to 20% of their total body weight. It should be noted that this is not the same amount of weight that was lost after the original gastric bypass. However, the weight that the patient loses after endoscopic bariatric revision is usually maintained for many years. The intention is to stop additional weight gain. Although individual results may vary, following the recommendations in our nutritional plan and a good exercise routine will increase the long-term success of the procedure.
It is very similar to gastric bypass surgery, patients are recommended to adopt healthier eating habits and nutrition accompaniment after undergoing an endoscopic bariatric revision. Eating slowly and avoiding overeating are definitely keys to long-term success with this procedure.
We recommend an upper GI endoscopy or barium test to assess the status of your pouch and outlet if you have not had a recent evaluation. This evaluation is done to confirm that the pocket is enlarged and that the revision should be done endoscopically. In some cases, the pouch or outlet may not be enlarged and the weight gain may be tied to other factors.
Yes. While endoscopic revision is commonly used to repair a Roux-en-Y gastric bypass, we can also correct an enlarged vertical sleeve gastrectomy. The procedure involves endoscopically suturing the sleeve to make it small again. This process is closely related to the endoscopic sleeve gastroplasty procedure. Contact us to find out if you can be a candidate.