Efficacy and safety of transoral outlet reduction via endoscopic suturing in patients with weight regain after a surgical Roux-en-Y gastric bypass

Coll, Eduardo Espinet; Durán, Javier Nebreda; Breviere, Gontrand López-Nava; Neto, Manoel Galvao; Valero, José Antonio Gómez; Bacchiddu, S; Lolo, C Vila; Galán, Patricia Díaz; Bautista-Castaño, Inmaculada; Comamala, A Juan-Creix

doi:10.17235/reed.2018.5419/2017

Cited by 7 publications

(5 citation statements)

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“…There were also no severe adverse events in either group, demonstrating the safety of this intervention [39]. Subsequent TORe studies have also shown sustained and continued weight loss 3 to 5 years after TORe for weight recurrence after LRYGB [41][42][43]. A 2020 study also found that a modified endoscopic submucosal dissection around the GJA prior to endoscopic suturing increases weight loss compared to the APC-TORe procedure [44].…”

Section: Endoscopic Suturingmentioning

confidence: 87%

Bariatric endoscopy: from managing complications to primary metabolic procedures

Dang

Kim

Kroh

2023

J Minim Invasive Surg

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Obesity is a worldwide epidemic and is the second leading cause of preventable death. The approach to treating obesity involves a multidisciplinary approach including lifestyle interventions, pharmacological therapies, and bariatric surgery. Endoscopic interventions are emerging as important tools in the treatment of obesity with primary and revisional bariatric endoscopic therapies. These include intragastric balloons, aspiration therapy, suturing and plication, duodenal-jejunal bypass liners, endoscopic duodenal mucosal resurfacing, and incisionless magnetic anastomosis systems. Endoscopic interventions have also demonstrated efficacy in treating complications of bariatric surgery. Approaches include stenting, endoscopic internal drainage, and endoscopic vacuum-assisted closure. This review aimed to discuss the current endoscopic procedures used as primary and revisional bariatric therapy including those used for managing bariatric surgical complications.

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Section: Endoscopic Suturingmentioning

confidence: 87%

Bariatric endoscopy: from managing complications to primary metabolic procedures

Dang

Kim

Kroh

2023

J Minim Invasive Surg

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“…It is hypothesized that the weight loss post TORe was secondary to reduction in GJA size, improved eating habits, quicker gastric emptying times, and induction of satiety by stimulating gastric stretch receptors 11 24 27 28 . Weight recidivism was reported to be due to genetic factors, lack of dietary compliance, or due to suture breakage/migration leading to dilation of the GJA after TORe 26 27 28 36 .…”

Section: Discussionmentioning

confidence: 99%

“…However, according to Jirapinyo et al, there was an increased incidence of nausea and vomiting with GJA < 4 mm 37 . The majority of the studies aimed for a GJA size < 10–12 mm 12 23 24 25 26 27 29 36 .…”

Section: Discussionmentioning

confidence: 99%

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Efficacy of transoral outlet reduction in Roux-en-Y gastric bypass patients to promote weight loss: a systematic review and meta-analysis

et al. 2020

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Background and study aims Transoral outlet reduction (TORe) is an endoscopic procedure used in patients with weight gain post Roux-en-Y gastric bypass (RYGB). We performed a systematic review and meta-analysis to evaluate the efficacy and safety of TORe with a full-thickness suturing device for treating patients with weight regain after RYGB. Patients and methods We conducted a comprehensive search of several databases and conference proceedings including PubMed, EMBASE, Google-Scholar, MEDLINE, SCOPUS, and Web of Science databases (earliest inception to March 2020). The primary outcomes assessed were technical success, absolute weight loss (AWL) and percent of total weight loss (% TWL) at 3, 6, and 12 months after the procedure. The secondary outcomes assessed were pooled rate of adverse events (AEs), adverse event subtypes and association of size of gastrojejunal anastomosis (GJA) and percent TWL. Results Thirteen studies on 850 patients were included. The pooled rate of technical success was 99.89 %. The absolute weight loss (kg) at 3, 6, and 12 months was 6.14, 10.15, and 7.14, respectively. The percent TWL at 3, 6, and 12 months was 6.69, 11.34, and 8.55, respectively. The pooled rate of AE was 11.4 % with abdominal pain being the most common adverse event. The correlation coefficient (r) was –0.11 between post TORe GJA size and weight loss at 12 months. Conclusion TORe is an endoscopic procedure that is safe and technically feasible for post RYGB with weight gain.

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“…Despite its efficacy, WR after RYGB is an escalating concern ( 11 ). Changes in anatomy, among other factors, have been shown to contribute to this pathology.…”

Section: Roux-en-y Gastric Bypassmentioning

confidence: 99%

Endoscopic Management of Weight Recurrence Following Bariatric Surgery

et al. 2022

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Metabolic and bariatric surgery is the most effective therapy for weight loss and improving obesity-related comorbidities, comprising the Roux-en-Y gastric bypass (RYGB), gastric banding, sleeve gastrectomy (SG), and biliopancreatic diversion with duodenal switch. While the effectiveness of weight loss surgery is well-rooted in existing literature, weight recurrence (WR) following bariatric surgery is a concern. Endoscopic bariatric therapy presents an anatomy-preserving and minimally invasive option for managing WR in select cases. In this review article, we will highlight the endoscopic management techniques for WR for the most commonly performed bariatric surgeries in the United States –RYGB and SG. For each endoscopic technique, we will review weight loss outcomes in the short and mid-terms and discuss safety and known adverse events. While there are multiple endoscopic options to help address anatomical issues, patients should be managed in a multidisciplinary approach to address anatomical, nutritional, psychological, and social factors contributing to WR.

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Efficacy and safety of transoral outlet reduction via endoscopic suturing in patients with weight regain after a surgical Roux-en-Y gastric bypass

Cited by 7 publications

References 0 publications

Bariatric endoscopy: from managing complications to primary metabolic procedures

Bariatric endoscopy: from managing complications to primary metabolic procedures

Efficacy of transoral outlet reduction in Roux-en-Y gastric bypass patients to promote weight loss: a systematic review and meta-analysis

Endoscopic Management of Weight Recurrence Following Bariatric Surgery

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