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Updated: Aug 23, 2026
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, Hirslanden Clinic 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 the efficacy and safety of endoscopic transoral outlet reduction (TORe), comparing suturing vs 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 a combination of techniques. Outcomes included percentage total body weight loss (%TWL) and symptomatic remission of dumping syndrome at 3, 6, 12, and 24 months, with 12 months as the primary reference time point (80.6% follow-up). Additional outcomes included technical success and 30-day adverse events.
Results:
Ninety-three patients were included (47.3 ± 11.5 years; 81.7% female). Techniques used were: suturing, n = 48 (51.6%); OTSC, n = 33 (35.5%); combined, n = 8 (8.6%); and Bariatric Anastomotic Repair System, n = 4 (4.3%). Baseline body mass index was 32.6 ± 5.4 kg/m². Mean gastrojejunal anastomosis diameter was reduced from 25.0 ± 7.0 mm to 10.7 ± 2.1 mm (P <.001), with a technical success rate of 97.8%. At 12 months, %TWL was 1.1 ± 6.4% (Suturing: -0.1 ± 5.4% vs 1.5 ± 6.4%; P =.61). Among 47 patients (50.5%) with dumping syndrome, symptomatic remission was achieved in 74.4% at 3 months and in 61.9% at 12 months. The suturing group (n = 23) achieved 89.5% symptomatic remission at 3 months and 71.4% at 12 months, vs the OTSC group (n = 21), which achieved 60.0% and 52.4%, respectively (12-month odds ratio, 2.27; 95% CI, 0.71-7.84; P =.341). The adverse event rate was 6.5%.
Conclusion:
TORe achieves excellent anatomical reduction. Although weight outcomes were heterogeneous (mean %TWL was 1.1%; 42.7% experienced continued weight gain), dumping syndrome symptomatic remission was substantial (61.9% at 12 months), supporting TORe as an anatomical stabilization measure within multidisciplinary obesity management rather than a standalone weight-loss intervention.
