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Transoral Gastric Outlet Reduction
Transoral gastric outlet reduction is a minimally invasive procedure that can help patients who regain weight after gastric bypass surgery. While gastric bypass limits the amount of food you can eat and increases your feeling of fullness, its effectiveness can diminish over time. This occurs because your gastric outlet (the connection between your stomach and small bowel) will expand, making you feel less full and able to eat more, which can cause you to regain weight.
Transoral gastric outlet reduction can repair your gastric outlet by reducing its size. During this procedure, your physician inserts stitches into your gastric outlet through an endoscope — a flexible tube with a camera and a suturing device (a tool that makes surgical stitches) attached. Since this outpatient procedure is minimally invasive, it has a reduced risk of complications.
Patients who have undergone this surgery feel full earlier in their meals and may lose weight — and maintain the weight loss — in the years following surgery. Like other weight loss programs, however, a commitment to a healthier lifestyle will help to ensure long-term success and permanent weight loss.
How It's Performed
Vivek Kumbhari, director of bariatric endoscopy for Johns Hopkins, answers questions about the transoral gastric outlet reduction procedure, including how it works and how you can expect to feel after the procedure.
What to Expect:
Your physician will perform transoral outlet reduction in the hospital under anesthesia. Before your procedure, you will need to follow specific preparation instructions, which you will discuss with your doctor in advance.
During the Procedure:
- The endoscope is inserted down your throat and goes into the stomach.
- The tiny camera allows the doctor operating the endoscope to see and operate inside your stomach without making incisions in your abdomen.
- Using the endoscope, the doctor inserts stitches to reduce the size of the gastric outlet to its original 10 to 12 millimeters in diameter.
The procedure takes approximately 30 to 60 minutes, and the majority of patients go home the same day. Patients may have some mild abdominal discomfort and nausea in the days after the procedure. You may be prescribed medication to treat these potential side effects.
After the Procedure:
- You will be on a modified diet that transitions from liquids to soft foods over 4 weeks. This will be given to you by your doctor's office.
- It is recommended that you follow-up with a nutritionist.
To qualify for a transoral gastric outlet procedure, you should:
- Have had a previous gastric bypass.
- Be 18 years of age or older.
- Have a body mass index (BMI) of 30 or higher.