What is Gastric Bypass?
The most popular and effective procedure for the treatment of obesity is the Roux-en-Y gastric bypass (RNYGB). The RNYGB is a combination of a restrictive procedure which reduces the size of the stomach and a malabsorptive procedure that bypasses a section of the small intestine (called the jejunum).
Studies show the following rates of excess weight loss after RNYGB:
- 67% of excess weight at 1-2 years post-op
- 60% at 5 years post-op
- More than 50% at years 5 through 10 post-op
- RNYBG will fail in some 20-35% of patients for a variety of reasons that are likely multifactorial
Why Gastric Bypass Sometimes Fails
The lack of response to gastric bypass anti-obesity surgery is often referred to as post-gastric bypass recidivism.
Weight regain after Gastric Bypass may very well be related to dietary habits. However, many clinicians and studies, including those conducted and published by Dr. Starpoli, have shown that the stomach pouch and/or outlet made smaller by Gastric Bypass surgery can gradually stretch, making the patient lose the sense of fullness and start to eat more. As a result, patients may regain weight.
Read Dr. Starpoli's published work on the success of stomal revision with TORe
It has also been shown that open, surgical revision of stomach pouch and/or outlet is undesirable because of the inherent surgical risks and the possibility of anastomotic leakage. This observation has lead to incisionless, endoscopic or endolumenal approaches to reduce the diameter and restore it to its former post-operative size.
What Can Be Done - Endoscopic Therapy
Dr. Starpoli offers qualified patients a safe and effective incisionless, endoscopic suturing procedure to reduce the size of an enlarged outlet to the original post-bypass proportions. This procedure is performed using a small flexible endoscope and specialized devices that allows sutures to be placed through the endoscope. The scope and suturing devices are inserted through the mouth into the stomach pouch the same way as a standard endoscope. Sutures are then placed around the outlet to reduce the diameter, typically from the size of a silver dollar to less than the size of a dime. The same technique may then be used to place additional sutures in the stomach pouch to reduce its volume capacity.
