Endoscopic revision of roux en y gastric bypass

Endoscopic Revision of Roux-en-Y Gastric Bypass Stomal

  1. 10. Thompson C, Slattery J, Bundga M, Lautz D. Peroral endoscopic reduction of dilated gastrojejunal anastomosis after Roux-en-Y gastric bypass: a possible new option for patients with weight regain. Surg Endosc. 2006;20:1744-1748. 11
  2. utes. A Revision of Roux-en-Y Gastric Bypass requires anesthesia. Under these circumstances, patients are required to have a licensed driver take them back.
  3. We believe this case demonstrates that endoscopic gastrojejunal revision (or EGJR) is an effective treatment option for postprandial hypoglycemia following Roux-en-Y gastric bypass. Obes Surg . 2019 Nov;29(11):3773-3775. doi: 10.1007/s11695-019-04113-x
  4. Endoscopic management of weight regain following Roux-en-Y gastric bypass. Hourneaux De Moura DT(1), Thompson CC(1). Author information: (1)a Division of Gastroenterology, Hepatology and Endoscopy , Harvard Medical School, Brigham and Women's Hospital , Boston , MA , USA
  5. Thompson CC et al. (2006) Peroral endoscopic reduction of dilated gastrojejunal anastomosis after Roux-en-Y gastric bypass: a possible new option for patients with weight gain
  6. imally invasive procedure is designed to treat weight regain after gastric bypass surgery

Revision of Roux-en-Y Gastric Bypass Gastro Healt

While endoscopic revision is most commonly used to fix a Roux-en-Y gastric bypass, we can also correct an enlarged vertical sleeve gastrectomy. The procedure involves endoscopically suturing the sleeve to make it small again. This process is closely related t Endoscopic Gastric Bypass Revision is for patients who have regained weight following previous surgical gastric bypass. Endoscopic suturing is used to reduce the size of the gastric pouch and the size of the outlet between the gastric pouch and intestine, helping patients to again lose weigh Currently, the best treatment for obesity is bariatric surgery where both roux-en-Y gastric bypass and sleeve gastrectomy offer substantial weight loss. Unfortunately, 20% of patients who undergo bariatric surgery fail to lose enough weight defined as less than 50% of excess body weight loss or regain of weight The data indicates the long-term weight loss success from the Mini Gastric Bypass is the same as that of the Roux-en-Y gastric bypass. Several studies have now shown multiyear, long term, follow-up with equivalent weight loss results to the Roux-ex-Y gastric bypass. With respect to weight loss results, remember no surgery is a magic wand I am almost ashamed to even post here. I had my surgery 7 years ago. My lowest weight was 179 lbs. I have slowly gained back to 215 lbs right now. I feel like a failure. I saw information on another site about a Revision for the rouen y gastric bypass and wondering if anyone has had that done. Do..

Endoscopic Gastrojejunal Revision (Transoral Outlet

Patients requiring gastric bypass revision surgery - especially patients who were super obese prior to gastric bypass surgery (50+ BMI) - may find a conversion to duodenal switch surgery to be the best option. For example, one study evaluated 12 patients undergoing a conversion from Roux-en-Y gastric bypass to a duodenal switch Weight regain has led to an increase in revision of Roux-en-Y gastric bypass (RYGB) surgeries. There is no standardized approach to revisional surgery after failed RYGB. We performed an exhaustive literature search to elucidate surgical revision options. Our objective was to evaluate outcomes and complications of various methods of revision after RYGB to identify the option with the best. Conclusions: Endoscopic revision of the gastrojejunal anastomosis is associated with significantly fewer total and severe adverse events and similar long-term weight loss when compared with surgical revision. Keywords: Roux-en-Y gastric bypass, weight regain, recidivism, transoral outlet reduction (TORe), restorative obesity surgery endoluminal. This narrated video demonstrates endoscopic (incision-less) revision of a dilated gastric pouch and anastomosis after Roux en Y gastric bypass. This procedur..

Frezza EE, Herbert H, Ford R, Wachtel MS. Endoscopic suture removal at gastrojejunal anastomosis after Roux-en-Y gastric bypass to prevent marginal ulceration. Surgery for obesity and related diseases: official journal of the American Society for Bariatric Surgery . 2007;3(6):619-622 StomaphyX is an incision-free procedure that reduces the stomach volume to help gastric bypass patients get back on track with weight loss. StomaphyX is an endoscopic revision procedure for individuals who have had Roux-en-Y gastric bypass surgery and have regained weight due to a stretched stomach pouch or enlarged stomach outlet. The StomaphyX procedure reduces the stomach pouch and stomach. N2 - In the care of post Roux-en-Y gastric bypass (RYGB) surgery patients, the late complications of suboptimal weight loss and weight regain are common. Although surgical revision has been the standard of care for these patients, there are now endoscopic technologies and endoluminal procedures available to help gastrointestinal endoscopists. Roux-en-Y gastric bypass is currently considered the gold standard for severely obese patients but weight regain can appear in up to 20% of patients. In this key lecture, Dr. Galvao Neto presents the different endoscopic procedures to manage weight regain Al-Bader I, Khoursheed M, Al Sharaf K, et al. Revisional laparoscopic gastric pouch resizing for inadequate weight loss after Roux-en-Y gastric bypass. Obes Surg. 2015. Hamdi A, Julien C, Brown P, et al. Midterm outcomes of revisional surgery for gastric pouch and gastrojejunal anastomotic enlargement in patients with weight regain after.

Gastric bypass revision is another revision surgery option wherein a distal gastric bypass is converted to a proximal gastric bypass also known as an extended gastric bypass or ERNY (extended roux-en-y). The difference in the distal and proximal gastric bypass surgeries is the amount of intestine bypassed Morbid obesity is a global chronic disease, and bariatric procedures have been approved as the best method to control obesity. Roux-en-Y gastric bypass is one of the most common bariatric surgeries in the world and has become the gold standard procedure for many years. However, some patients experience weight regain or weight loss failure after the initial bypass surgery and require revisional. Gastric Bypass, Laparoscopic . 43644 Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and Roux -en-Y gastroenterostomy (roux limb 150 cm or less) Facility Only:$1,791 Inpatient only, not reimbursed for hospital outpatient or ASC 43645 Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and smal

Laparoscopic distal Roux-en-Y gastric bypass. Classically, reduction to a LDRYGB has been the most common revision for inadequate weight loss after LRYGB. 19 In a proximal Roux-en-Y gastric bypass, the Roux limb is constructed with a length of 80-150 cm, preserving most of the small bowel for absorption of nutrients. Conversion to a LDRYGB is. Roux‐en‐Y gastric bypass (RYGB) is the most commonly performed bariatric operation across the world, but sometimes revision is necessary. Inadequate weight loss, weight regain, and complications such as dumping syndrome are common reasons for revision

Marginal ulceration is one of the most common adverse events after Roux-en-Y gastric bypass (RYGB). The incidence rate of marginal ulcer may be as high as 7%.1-3 Antisecretory therapy is the first-line treatment. However, more than one-third of patients undergo surgical revision for intractable ulcers.4,5 The surgical outcome is excellent overall, except for smokers.5,6 Smokers with. Patients want to regain the restriction they had right after the Roux-en-Y gastric bypass surgery. Endoscopic reduction of the pouch and stoma will increase the restriction patients' experience, and their weight loss can be maximized with dietary changes and behavior modification

Revisional Procedures After Roux-en-Y Gastric Bypass. Laparoscopic procedures for weight issues after primary LRYGB. Normal anatomy. Alternatively, the stricture is incised by an endoscopic cold or hot knife, surgical revision may be contemplated. A safe and effective approach is reversal of the bypass to a normal anatomy Materials and Methods: A 48-year-old female presented to our clinic with vague epigastric abdominal pain associated with food and weight regain status post laparoscopic Roux-en -Y gastric bypass in 2002. Preoperative UGI study showed an enlarged gastric pouch and an EGD showed a questionable gastro-gastric fistula Endoscopic suturing for bariatric revision can be a simple way to adjust the outcome of a bariatric surgery procedure, putting patients back on the right track. What Is a Bariatric Revision? When bariatric surgery is performed, namely gastric bypass procedures, surgeons reduce the size of the stomach and intestines within the body, successfully.

Endoscopic management of weight regain following Roux-en-Y

Roux-en-Y (RNY) Vertical Sleeve (VSG) Bariatric Surgery in Mexico Ontario Canada See more forums Members Before & After Photos Member Photos Find Members Recent Surgeries Hi.. I am new here. I just found out about endoscopic gastric bypass repair/revision at this address:. AbstractBackground Approximately 20-30 % of patients who undergo Roux-en-Y gastric bypass (RYGB) will not meet the goals of weight loss surgery. Revisional surgery is associated with higher morbidity compared to initial operative management, and results in terms of weight loss have been inconsistent. Endoscopic plication has been seen as a less invasive option, with encouraging initial results

BACKGROUND: Weight regain after Roux-en-Y gastric bypass affects up to 30% of individuals. A dilated gastrojejunostomy contributes to regain through decreased restriction. Endoscopic gastrojejunostomy revision is a safe alternative to revisional surgery Endoscopic Gastric Revision (EGR) Over time, some patients who have had bariatric surgery may experience a gradual stretching of either their stomach or the entrance to their stomach. This can stall your weight loss efforts and even lead to weight gain

Weight loss after endoscopic revision of Roux-en-Y gastric

  1. Roux-en-Y gastric bypass (RYGB) is one of the most common bariatric surgeries for the management of class II and III obesity. It combines restrictive and malabsorptive physiologies to achieve weight loss. The gastric fundus, body, and antrum, along with the duodenum, are excluded from the alimentary tract after RYGB, with accelerated delivery of nutrients to the jejunum and ileum, leading to.
  2. Roux-en-Y gastric bypass surgery. Gastroenterology. 2013;145: 129-137. 5. Jirapinyo P, Slattery J, Ryan MB, Abu Dayyeh BK, Lautz DB, Thompson CC. Evaluation of an endoscopic suturing device for transoral outlet reduction in patients with weight regain follow-ing Roux-en-Y gastric bypass. Endoscopy. 2013;45:532-536. 6
  3. Gastric Outlet Obstruction My opinion would be to agree with the original physician's take on this. Although the patient had a gastric bypass, the surgery simply lessened the amount of gastric available for digestion. The physician re-approximated the jejunum to a different spot on the stomach but this is still the outlet. 43235 is the.
  4. ishes the restrictive capacity of RYGB. Endolu
  5. Gastric restrictive procedure, with gastric bypass for morbid obesity; with short limb (150cm or less) Roux-en-Y gastroenterostomy $ 1,710 43847 Gastric restrictive procedure, with gastric bypass for morbid obesity; with small intestine reconstruction to limit absorption $1,902 4384
  6. Anatomic relationships of Roux-en-Y gastric bypass is shown on the left. A and B. The transoral outlet reduction (TORe) endoscopy procedure. An endoscopic suturing system is used to plicate the gastrojejunal anastomosis (Before) and reduce its size to 1 cm (After), thus restoring the restrictive component of the gastric bypass
  7. Michigan Medicine performs two types of bariatric surgery procedures: gastric bypass and sleeve gastrectomy. Gastric Bypass (Roux-en-Y) Gastric bypass surgery divides the stomach to create a gastric pouch (about the size of an egg) and surgically connects the small intestine to the smaller stomach. This causes food to bypass the stomach and.

Macgregor AM, Rand CS (1991) Revision of staple line failure following Roux-en-Y gastric bypass for obesity: a follow-up of weight loss. Obes Surg 1:151-154 Obes Surg 1:151-154 Hunter R, Watts JM, Dunstan R et al (1992) Revisional surgery for failed gastric restrictive procedures for morbid obesity The textbook Townsend: Sabiston Textbook of Surgery (2012) states that, in regard to investigational bariatric procedures, endoscopic incisionless surgery has focused on patients after Roux-en-Y gastric bypass (RYGB) who have inadequate weight loss or significant weight regain and who have a dilated gastrojejunostomy Weight regain after Roux-en-Y gastric bypass affects up to 30% of individuals. A dilated gastrojejunostomy contributes to regain through decreased restriction. Endoscopic gastrojejunostomy revision is a safe alternative to revisional surgery. There is evidence that technique affects outcome, but the mechanical properties of various sutured repairs have not been evaluated

Open Gastric Bypass (RYGB) Open gastric bypass (CPT code 43846) involves both a restrictive and a malabsorptive component, with the horizontal or vertical partition of the stomach performed in association with a Roux-en-Y procedure (ie, a gastrojejunal anastomosis). Thus, the flow of food bypasses the duodenum and proximal small bowel In roux-en-Y gastric bypass surgery, the surgeon fashions an alternate egg-sized pouch, which is joined with the small intestine, so food skips the upper stomach and goes straight to the pouch. The doctor will create tiny incisions in the stomach with the help of a laparoscope, or guided camera that transmits images to a monitor so the entire. Early results of trans-oral endoscopic plication and revision of the gastric pouch and stoma following Roux-en-Y gastric bypass surgery, Journal of the Society of Laparoendoscopic Surgeons, vol. 14, no. 2, pp. 217-220, 2010 StomaphyX revision is a completely endoscopic revision technique used to tighten a stretched gastric pouch using internal sutures or fasteners. It may be used in patients who have had prior Roux-en-Y gastric bypass surgery and have a stretched stomach pouch. Our experienced, compassionate bariatric surgeons have undergone advanced-level.

Comparison of Revision in Roux-en-Y vs Mini-Gastric Bypass

The ROSE procedure, which stands for revision obesity surgery endoscopic, uses a simple method for narrowing your stoma. It costs between $8,000 and $13,000. The StomaphyX is another option and works in a similar manner as the ROSE procedure. This is also $8,000 to $13,000. Distal Vs Proximal Bypass Endoscopic gastric bypass revision is a technically challenging procedure that requires a high level of endoscopic skill and experience. Dr. McGowan, a board-certified gastroenterologist and endoscopist, is a leader and educator in the field of endoscopic weight loss, and regularly trains physicians from around the nation in the technique of endoscopic suturing The ROSE procedure is designed for patients who previously had a Roux-en-Y gastric bypass and were successful in losing over 50% of their excess weight but are now gaining back weight. Typically, the original procedure must have been performed more than 2 years ago and weight regain has reached 15% or more of the lost weight The gastric bypass revision cost in the US or Canada is currently in the range of $20,000 to $30,000 on average. You may also consider an equally competent but far more affordable option of medical tourism to Mexico for this surgery. Gastric bypass revision cost in Mexico may range from $7,000 to $10,000 on average

Gastric Bypass (CPT 43846, 43847) and Laparoscopic Gastric Bypass (CPT 43644 and 43645) - procedures that also limit the gastric reservoir capacity by the creation of a 15 ml stapled gastric pouch. However, the stapled pouch is connected by a 10-mm anastamosis to a 40-cm Roux-en-Y jejunal limb, thus bypassing the distal stomach, duodenum, and. The StomaphyX procedure is a new and innovative revision procedure for individuals who have had Roux-en-Y gastric bypass surgery and have regained weight due to a stretched stomach pouch or enlarged stomach outlet. Approved by the U.S. FDA in 2007, the StomaphyX procedure reduces the stomach pouch and stomach outlet (stoma) to the original. An adjustable gastric band is an inflatable silicone prosthetic device that is placed around the top portion of the stomach. This procedure can be performed as a revision procedure for many patients who have had a previous stomach stapling, gastroplasty procedure, or Roux-en-Y gastric bypass surgery but have regained weight A normal BMI is 18.5-25. Roux-en-Y gastric bypass is a weight loss option for people with: BMI greater than 40. BMI 35-39.9 and a life-threatening condition or severe physical limitations that affect employment, movement and family life. The success of gastric bypass surgery depends on your commitment to lifelong health habits In the sleeve gastrectomy group, 1 obstruction of the gastric sleeve was treated by laparoscopic revision. In the Roux-en-Y gastric bypass group, 2 patients needed surgical evacuation of intraabdominal abscess formation and 1 for pleural empyema, and 1 patient had an obstruction of the biliopancreatic limb

Gastric Bypass Revision - UCLA Bariatric Surgery, Los

Roux-en-Y Gastric Bypass Surgery has been very popular overseas for many years and can result in excellent long-term sustained weight loss. This Weight Loss Surgery procedure is performed using a few small laparoscopic (keyhole) incisions, and creates a small portion of narrow stomach which is disconnected from the rest of the stomach Background . Complications at the gastrojejunal anastomosis after laparoscopic Roux-en-Y gastric bypass (LRYGB) are challenging in terms of diagnosis, therapy, and prevention. This study aims at identifying these complications and discussing their management. Methods . Data of 228 patients who underwent a LRYGB between October 2008 and December 2011 were reviewed retrospectively to evaluate.

Endoscopic management of dumping syndrome after Roux-en-Y

Roux-en-Y gastric bypass (roux limb less than 150 cm) 43846 43644 Roux-en-Y gastric bypass (roux limb greater than 150 cm) 43847 43645 Biliopancreatic Diversion with Duodenal Switch (BPD/DS) 43845 43659, 44799 Billiopancreatic Diversion (BPD) without DS 43633 43659 Revision of gastrojejunal anastomosis (gastrojejunostomy) 43860 4365 Endoscopic sclerotherapy appears to be a safe and effective tool for the management of weight regain after Roux-en-Y Gastric Bypass (RYGB). [8] Barham K. Abu Dayyeh, Pichamol Jirapinyo Endoscopic Sclerotherapy for the Treatment of Weight Regain after Roux-en-Y Gastric Bypass: Outcomes, Complications, and Predictors of Response in 575 Procedure Gastric bypass with weight regain - Biliary limb distalization plus endoscopic transjejunal A.P.C. pouch therapy in one step: Case report January 2020 International Journal of Surgery Case.

Endoscopic Revision of Gastric Bypass - Brigham and Women

Advanced endoscopy to treat weight regain after Roux-en-Y Gastric Bypass: Stoma dilation is the most cited cause of insufficient weight loss or weight regain after a Roux-en-Y Gastric Bypass (RYGB). Surgical revision to restore its baseline restriction characteristic may be technically demanding and associated with increased morbidity The overstitch endoscopic suturing system (Apollo Endosurgery, Austin, Texas) is a disposable, single-use, in vivo reloadable device that is mounted onto a double channel gastroscope that enables suture application. Method We present a video and discuss the technical details of roux-en-y gastric bypass revision using the Apollo OverStitch

Coding a revison of Roux-en-Y Medical Billing and Coding

Study Weighs in on Best Revision for Failed Roux-en-Y Bypas

Endoscopic Gastric Bypass Revision - Jefferson University

Introduction The Apollo OverStitch is a minimally invasive endoscopic suturing device which allows full thickness suturing without the need for surgery Roux-en-Y gastric bypass (RYGB) can achieve up to 60% weight loss 2 years after surgery but 30% of patients will regain their weight within 2 years. The options for this group of patients are limited; redo surgery can be challenging with a. The Roux-En-Y gastric bypass procedure is the most commonly performed bariatric procedure in the United States. Despite initial weight loss, some patients experience weight regain that may be related to an increase in the size of the gastric pouch and/or stoma Roux-en-Y gastric bypass (RYGB) is a type of weight-loss surgery. Weight-loss surgery is also called bariatric surgery. It's often done as a laparoscopic surgery, with small incisions in the abdomen. This surgery reduces the size of your upper stomach to a small pouch about the size of an egg. The surgeon does this by stapling off the upper. Tufts Health Plan considers endoscopic sclerotherapy for bariatric indications (e.g. revision of Roux-en-Y procedure to address weight regain) and endoscopic gastric suturing (e.g. with the Apollo Overstitch™ System) for revision of gastric bypass or as a primary bariatric procedure to be investigational and, therefore, not medically necessary Data from the current study support results from research evaluating endoscopic gastric plication for revision after RYGB using the revision obesity surgery endoscopic (ROSE) procedure to reduce gastric pouch and/or stoma size. 14 A small study of the ROSE procedure in 5 patients demonstrated a mean weight loss after 3 months of 7.8 kg, with no.

Endoscopic Surgery for Bariatric Revision After Weight

StomaphyX™ - Gastric Bypass Revision This revolutionary procedure is now available for individuals who have had previous gastric bypass surgery and who are regaining weight. This procedure involves placing an endoscope through the mouth into the stomach pouch without involving incisions or a long recovery Pedziwiatr M, et al. Revisional Gastric Bypass Is Inferior to Primary Gastric Bypass in Terms of Short- and Long-term Outcomes—Systematic Review and Meta-Analysis. Obes Surg 2018 volume 28, pages2083-2091 Tran DD. Revision of Roux-En-Y Gastric Bypass for Weight Regain: a Systematic Review of Techniques and Outcomes BACKGROUND & AIMS Weight regain or insufficient loss after Roux-en-Y gastric bypass (RYGB) is common. This is partially attributable to dilatation of the gastrojejunostomy (GJ), which diminishes the restrictive capacity of RYGB. Endoluminal interventions for GJ reduction are being explored as alternatives to revision surgery. We performed a randomized, blinded, sham-controlled trial to. Using a laparoscopic approach, the stomach is segmented, similar to a traditional gastric bypass, but instead of creating a Roux-en-Y anastomosis, the jejunum is anastomosed directly to the stomach. Long Limb Gastric Bypass. The long-limb gastric bypass differs from the conventional gastric bypass only in the length of defunctionalized jejunum Introduction: Gastrogastric fistula (GGF) is a known complication of Roux-en-Y gastric bypass (RYGB) that may contribute to weight regain. Surgical revision may be technically challenging, while endoscopic closure especially of large GGF has limited efficacy

Endoluminal Revision (OverStitchTM , Apollo Endosurgery

Revision Weight Loss Surgery Reno Revision Bariatric

Gastric bypass is a surgical treatment approach to help obese patients reduce their weight. However, some patients still experience significant weight gain after this surgery. Surgery for gastric bypass revision may be an option in certain cases. Weight Gain after Gastric Bypass Surgery The most common type of bariatric surgery, known as the Roux-en-Y gastric [ Hi. This is Dr. Matthew St. Laurent and today I will be presenting a laparoscopic Roux-en-Y gastric bypass revision. Our operation begins with a 5-millimeter optical trocar entry into the abdomen. The abdomen is then insufflated with carbon dioxide to create a working space. A cursory exam is performed and then we introduce our remaining trocars Perioral endoscopic reduction of dilated gastrojejunal anastomoses after Roux-en-Y gastric bypass: a possible new option for patients with weight regain. Surg Endosc. 2006; 20(11):1744-1748. Tran DD, Nwokeabia ID, Purnell S, et al. Revision of Roux-en-Y gastric bypass for weight regain: a systematic review of techniques and outcomes

Revision after Roux en y gastric bypass - Weight Loss

During Roux-en-Y gastric bypass surgery, your surgeon: Makes a small stomach pouch - about the size of an egg - by dividing the top of the stomach from the rest of the stomach. Then, the small intestine is divided, and the bottom end of the divided small intestine is brought up and connected to the newly created small stomach pouch Gastric bypass, also known as the Roux-en-Y surgery, is a common type of weight loss surgery that involves altering the digestive tract. A smaller pouch is created from the stomach which bypasses the first section of the small intestine Chronic strictures following Roux-en-Y Gastric Bypass (RYGB) are a troublesome complication that can lead to significant morbidity. The use of stents has been described but the need for X-ray and risk of migration have meant limited use in the management of these strictures. Lumen apposing metal stents (LAMS) have traditionally been used for management of pancreatic pseudocysts

Gastric Bypass Revision Surgery - 6 Options - Bariatric

Roux-en-Y gastric bypass surgery is associated with a number of early and late gastrointestinal complications. This manuscript aims to review the early and late gastrointestinal complications of Roux-en-Y gastric bypass surgery. In cases of recurrent bleeding despite endoscopic intervention, surgical revision may be necessary. In all cases. Background . Drain inclusion inside the gastric pouch is rare and can represent an important source of morbidity and mortality associated with laparocopic Roux-en-Y gastric bypass (LRYGBP). These leaks can become chronic and challenging. Surgical options are often unsuccessful. We present the endoscopic management of four patients with drain inclusion Data on endoscopic scissor use was obtained from multiple gastroenterologists with varying years of experience. This study was approved by the university Institutional Review Board. Eligible patients for inclusionwere those p atients with a history of prior Roux-en-Y gastric bypass with or without previoussurgery endoscopic revision Should this happen, the sleeve can easily be converted into a gastric bypass during revision surgery. Hunger Reduction: With this procedure, the upper portion of the stomach is eliminated. It is this portion that produces the majority of ghrelin in the body. Known as the hunger hormone, it stimulates appetite, so reducing it can stop hunger pangs

Studies Archives - San Francisco Institute for Weight Loss

Revision of Roux-En-Y Gastric Bypass for Weight Regain: a

Several endoscopic suturing strategies have been described as revision therapies for weight regain after gastric bypass (RYGB) surgery. Although evidence exists regarding outcomes of trans-oral GJ outlet reduction (TORe) in terms of weight loss, the efficacy of gastric pouch revision is still unclear Laparoscopic Gastric Bypass. Gastric bypass (also known as Roux-en-Y or the bypass) is the most common weight loss surgical procedure performed worldwide. It has the longest proven track record and has more long term studies proving its efficacy and is therefore considered by many as the 'gold standard' of weight loss surgery The roux-en-y gastric bypass has stood the test of time and has been proven to be both safe and effective for most patients. Our surgical team has some of the best talent in the world, having performed this procedure for more than 20 years. How The Roux-en-Y Works There are two components to the procedure

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