The Endoscopic Bariatric Revision Procedure2019-04-30T05:43:15-07:00

Help for Weight Gain AFTER Bariatric Surgery

Weight loss can be hard to sustain, even after weight loss surgery.

Unfortunately, some people experience weight regain following bariatric surgery. More than 20% of patients will regain significant amounts of weight, which may lead to the return of diseases such as high blood pressure or hypertension, diabetes, sleep apnea, high cholesterol, and joint pain. More than 30% of those who have a surgically performed gastric bypass gain all of their lost weight back. And it’s not uncommon for patients who have had the laparoscopic sleeve procedure to gain a portion of weight back as well.

Oftentimes patients feel as though they have failed and wasted the surgery. Stretching of the surgically created gastric pouch and stoma (outlet of the pouch) does occur frequently, as does the associated weight gain. When the pouch has stretched, patients often share how they begin eating more but still feel hungry. However, all is not lost…we can help! The Endoscopic Bariatric Revision procedure can help reduce the size of the pouch and jump-start weight loss.

Insurance usually covers this procedure.

The Endoscopic Bariatric Revision procedure provides an option to stop the weight gain after bariatric surgery.

  • No skin incisions
  • Less expensive than surgical options
  • Short recovery time
  • Minimally invasive
  • Usually covered by insurance

While traditional revision operations are effective at reestablishing weight loss, they are associated with increased risks compared with the original operation; therefore, patients and surgeons are often reluctant to pursue this option. Fortunately, the Endoscopic Bariatric Revision procedure, whereby a suturing technique is used, can restore the normal stomach pouch size. This minimally invasive technique is an effective alternative to an open surgical revision and has been used as a treatment of weight regain for more than a decade.

Results from Endoscopic Bariatric Revision procedures show that nearly all patients achieve weight stabilization (their weight gain stops), while most will lose 20-50% of their excess weight. The procedure is well tolerated, and most patients are able to return home within 24 hours and return to work within a couple days. Notably, in almost all cases, insurance will cover the procedure on an outpatient basis.

While the Endoscopic Bariatric Revision procedure can help patients eat less and help eliminate ongoing feelings of hunger, it is best seen as a tool to help reinvigorate weight loss rather than a second operation. Most importantly, we encourage all weight loss patients to reconnect with support groups, visit with a dietician, and refocus on establishing healthy lifestyle choices.

The Endoscopic Bariatric Revision Procedure

The Endoscopic Bariatric Revision procedure is performed under anesthesia and typically takes 1 to 2 hours to perform. The endoscope is placed through the patient’s mouth and, once in the stomach, our physician uses a sewing device through the endoscope. Our physician uses permanent sutures to tighten up the stomach pouch. After the procedure, patients generally follow a liquid diet for a brief amount of time and usually can go home that same day or within 24 hours.

1. Before the Endoscopic Bariatric Revision Procedure

The Endoscopic Bariatric Revision procedure is designed to work with a diet and exercise. Before the procedure, you will have a consultation with our patient coordinator who will discuss the details of the procedure and if it is right for you. 

While an Endoscopic Bariatric Revision procedure can help patients eat less and help eliminate ongoing feelings of hunger, it is best seen as an important tool to help in an overall weight loss effort.

2. What to Expect During the First Few Days

A little discomfort and nausea are normal in the first 48 to 72 hours after the procedure, but neither lasts for long. To reduce post-procedure symptoms, you will be provided with medications that can be taken as needed. 

In order for your stomach to adjust, it is best to ease yourself into eating solid foods. We recommend patients be on a liquid diet for 2 weeks following the procedure.

3. Creating a Healthy Lifestyle Long Term

Very importantly, for ongoing health and weight management and monitoring, we encourage all patients to work with their primary care physician, community gastroenterologist and/or endocrinologists to create plans to improve and enhance health. It is important to create a connection with support groups and visits with a dietician. To maximize success, we urge patients to view the Endoscopic Bariatric Revision procedure as a jump-start—a way to kick off a complete plan to achieve lasting weight loss by focusing on establishing healthy lifestyle choices and incorporating effective diet and exercise programs.

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