TORe Procedure for Gastric Bypass Revision: What to Know

Have you experienced weight regain after gastric bypass surgery? The TORe procedure can help you get back on track. Gaining weight after gastric bypass is frustrating, but TORe offers a second chance for sustainable weight loss without the need for further surgery.

By re-tightening the stomach outlet, the TORe procedure helps patients regain control of their eating habits. Below, we’ll explain how the TORe procedure works, who it’s for, and how it compares to gastric bypass revision surgery. We’ll also break down the various techniques and explain why the TORe+ technique offers superior results.

What is the TORe Procedure?

The TORe procedure (Transoral Outlet Reduction) is a non-surgical, endoscopic revision treatment for weight regain after gastric bypass surgery. Over time, the stomach outlet - where the stomach pouch connects to the small intestine - can stretch. This allows food to pass through the digestive system more quickly, leading to weight regain.

Transoral Gastric Outlet Reduction (TORe) is used to correct this stretching by placing sutures to re-tighten the stomach outlet. This slows the passage of food through the digestive system so that patients feel fuller sooner and stay satisfied longer.

Since TORe is performed endoscopically, no incisions are needed. The procedure typically takes 30 - 45 minutes and offers 12-15% weight loss with fewer risks and a faster recovery compared to surgical revision. 

Who is the TORe Procedure For?

Studies show that 35% of gastric bypass patients experience weight regain within two to five years after the surgery, and by 10 years after the surgery, 30% of patients have gained everything back. TORe is an ideal solution for patients who are looking for a non-invasive solution to treat weight regain after gastric bypass without the need for further surgery.

You might be a good candidate for the TORe procedure if you:

• Are experiencing noticeable weight regain after gastric bypass.
• Want to avoid the risks and long recovery associated with gastric bypass revision surgery.
• Are seeking a non-invasive way to regain control of your eating habits and restore the feeling of fullness you initially experienced after gastric bypass surgery.  

TORe offers a second chance at sustainable weight loss for Roux-en-Y gastric bypass patients who previously experienced successful weight loss and need an extra step to get back on track. 

Transoral Outlet Reduction (TORe) vs Gastric Bypass Revision Surgery

Both TORe and gastric bypass revision surgery are used to treat weight regain after gastric bypass, but they differ significantly in their approach, risks, and recovery.

Gastric bypass revision surgery involves surgically altering the stomach or small intestine. This can include resizing the stomach pouch or modifying the connection between the stomach and small intestine. 

Revision surgery takes 2 to 4 hours and requires a hospital stay of 2 to 3 days. Recovery can take several weeks, during which patients may need to take time off work and will need to refrain from strenuous physical activity.

The surgery carries higher risks, such as infections, bleeding, blood clots, or internal leaks and requires more downtime. While it can produce effective results, the invasive and downtime can be a roadblock for many patients.

In contrast, TORe is a 30 to 45 minute outpatient procedure that allows patients to go home the same day. The recovery is quick, and many patients return to work and their normal routine in just a few days. 

TORe is typically far more affordable than revision surgery, and the risk of complications is also much lower. This makes TORe a better solution for patients who want effective results with minimal disruption to their daily lives..

Transoral Gastric Outlet Reduction (TORe) Techniques Explained

The TORe procedure can be performed using three different suturing techniques that vary in terms of effectiveness and long-term outcome. Understanding the differences between these approaches can help you make an informed decision when discussing the procedure with your doctor.

Standard Suturing (Non-Pursetring)

The standard suturing technique, also known as “interrupted” or non-pursestring suturing, is one of the methods used in the TORe procedure to tighten the stomach outlet. This approach involves placing individual stitches around the stomach outlet using patterns such as interrupted, running, or figure-of-eight sutures.

While it can help reduce the size of the stomach outlet to some degree, studies show that the weight loss results from this technique are typically lower. Patients generally lose around 5% of their starting weight with this method.

Pursetring Suturing Technique

The pursestring suturing technique involves placing a continuous suture around the entire circumference of the stomach outlet, much like the tightening of a drawstring. This technique not only allows for more uniform tightening but can also withstand stronger pressure and force over time compared to the interrupted pattern, contributing to more durable results.

This technique allows for more uniform tightening and leads to better weight loss outcomes compared to the standard technique. Patients typically lose around 10% of their starting weight within one year.

TORe+ (ESD Enhanced Suturing)

The TORe+ technique is an advanced variation of the TORe procedure that combines traditional suturing with Endoscopic Submucosal Dissection (ESD). This method allows the surgeon to access deeper layers of tissue around the stomach outlet, creating stronger, more durable sutures. 

By placing the stitches in the deeper layers, TORe+ enhances the tightening effect, leading to superior results and more sustained weight loss. Patients typically lose 12-15% of their starting weight, and studies suggest the results may last up to 10 years.

Achieve Long Term Results with TORe

Purse-string and TORe+ at Bariendo offer powerful, non-surgical solutions to help gastric bypass patients regain control of their weight. By tightening the stomach outlet these procedures help patients feel fuller faster, stay satisfied longer, and control portion sizes more easily.

These immediate benefits make it much easier for patients to manage their eating habits, especially after struggling with weight regain. However, maintaining these results requires a commitment to healthier lifestyle choices, including a low-calorie diet, portion control, and regular exercise. 

At Bariendo, patients receive ongoing support from our compassionate team of registered dieticians and nurse practitioners who guide them through their weight loss journey. This personalized care helps ensure that every patient is equipped with the tools they need to help them succeed for years to come.

Get Back On Track with TORe

Purse-string TORe and TORe+ offer gastric bypass patients non-surgical, highly effective solutions to regain control of their weight. By combining advanced suturing techniques with personalized care, TORe helps patients achieve long-lasting weight loss success.

Ready to get started? Schedule your free consultation today and learn how TORe can give you a second chance at weight loss!