Obesity Surgery Houston Center of Excellence American College of Surgeons

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Obesity Surgery

Endoscopic Revisional Bariatric Surgery

Patients who regain weight after their initial weight loss surgery now have options.

Have you started to regain weight after initial success from weight loss surgery? Overtime, the stomach pouch or the outlet that connects it to the small intestine can stretch. As a result, patients can eat more food before feeling full. We now offer a safe and effective endoscopic procedure to reduce your enlarged pouch and outlet to their original post-operativeproportions.

Why would I regain weight after weight loss surgery?

Several studies suggest the majority of patients regain significant weight after weight loss surgery. A common cause includes gradual stretching of the stomach pouch or outlet. When the standard-of-care WLS procedures are performed, the stomach and outlet are made very small to reduce the amount of food consumed and slow the passage of food through the digestive tract. Together, this helps patients feel fuller, longer after eating just a small amount. As a result, weight loss occurs from a dramatic decrease in calories. Many clinicians have shown when the stomach pouch and/or outlet gradually stretch, it takes longer for the patient to feel full. As a result, patients may begin to regain weight.

Endoscopic outlet and pouch repair

We now offer qualified patients an endoscopic procedure to reduce the volume of an enlarged pouch and the diameter of the outlet. This procedure is performed using a small flexible endoscope and specialized devices that allows sutures to be placed through the endoscope. The scope and suturing devices are inserted through the mouth into the stomach pouch the same way as a standard endoscope. Sutures are then placed around the outlet to reduce the diameter, typically from the size of a silver dollar to the size of a dime. The same technique may then be used to place additional sutures in the stomach pouch to reduce its volume capacity.

What are the benefits of the endoscopic procedure?

Scarring and adhesions from the initial weight loss surgery procedure often make open or laparoscopic revisionsurgery very challenging, and at times impossible. Abdominal revision surgery takes longer than the original weight loss surgery and patients are three times more likely to develop complications.

Having a revision through endoscopic procedure decreases the patient’s risks when compared to abdominal revision surgery. Patients experience less pain, recover faster, and have no abdominal scarring. Typically, patients go home the same day, but each patient’s discharge will vary based on the physician’s recommendation.


Bariatric Revision Patient Education Video

© Ricardo Bonnor MD Obesity Surgeon Bariatric Surgery Gastric Banding Gastric Bypass Sleeve Gastrectomy Texas
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