Transoral outlet reduction zipper technique for enhanced tissue approximation and potential improved durability

Area of Science:

• Bariatric Surgery
• Minimally Invasive Procedures
• Gastroenterology

Background:

• Roux-en-Y gastric bypass (RYGB) can lead to weight regain and dumping syndrome.
• Transoral outlet reduction (TORe) is an endoscopic procedure to restore RYGB restriction.
• Traditional TORe methods may require repeat interventions.

Purpose of the Study:

• To present an alternative suturing technique for TORe.
• To evaluate the durability of the novel zipper technique for TORe.

Main Methods:

• A 60-year-old female patient with RYGB, weight regain, and dumping syndrome underwent TORe.
• Initial TORe used a traditional purse-string suture, which failed after one year.
• A repeat TORe was performed using a novel zipper technique with zigzag suturing.

Main Results:

• The zipper technique successfully reduced the gastric outlet diameter to 11 mm.
• The patient's dumping syndrome symptoms resolved.
• The gastric outlet remained stable for several months post-procedure.

Conclusions:

• The zipper technique is an effective alternative for TORe.
• This method enhances tissue approximation and may improve durability.
• The zipper technique could potentially reduce the need for repeat interventions.