For patients with weight regain after a gastric bypass, an effective endoscopic solution — without further surgery.
Gastric bypass (Roux-en-Y gastric bypass) is one of the most effective bariatric procedures in the world. However, some patients notice a gradual weight regain over the years. The most common cause: dilatation of the gastrojejunal anastomosis — the gradual widening of the junction between the gastric pouch and the small intestine.
This dilatation leads to accelerated gastric emptying, reduced satiety and a return of calorie intake. The TORe (Transoral Outlet Reduction) is the endoscopic answer to this situation: using the OverStitch™ system introduced through the mouth, Dr. Sitte places internal sutures that reduce the diameter of this dilated anastomosis, thereby restoring the bypass's original restrictive effect.
Data from the international scientific literature confirm the efficacy and safety of endoscopic revision after bypass.
On average, patients recover a significant portion of the bypass's initial weight loss, with a lasting improvement in satiety and eating habits.
The procedure is technically feasible in the vast majority of cases, provided the anatomy is accessible to the endoscope.
Serious complication rate below 2%, with no mortality reported in the published series.
Sources : Abu Dayyeh BK et al., Gastrointestinal Endoscopy 2019 · Jirapinyo P et al., Endoscopy 2020 · Thompson CC et al., Obesity Surgery 2022
TORe is intended for patients who meet the following criteria:
Have had a gastric bypass and notice a gradual weight regain, usually several years after the initial procedure.
Have a dilated anastomosis confirmed by diagnostic endoscopy — an essential technical criterion before considering the procedure.
Wish to avoid a surgical re-intervention — which would be technically more complex, riskier and slower to recover from than an endoscopic revision.
Are committed to comprehensive follow-up — TORe is always part of a nutritional and lifestyle support programme, without which results would be limited.
"TORe makes it possible to restore, for patients in partial failure, the effectiveness of their original bypass — by the same route as the first time: no incision, no scar."
Eligibility for this technique is assessed during an in-depth consultation with Dr. Sitte.
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