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.

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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Endoscopic Revision of Sleeve Gastrectomy

Weight regain after sleeve gastrectomy can occur due to several factors, with a common one being dilation of the sleeve. In the revision procedure, known as ‘Sleeve-in-Sleeve’ or ‘SIS’, your doctor will re-tighten your sleeve endoscopically to restore the original post-surgical anatomy. This reduction in volume will lead to earlier satiety and, as a result, reduced food intake.

Endoscopic Revision of Roux-en-Y Gastric Bypass

Weight regain after gastric bypass can occur for various reasons, with one common cause being dilation of the gastric pouch and/or outlet (i.e. the connection between your pouch and small bowel). In the revision procedure known as ‘Transoral Outlet Reduction’ or ‘TORe’, your doctor will endoscopically reduce the size of either or both the pouch and outlet to reinstate your original gastric bypass anatomy, helping you feel full sooner and thus eat less.

Tailored Endoscopic Revisions for Previous Weight Loss Procedures

If you have undergone lap band surgery or even Endoscopic Sleeve Gastroplasty (ESG) with another provider but have experienced weight regain, our doctors offer specialized procedures to re-tighten your stomach to assist with weight loss. Reach out to learn how modern endoscopic techniques can assist in losing the regained weight without undergoing another surgery.

Request a free consultation

Revision of Bariatric Surgery

Sleeve Gastrectomy Revision

Gastric Bypass Revision

Endoscopic Sleeve Revision

Request a free consultation

Verfied source

Latest updated:2021 May

Expected results from ESG Stomach Tightening™

  • Highly respected database from the National Institutes of Health

Go to source

Endoscopic Revision of Sleeve Gastrectomy

Weight regain after sleeve gastrectomy can occur due to several factors, with a common one being dilation of the sleeve. In the revision procedure, known as ‘Sleeve-in-Sleeve’ or ‘SIS’, your doctor will re-tighten your sleeve endoscopically to restore the original post-surgical anatomy. This reduction in volume will lead to earlier satiety and, as a result, reduced food intake.

Endoscopic Revision of Roux-en-Y Gastric Bypass

Weight regain after gastric bypass can occur for various reasons, with one common cause being dilation of the gastric pouch and/or outlet (i.e. the connection between your pouch and small bowel). In the revision procedure known as ‘Transoral Outlet Reduction’ or ‘TORe’, your doctor will endoscopically reduce the size of either or both the pouch and outlet to reinstate your original gastric bypass anatomy, helping you feel full sooner and thus eat less.

Tailored Endoscopic Revisions for Previous Weight Loss Procedures

If you have undergone lap band surgery or even Endoscopic Sleeve Gastroplasty (ESG) with another provider but have experienced weight regain, our doctors offer specialized procedures to re-tighten your stomach to assist with weight loss. Reach out to learn how modern endoscopic techniques can assist in losing the regained weight without undergoing another surgery.

Request a free consultation

Revision of Sleeve Gastrectomy

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.

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.

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.

ESD Transoral Outlet Reduction (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-procedure. 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.

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

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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

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“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

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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-TORe.

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 revision. ESD-TORe, when used alongside medications, offers an effectiveness akin to undergoing an additional surgery, but without the need for surgical intervention.

Request a free consultation
Request a free consultation

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.

3500 cases suture procedures
Inventor of ESG Stomach Tightening

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

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).

Medication
dedicated care team

Sustainable lifestyle changes through a dedicated care team

Sustainable lifestyle changes through a dedicated care team

Sustainable lifestyle changes through a dedicated care team

Medication

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 $9,995, 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.

Why Bariendo?
World-class doctors vetted by ESG pioneer
With leading doctors and advanced research at its core, Bariendo upholds the highest standards in patient care. Our commitment? Grounded in best practice protocols, we deliver scientifically-backed, superior care in your health journey
Personalized ongoing weight loss support
Our smart web app simplifies and personalizes your weight loss journey. Manage appointments, receive personalized care, monitor your progress with a smart scale, enjoy extended support for 12 months, and receive convenient at-home care.
Transparent pricing
Bariendo champions transparency - procedure to 12-month follow-up, all costs upfront. Enjoy flexible payment options including HSA/FSA and 0% interest plans. Here, wellness meets budget
Why Bariendo?
World-class doctors vetted by ESG's pioneer
With leading doctors and advanced research at its core, Bariendo upholds the highest standards in patient care. Our commitment? Grounded in best practice protocols, we deliver scientifically-backed, superior care in your health journey
Personalized ongoing weight loss support
Our smart web app simplifies and personalizes your weight loss journey. Manage appointments, receive personalized care, monitor your progress with a smart scale, enjoy extended support for 12 months, and receive convenient at-home care.
Transparent pricing
Bariendo champions transparency - procedure to 12-month follow-up, all costs upfront. Enjoy flexible payment options including HSA/FSA and 0% interest plans. Here, wellness meets budget

Ready to take the next step?