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Roux-en-Y Gastric Bypass Operation in Rats
Published on: June 11, 2012
Endoscopic Transoral Outlet Reduction for Weight Recurrence After Roux-en-Y Gastric Bypass: A Retrospective
F Da Canal1, C Di Pietro Martinelli1, N Potoczna2
1Chirurgie Zentrum St. Anna, Lucerne, Switzerland.
Purpose:
Weight recurrence after Roux-en-Y gastric bypass affects 25% of patients. Gastrojejunal anastomosis dilation is a modifiable contributor. This study evaluates endoscopic transoral outlet reduction (TORe) efficacy and safety, comparing suturing versus over-the-scope clips (OTSC).
Methods:
Retrospective analysis of consecutive patients undergoing TORe for weight recurrence (2012-2024) at a tertiary center. Treatments included endoscopic suturing (OverStitch, Boston Scientific), OTSC, or combined techniques. Outcomes included %TWL and dumping syndrome symptomatic remission at 3, 6, 12, and 24 months, with 12 months as the primary reference timepoint (80.6% follow-up). Additional outcomes: technical success and 30-day adverse events.
Results:
Ninety-three patients were included (47.3±11.5 years; 81.7% female).
Techniques:
suturing n=48 (51.6%), OTSC n=33 (35.5%), combined n=8 (8.6%), BARS n=4 (4.3%). Baseline BMI 32.6±5.4kg/m². Mean GJA diameter reduced from 25.0±7.0mm to 10.7±2.1mm (p<0.001), technical success 97.8%. At 12 months, %TWL was 1.1±6.4% (Suturing: -0.1±5.4% vs 1.5±6.4%, p=0.61). Among 47 patients (50.5%) with dumping syndrome, symptomatic remission was achieved in 74.4% at 3 months and 61.9% at 12 months. Suturing group (n=23) achieved 89.5% symptomatic remission at 3 months and 71.4% at 12 months versus OTSC group (n=21) 60.0% and 52.4% respectively (12-month OR=2.27, 95%CI 0.71-7.84, p=0.341). Adverse event rate was 6.5%.
Conclusion:
TORe achieves excellent anatomical reduction. Although weight outcomes were heterogeneous (mean %TWL 1.1%; 42.7% experienced continued weight gain), dumping syndrome symptomatic remission was substantial (61.9% at 12 months), supporting TORe as anatomical stabilization within multidisciplinary obesity management rather than a standalone weight loss intervention.
