An illustration of a stomach

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).

Authorized by FDA

Featured in top scientific publications

NIH National Library of Medicine PubMed Central American College of Gastroenterology ScienceDirect MDedge iGIE

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.
Happy woman with a diagram showing a revision of gastric bypass surgery
Average weight loss1
Participants losing at least 10% body weight1
Procedure duration
30-45 minutes
Typical recovery time off work
1-3 days


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
Revision of gastric sleeve candidates
Before and after images of Mindi who lost 53 pounds in 6 months through Bariendo's non-surgical revision procedure


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!

Bariendo Revision of Gastric Sleeve patient

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

Ready to take the next step?

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