We are following COVID-19 protocols

TORe Procedure Specialist

Endoscopic Wellness Center of America -  - Medical Wellness

Endoscopic Wellness Center of America

Medical Wellness Facility located in Reston, VA

Recently, with advancements in endoscopic suturing devices, a novel approach to reduction of the stoma diameter has emerged: Transoral Outlet Reduction Endoscopy (TORe). This procedure can be performed on an outpatient basis with a favorable risk profile compared with revisional bariatric surgery. An endoscopic suturing system is used to plicate the gastrojejunal anastomosis and reduce its size to 1 cm, thus restoring the restrictive component of the gastric bypass.   A dilated gastrojejunal anastomosis (GJA) is a major predictor of weight regain after RYGB. Surgical correction of this problem is technically challenging, requires a longer procedure and hospital stay than RYGB, and is associated with significant morbidity and limited efficacy.   One of the most common anatomical changes over time is the enlargement of gastrojejunal stoma size, contributing to weight regain by a reduction in satiety and allowing the patient to increase the volume of food consumed in one meal. The dilated gastrojejunal stoma can be treated surgically; however, this revision requires a technically difficult dissection and has a significant risk of morbidity and complications.   Weight regain after bariatric surgery can be devastating to patients, as they often feel like failures and are at a loss for where to go next. A multidisciplinary approach such as the one at Endoscopic Wellness Center of America, which includes TORe and our Wellness Program can provide patients with an array of effective options. Individual results may vary. 

TORe Q & A

Why do I need a stomal revision?

Stomas are connections made surgically between two segments of the bowel. Roux-en-Y bariatric procedure creates a stomal opening between the stomach remnant and the proximal small intestine, Je-junction.

As patients with previous Roux-en-Y gastric bypass procedures stretch the stomal opening, the results are increased weight gain. Reducing the stomal opening directly correlates with weight gain/loss.

Stomas can be temporary or permanent. A stomal revision procedure may involve treating your temporary stoma and reattaching your bowels or making repairs to either a temporary or permanent stoma.

What happens during a stomal revision?

At Endoscopic Wellness Center of America, you meet with a skilled, board-certified gastroenterologist. 

Your stoma revision is personalized to your needs and is usually performed under general anesthesia. During your stomal revision, Dr. Blosser or a member of his team will:

Reduces the stoma opening with the Apollo Overstitch Device

The team at Endoscopic Wellness Center of America counsels you throughout every part of your preoperative and postoperative stages, so you have the support you need and understand what to expect. Patients are discharged the same day as their procedure. 

How long is the recovery after a stomal revision?

The team at Endoscopic Wellness Center of America spends time coaching you about nutritional wellness and teaching you about which foods you can eat, which foods to avoid, and how to plan your meals. Their goal is to ensure your stoma revision is successful and long-lasting. 

Click on the online scheduler to request your stomal revision evaluation at Endoscopic Wellness Center of America today. You can also call the practice to speak with a team member directly. 

Individual results may vary.