Revision of Gastric Sleeve
Regained weight after a gastric sleeve surgery? Reclaim your success with a non-surgical, minimally invasive revision procedure called sleeve-in-sleeve (SIS).
Featured in top scientific publications
What is sleeve-in-sleeve (SIS)?
Reverse weight regain
Weight regain after sleeve gastrectomy often occurs due to stretching of the sleeve. SIS (sleeve-in-sleeve) is a non-surgical, scar-free procedure that tightens the sleeve to restore the original, post-surgery size.
- Tackling weight regain.
- Post-bariatric surgery weight regain can be effectively addressed through non-surgical revisions by targeting the specific mechanisms contributing to weight gain.
- Non-surgical. No scars.
- Our revision procedures are performed endoscopically and avoid major incisions. This approach typically results in shorter recovery times, reduced risk of complications, and less post-operative discomfort compared to traditional surgery.
- Quick recovery.
- You can go home on the same day. Most patients take 1-3 days off work.
Eligibility
Who is SIS for?
- Previous sleeve gastrectomy patients
- with enlarged stomach sleeves
- Those who regained weight with body mass index (BMI) over 30
- or between 27 and 29.9 with conditions such as high blood pressure, diabetes, high cholesterol, sleep apnea, or fatty liver disease
Testimonial
I no longer feel like a fraud in my job; I have more stamina for softball and volleyball; and I am excited to go dress shopping!
How SIS work
The science behind SIS's efficacy
The SIS procedure reduces stomach size by folding and stitching the stomach into a smaller tube, creating an inner sleeve within the original stomach.
- Endoscopic suturing
- The SIS procedure uses an endoscope to place precise folds and sutures in the stomach tissue, effectively reducing the size of the stomach without additional surgery.
- Restoring sleeve size
- By creating additional folds and tightening the existing sleeve, the SIS procedure restores the stomach to its original, smaller size, enhancing its weight loss benefits.
- Promoting earlier satiety
- The reduced stomach capacity from the SIS procedure promotes a feeling of fullness earlier during meals, helping you eat less again.
What sets us spart
Our revision procedures are unique
Bariendo’s SIS utilizes best practice protocols refined through a decade of research with year-long personalized support
- We invented the procedure
- Our co-founders, Dr. Christopher Thompson and Dr. Pichamol Jirapinyo, invented the sleeve-in-sleeve (SIS) procedure in 2018.2
- 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
- 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
- Our support doesn’t end once the procedure is complete. For 12 months, you have direct access to a multidisciplinary team consisting of your physician, physician assistant, registered dietitian, exercise coach, and patient liaison. We also provide you with a smart scale that allows our care team to monitor your weight loss journey in real-time.
Frequently asked questions
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The procedure itself takes approximately 30 to 45 minutes. However, you should plan on spending about half a day with us including preparation and recovery.
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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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About 5-12% of people who had a sleeve gastrectomy underwent a revision, and 87% of those revisions were due to ongoing obesity.4 Those with a previous gastric band were more likely to need a revision. Most people opted for gastric bypass or resleeve, but since the introduction of the sleeve-in-sleeve procedure in 2018, an increasing number are choosing endoscopic revisions for safety.
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Endoscopic revision is safer, done through the mouth with a 1% complication rate, and offers quick recovery. Surgical revisions, such as recreating a smaller sleeve or converting sleeve gastrectomy to a gastric bypass or duodenal switch, are riskier with an average complication rate of 29%.3
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Discomfort, nausea, chest pressure, or spasms may occur. The major complication rate, including infection or bleeding, is less than 1%.
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Unfortunately, insurance does not cover endoscopic sleeve revision procedures yet. However, we offer several financing options. Learn more about our pricing and financing options.
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References
- de Moura DTH, Barrichello S Jr, de Moura EGH, de Souza TF, Dos Passos Galvão Neto M, Grecco E, Sander B, Hoff AC, Matz F, Ramos F, de Lima JHF, Teixeira L, Dib V, Falcão M, Potti H, Baretta G, Jirapinyo P, Thompson CC. Endoscopic sleeve gastroplasty in the management of weight regain after sleeve gastrectomy. Endoscopy. 2020 Mar;52(3):202-210. doi: 10.1055/a-1086-0627. Epub 2020 Jan 15. PMID: 31940667.
- Jirapinyo P, de Moura DTH, Thompson CC. Sleeve in sleeve: endoscopic revision for weight regain after sleeve gastrectomy. VideoGIE. 2019 Aug 13;4(10):454-457. doi: 10.1016/j.vgie.2019.07.003. PMID: 31709328; PMCID: PMC6831909.
- Dolan RD, Jirapinyo P, Thompson CC. Endoscopic versus surgical gastrojejunal revision for weight regain in Roux-en-Y gastric bypass patients: 5-year safety and efficacy comparison. Gastrointest Endosc. 2021 Nov;94(5):945-950. doi: 10.1016/j.gie.2021.06.009. Epub 2021 Jun 12. PMID: 34126065; PMCID: PMC8908793.
- Lazzati A, Bechet S, Jouma S, Paolino L, Jung C. Revision surgery after sleeve gastrectomy: a nationwide study with 10 years of follow-up. Surg Obes Relat Dis. 2020 Oct;16(10):1497-1504. doi: 10.1016/j.soard.2020.05.021. Epub 2020 May 29. PMID: 32636173.