Endoscopic Gastric Suturing

The Center for Surgical Weight Control offers a full spectrum of services for weight loss. Now another option is being offered — a minimally invasive procedure that is designed to help patients who are struggling with regaining weight after bariatric surgery.

Why some patients may regain weight

Studies suggest that when patients regain significant weight after their initial gastric bypass, it is often caused by the gradual stretching of the stomach pouch and outlet. When the standard-of-care Roux-en-Y procedure is performed, the stomach and outlet are made very small, which reduces the amount of food that can be consumed and slows the passage of food through the digestive tract. This helps patients feel full after eating just a small amount of food, so they lose weight from a dramatic decrease in calories. If the stomach pouch and/or stoma gradually stretch, it takes longer to feel full, so patients start eating larger meals and may begin to regain weight. Now, these patients have an option for a second chance.

A safe and effective endoscopic procedure

Endoscopic Outlet and Pouch Repairs

The Center for Surgical Weight Control offers qualified patients an endoscopic procedure to reduce the volume of an enlarged pouch and the diameter of the outlet. Through an endoscope passed through the patient’s mouth, the physician can safely place the same type of sutures used during traditional abdominal surgery. Instead of being admitted to the hospital and facing the risks associated with abdominal surgery, this minimally invasive endoscopic procedure can be performed in an outpatient setting and leaves no external scars. 

View an animation of the procedure

Benefits & Risks

With the endoscopic approach, patients avoid many of the risks of major abdominal surgery, have less post-operative pain, recover faster and have no abdominal scars. Typically, patients go home the same day, but each patient’s discharge will vary based on the physician’s recommendation. Most patients feel little or no discomfort from the endoscopic procedure. Minor side effects may include nausea, a temporary sore throat, swollen tongue and/or lip pain from the insertion of the endoscope into the mouth. Typically, patients return to their normal routine within 48 hours. Following endoscopic suturing repair, patients should follow the same diet and exercise regimen they did after their initial bypass surgery.

Please call 304-399-4121 for pricing information.

A Second Chance

Blaine Nease, MD, FACS, director of the Center for Surgical Weight Control at Cabell Huntington Hospital, often tells his patients to view their bariatric surgery as a tool to help them make better lifestyle choices. And at the Center for Surgical Weight Control, there are numerous tools available to ensure weight loss success well beyond the surgery itself. 

From ongoing dietary counseling to regular follow-up appointments, bariatric patients have a lasting support system at the Center for Surgical Weight Control. Now, with the introduction of a minimally invasive revisional procedure called endoscopic gastric suturing, patients have access to another lasting benefit – a second chance. 

“Endoscopic gastric suturing is a treatment option for patients who have undergone weight loss surgery and have experienced weight regain after their procedure,” Dr. Nease said. “It is not meant to replace the original surgery; it is not replacing that original tool. It is taking that tool and learning how to use it again or how to use it better.” 

During the first few years after a bariatric procedure, patients may experience a loss in restriction, causing them to feel less full after meals and start to regain weight. Dr. Nease said it is during these early stages of weight regain that patients are most likely to benefit from an endoscopic revision procedure. 

regular exercise“This is not for patients who have gained all of their weight back or those who are gaining weight not because of a loss in restriction but because of dietary choices like consuming high-calorie drinks,” Dr. Nease said. “However, for patients who have put some weight back on and are motivated, the endoscopic gastric suturing procedure can actually take them back to the same level of restriction they felt after their initial surgery. In fact, we mentally prepare them to go back to that day – they follow the same steps and return to the same diet they followed after their first surgery.”

Dr. Nease was the first surgeon in West Virginia and the Tri-State to offer endoscopic gastric suturing. Using an endoscope, which travels through the mouth and down the esophagus into the stomach, Dr. Nease sutures the opening to the stomach – or, in patients who have had gastric sleeve resection surgery, sutures the stomach itself – to tighten the area back to the size it was after the first weight-loss procedure. It is a low-risk alternative to other revisional surgeries, requiring no incisions and only taking one to two hours to complete. 

Dr. Nease said although some patients may still require laparoscopic or more invasive revisional procedures, endoscopic gastric suturing is the best and most advanced option for patients who are in the beginning stages of weight regain due to restriction loss. It is yet another aspect of his surgical practice that sets the Center for Surgical Weight Control apart.

Blaine Nease, MD, FACS

Blaine Nease, MD, FACS

“The best bariatric surgical practices are ones that offer a variety of options for weight-loss surgery,” Dr. Nease said. “Our mission is to be a one-stop bariatric surgical practice. If you want an adjustable gastric band and it’s appropriate for you, we can provide it. If you want a gastric bypass or a gastric sleeve, we can provide that. If you need revisional surgery, we have experience in doing that, too. And now, we have experience in offering a more minimally invasive revisional procedure. This is just one more treatment option for our patients. It is another way for us to provide the best care possible.”

Are you a candidate? To find out, please complete this survey and mail it to the Center for Surgical Weight Control at the address at the bottom of the survey.

To make an appointment, please call 304-399-4121.

Download the Endoscopic Outlet and Pouch Repair brochure

Endoscopic Outlet and Pouch Repair Animation

  • Last updated: 05/27/2014
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