Year 2018 / Volume 110 / Number 9
Original
Efficacy and safety of transoral outlet reduction via endoscopic suturing in patients with weight regain after a surgical Roux-en-Y gastric bypass

551-556

DOI: 10.17235/reed.2018.5419/2017

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

Abstract
Introduction: many patients that undergo bariatric surgery (Roux-en-Y gastric bypass [RYGB]) may regain some of their weight lost over time. A transoral outlet reduction (TORe) with endoscopic suture could be a valid alternative in these patients. Methods: this was a retrospective initial series of 13 consecutive patients with weight regain after RYGB and a dilated gastro-jejunal anastomosis (> 15 mm). TORe was performed using an endoscopic transmural suture device (OverStitch-Apollo®), which was used to reduce the anastomosis aperture and also to treat the gastric pouch. The initial data of feasibility, safety and weight loss are described with a limited follow-up of six months. Results: there was a mean maximum weight loss of 37.69 kg after RYGB and a subsequent average regain of 21.62 kg. The mean anastomosis diameter was 36 mm (range 20-45) which was reduced to 9 mm (range 5-12) (75% reduction), with an average of 2.5 sutures. The mean pouch size was 7.2 cm (range 2-10), which decreased to 4.7 cm (range 4-5) (34.72% reduction), with an average of 2.7 sutures. The mean weight loss six months after TORe was 12.29 kg, a weight loss of 56.85% of the weight regained after RYGB. No complications related to the procedure were recorded. Conclusions: endoscopic suture reduction of the dilated gastro-jejunal anastomosis and the gastric pouch seems a feasible and safe option in our limited initial experience. With a multidisciplinary approach and a short term follow-up, this seems to be a minimally invasive and effective option to control weight regain after RYGB.
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Espinet Coll E, Nebreda Durán J, López-Nava Breviere G, Galvao Neto M, Gómez Valero J, Bacchiddu S, et all. Efficacy and safety of transoral outlet reduction via endoscopic suturing in patients with weight regain after a surgical Roux-en-Y gastric bypass. 5419/2017


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Publication history

Received: 08/12/2017

Accepted: 25/02/2018

Online First: 09/05/2018

Published: 31/08/2018

Article revision time: 67 days

Article Online First time: 152 days

Article editing time: 266 days


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