Dr. Sasse has written a 2020 update to gastric bypass pouch tightening without surgery.
Did you know that a stretched stomach pouch from gastric bypass can now be revised and shrunk without surgical cutting? Millions of individuals have undergone gastric bypass surgery, most of them with great results. But some have experienced weight re-gain and many who had a stomach surgical procedure five, 10, or more years ago have lost the sense of “restriction” and can now eat more.
One of the ways that gastric bypass and other forms of bariatric surgery work is by restricting the food and calorie intake. The stomach, once large and elastic, becomes a small pouch with less elasticity. An individual with a small stomach pouch has to slow down, chew more, and ultimately consume less calories. The outlet from this pouch, sometimes referred to as the stoma, or anastomosis, is usually small, limiting the passage of food from the pouch to the intestine. Over time the result is less food in and a calorie deficit, and … weight loss.
But what happens if the pouch stretches over time? And what happens if the outlet, or the connection formed from the stomach pouch to the intestine, becomes larger? In most cases the person can eat more, feels less restriction, and the chances go up that pounds may come back on.
In the past, efforts to deal with this situation required surgery, sometimes with large open incisions. Today, successful tightening of the pouch, and reduction of the size of the outlet, can be safely performed without any cutting or surgery. The procedure is performed using endoscopy and technology that has been perfected in the last few years that allows the surgeon to apply sutures from the inside of the stomach itself.
The technology was FDA approved in 2012, and requires a fairly unusual combination of abilities, skills at both surgical procedures on the stomach, and endoscopy. Bariatric surgeons are uniquely qualified in this realm, and have been achieving excellent results revising stretched pouches for several years.
Our approach is a holistic one which views the endoscopic tightening of the pouch and reduction of the outlet as part of a global solution. Thus, we emphasize a specific diet program, daily exercise, and often add FDA approved prescription weight-loss medications to achieve successful weight loss.
The pouch becomes smaller, the outlet is narrower, and a person can once again feel like they did when they first had gastric bypass.
Kent C. Sasse, M.D., MPH, FACS, FACRS
Assistant Clinical Professor, University of Nevada School of Medicine Minimally Invasive Solutions
