Indications  

Patients that have undergone Roux-en-Y gastric bypass may experience a change in symptoms years after their original surgery. This may include acid reflux, altered bowel habits with frequent bowel movement or other symptoms. A minority of patients may experience drastic changes the ability to tolerate larger volumes of food without experiencing satiety (feeling of satisfaction, fullness).  Some of these late changes may resolve by revising the original bypass. Now, revising the bypass can be performed endoscopically.

Pre-Operative Assessment

Your surgeon may request a series of exams to determine if any changes are due to a breakdown of the original bypass or due to stretching of the inside tissues. Other causes of reflux, weight gain, such as dietary changes or change of eating habits may have to be taken into consideration and addressed as necessary.

If stretching of the tissues is found to be the primary cause of change, the tissues around the pouch and the connection to the bowel (anastomosis) may be gather and made smaller by endoscopic means.  

Procedure and Aftercare

Endoscopic surgery is best performed under general anesthesia at the hospital. The gastroscope and an endoscopic suturing device is introduce into the stomach and sutures are passes from whithin reduce the size of the pouch and stoma.

 After the procedure patients will need to remain on a liquid diet for several weeks to allow proper healing. Solid food should be introduced a month after the procedure.  Lifelong behavior modification of eating habits and exercise are essential for beneficial long term success.

Contrandications

Patients that have anatomical abnormalities to their original surgery or esophageal disorders may not be suitable candidates for endoscopic surgery.  Patients with poor eating habits will not benefit from endoscopic sugery. This may include patients that graze, sweet eaters or consume liquid calories.