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What is Revision of Prior Bariatric Surgery?
After undergoing weight loss surgery, such as gastric bypass or sleeve gastrectomy, patients may experience weight gain over time. Endoscopic revisions offer a nonsurgical, minimally invasive, same-day “tune-up” to reignite your weight loss journey without the need for additional surgery.
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Revision of Bariatric Surgery
Sleeve Gastrectomy Revision
Gastric Bypass Revision
Endoscopic Sleeve Revision
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Latest updated:2021 May
Expected results from ESG Stomach Tightening™
- Highly respected database from the National Institutes of Health
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Revision of Sleeve Gastrectomy (SIS)
Sleeve-in-Sleeve (SIS) is designed for individuals who have previously undergone surgical sleeve gastrectomy. As time passes, the sleeve can gradually expand, reducing the effectiveness of the original surgery. SIS offers a solution: a 45-minute endoscopic procedure that re-tightens the gastric sleeve, thereby restoring its weight loss benefits without the need for additional surgery. SIS was pioneered by Dr. Christopher Thompson and Dr. Pichamol Jirapinyo, Bariendo’s Co-Founders, in 2018.1
Who SIS is for
Prior surgical sleeve gastrectomy Regained a significant amount of weight BMI of at least 30, or between 27 and 29.9 with a condition such as high blood pressure, diabetes, high cholesterol, sleep apnea, or fatty liver disease
Expected results from SIS
Patients typically lose 15% of their body weight post-procedure. For someone with a starting weight of 230 lbs, this equates to a loss of about 35 lbs. A study shows that 82% of SIS participants lose at least 10% of their body weight.2
How SIS works
During the Sleeve-in-Sleeve (SIS) procedure, your doctor will pass an endoscope with an attached suturing device through the mouth to access your stomach, while you are asleep comfortably under anesthesia. Using the suturing device, your doctor will fold and stitch your sleeved stomach from the inside to make it tighter.
This procedure typically takes under an hour to complete. Being a minimally invasive endoscopic technique, it doesn’t involve any external incisions, so you won’t have any visible scars. Additionally, the recovery time is significantly shorter than that of traditional surgery, allowing you to go home on the same day and return to your everyday activities almost immediately.
Revision of Gastric Bypass (ESD TORe)
Years after Roux-en-Y gastric bypass, patients may face weight regain. This is primarily caused by stretching of the outlet (i.e. the connection between the stomach pouch and small bowel) or pouch. Dr. Christopher Thompson, our co-founder, recognized this issue over a decade ago and therefore developed the Transoral Outlet Reduction (TORe) procedure. This is a patented, minimally invasive, scar-free endoscopic method designed to tighten the stretched areas within your bypass anatomy. This 45-minute procedure effectively reduces the size of the gastric outlet and/or pouch, helping patients achieve a feeling of fullness sooner and thus reinvigorate their weight loss journey.
Who TORe is for
Prior Roux-en-Y gastric bypass surgery Regained a significant amount of weight BMI of at least 30, or between 27 and 29.9 with a condition such as high blood pressure, diabetes, high cholesterol, sleep apnea, or fatty liver disease
Expected results from TORe
Prior Roux-en-Y gastric bypass surgery
Regained a significant amount of weight
BMI of at least 30, or between 27 and 29.9 with a condition such as high blood pressure, diabetes, high cholesterol, sleep apnea, or fatty liver disease
Expected results from TORe Patients typically lose 12-15% of their body weight post-procedure3. For someone with a starting weight of 230 lbs, this equates to a loss of about 28 – 35 lbs. So far, data indicates that TORe is effective and durable for a minimum duration of five years.4
How TORe works
During the procedure, your doctor will pass an endoscope with an attached suturing device through the mouth to access your pouch, while you are asleep comfortably under anesthesia. Using the suturing device, your doctor will sew to reduce the size of the gastric outlet and/or pouch to restore the early fullness sensation. The TORe procedure takes less than an hour to perform and is minimally invasive, as it does not involve any external cut or scar. Patients are able to return home on the same day of the procedure.
Our success stories
Meet those who’ve made their weight loss
dreams come true with Bariendo
“Since having the procedure in August,
I am down 43 pounds and have so much more energy and confidence. It hasn’t always been an easy ride,
but the Bariendo staff has been there to support me…
Mindi M.
Revision Procedure
“Revision procedure was life-changing.
It’s not an end-all, but with work and dedication,
the results are worth it. Do it!”
Courtney T
Revision Procedure
How Bariendo’s ESD-TORe differs from the conventional TORe
The most common TORe method involves argon plasma coagulation (APC), which removes the top layer of the stomach lining, enhancing the stitching of the deeper layer and leading to more significant weight loss than just stitching alone.
In 2018, Dr. Christopher Thompson and Dr. Pichamol Jirapinyo, our co-founders, developed a new TORe variant using endoscopic submucosal dissection (ESD) in addition to APC and stitching. ESD uncovers the stomach’s deeper layers than APC before stitching, leading to better weight loss and more durable results than the typical APC-TORe method.
Research indicates that ESD-TORe results in an average 13.5% weight loss, compared to 9% with APC-TORe5. Furthermore, Dr. Jirapinyo and Dr. Thompson’s research demonstrates that combining ESD-TORe with medications results in a 15% reduction in body weight, comparable to the outcomes of surgical revision6. ESD-TORe, when used alongside medications, offers an effectiveness akin to undergoing an additional surgery, but without the need for surgical intervention.
What sets Bariendo’s Revision Program apart
We invented the field
We invented the field
Our co-founders have pioneered most of the endoscopic revision techniques used today. Dr. Christopher Thompson developed ESD-TORe, an endoscopic revision for gastric bypass, in 2018. He, along with Dr. Jirapinyo, also introduced SIS, an endoscopic revision for sleeve gastrectomy, in the same year.
Exclusively endoscopic approach
Exclusively endoscopic approach
While traditional revisions of prior bariatric surgeries are surgical, all of our revision procedures are endoscopic. This means they are non-surgical, leave no scars, and allow you to go home on the same day of the procedure with fast recovery.
Combination therapy with medications for enhanced weight loss
Combination therapy with medications for enhanced weight loss
The emerging field of combining endoscopic procedures with weight loss medications is led by Dr. Jirapinyo, our co-founder. Our comprehensive treatment packages include prescribing a weight loss medication after the endoscopic revision procedure to further augment the amount of weight loss. (The costs of medication are not included; however, the medication may be covered by your insurance).
Sustainable lifestyle changes through a dedicated care team
Sustainable lifestyle changes through a dedicated care team
Sustainable lifestyle changes through a dedicated care team
FAQs
How long does a revision procedure take?
The procedure itself takes approximately 45 minutes. However, you should plan on spending about half a day with us including preparation and recovery.
How much does a revision procedure cost?
A revision procedure costs $10,995, which includes 12 visits with your Bariendo healthcare team. Financing options are available.
What is recovery like after a revision procedure?
Patients go home on the same day. Most take a few days off to recover at home before returning to work. After the procedure, patients follow a full liquid meal plan, which includes protein shakes and similar products, then transition to a soft diet, which includes easy-to-eat foods such as oatmeal and bananas, and then return to regular eating.
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