TRANSORALGASTRIC OUTLET REDUCTION

Transoral Gastric Outlet Reduction

It is not unheard of for a patient to experience weight gain after undergoing bariatric surgery. A Transoral Gastric Outlet Reduction is an incisionless endoscopic procedure that tightens the stomach. Strengthening areas where the stomach has stretched. 


Transoral Gastric Outlet Reduction

A Transoral Gastric Outlet Reduction, a.k.a Endoscopic Overstitch’, is the most recommended bariatric procedure after the patient's initial bariatric surgery is unsuccessful in stopping weight gain. Although immediate weight-loss is nothing for a patient to worry about, if there is noticeable tolerance for larger means or steady weight-gain, an endoscopic overstitch can be considered. 

It is important for patients to consult with a bariatric therapy team on a regular basis post-bariatric surgery. For patients without a bariatric team, Dr. Michel Kahaleh can refer a number of his colleagues to aid him in achieving the weight-loss you expect after bariatric surgery. A team of nutritionists, gastroenterologists, endocrinologists, psychiatrists, and exercise therapists should be consulted before a significant amount of weight is regained.

If a patient notices a loss in restriction after bariatric surgery, an endoscopic examination of the gastrointestinal tract is necessary. This way Dr. Michel Kahaleh will be able to assess how the patient’s stomach has responded to the bariatric surgery, and if the patient qualifies for an endoscopic overstitch. 

The procedure takes no incisions, and can be performed as an out-patient option. Once the patient is put under anesthesia, an endoscope inserted through the mouth and into the stomach will suture the stomach internally. This will tighten areas of the stomach which have stretched out. Allowing the patient to achieve that sense of fullness when eating smaller meals. 

How is the Transoral Gastric Outlet Reduction Performed?

Like many of the Bariatric Endoscopic procedures performed by Dr. Michel Kahaleh, the Transoral Gastric Outlet Reduction can be performed as an outpatient procedure. Allowing the patient to return the same day as the operation. The procedure itself will typically take no more than 1 hour. Another 2 hours, or so, of observation is suggested after the operation has completed. 

Once the patient has been put under anesthesia, an examination of the gastrointestinal tract is conducted. This will allow Dr. Michel Kahaleh to determine how and where the previous bariatric surgery might have failed, as well as identify the areas of the stomach that have stretched and resulted in the patients increased tolerance to heavier meals.

After the examination has been completed, a specialty suturing head is attached to the endoscope. The stretched-out areas of the stomach are then sutured internally. Re-reducing the capacity of the stomach and allowing the patient to be satisfied from smaller meals.      

Do I Qualify for a Transoral Gastric Outlet Reduction?

The ideal candidate for an Endoscopic Sleeve Gastroplasty will exhibit the following:
  • Have regained 20% or more of the weight lost from their initial bariatric surgery.
  • A willingness to be observed and interviews in a medically supervised program.

What Can I Expect After a Transoral Gastric Outlet Reduction?

After receiving a Transoral Gastric Outlet Reduction patients will be asked to stay for a short observation period. Once at home, patients may feel some abdominal pain or cramps, which will be alleviated by medication prescribed by Dr. Michel Kahaleh. 


Patients should feel back to their normal self after 2 to 3 days. With the inclusion of being satisfied after smaller meals, one again. 


More importantly, the patient will undergo regular consultations with their bariatric therapy team. In order to lose the weight that has been re-gained. As well as continue to lose weight at a healthy pace and keep the weight off. 

How Much Weight Can I Expect to Lose?

Patients will return to their ideal BMI or lose the weight that they had regained. If the patient was not able to reach their ideal BMI prior to regaining their excess weight, a weight-loss plan will be constructed by their bariatric therapy team. 

On average, patients will lose between 30 to 40 pounds of their excess weight. Specific weight loss is determined by how much weight the patient is over their ideal BMI, and their dedication to the set weight-loss plan. 

What are the Risks of a Transoral Gastric Outlet Reduction?

There are no major risks from a Transoral Gastric Outlet Reduction, from either the procedure or after the operation. Some abdominal pain can be expected for 2 to 3 days after the procedure, but this is easily alleviated with some pain medication. Overall, the procedure is very safe and has historically shown no complications or risks. 

Who is Not a Candidate for Transoral Gastric Outlet Reduction?

A Transoral Gastric Outlet Reduction is intended to be a follow-up procedure to a prior bariatric surgery that no longer limits the food in-take tolerance of the patient. Patients who do not qualify for a Transoral Gastric Outlet Reduction will exhibit the following:
  • Have not received any other Bariatric Surgery or Bariatric Endoscopic procedure. 
Any patient that has qualified for bariatric surgery or any other endoscopic bariatric operation qualifies for a Transoral Gastric Outlet Reduction. An interview with Dr. Michel Kahaleh is required to determine if the patient is a candidate for a Transoral Gastric Outlet Reduction. 
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