Endoscopic Gastric Bypass Revision

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What Is Endoscopic Gastric Bypass Revision?

Endoscopic gastric bypass revision, also known as bariatric revision or transoral outlet reduction (TORe), is an outpatient, non-surgical procedure designed to stop weight regain and jumpstart weight loss after gastric bypass bariatric surgery. The procedure is performed by a highly-trained gastroenterologist who uses advanced techniques to help tighten the surgical pouch and outlet created during the original gastric bypass surgery to their original size – promoting rapid, sustainable weight loss. 

Patients lose the weight they’ve gained, experience a restored sense of fullness, and regain control of their health and life – all with a non-surgical procedure that takes less than 30 minutes. Most patients are back to work and regular activities in just two to three days.

Who Is Gastric Bypass Revision For?

Endoscopic gastric bypass revision is for patients who originally underwent a Roux-en-Y gastric bypass. However, we can also use this procedure to revise an enlarged vertical sleeve gastrectomy. In this case, the technique is more like our endoscopic sleeve gastroplasty, which is another effective, non-surgical weight loss treatment we offer.

You may be a candidate for endoscopic gastric bypass revision if you did not lose sufficient weight after your initial bypass or if you have gained weight back over time. Because it is a non-surgical procedure, it can also be appropriate for individuals who are not good candidates for additional surgery. 

Endoscopic gastric bypass revision may not be right for you if you experienced symptoms after your original procedure like ulcers. It is also not recommended for patients who have gained weight for reasons beyond enlargement of the gastric pouch or outlet. Our physicians will assess your specific situation and medical history to determine whether this weight loss treatment is the right choice for you. 

Our most successful patients are those who commit to lifestyle changes after the procedure. At True You Weight Loss, our team offers a personalized approach to care you won’t find anywhere else. We provide individualized, ongoing support after your treatment, including medical team follow-up, one year of personalized nutrition counseling, and our encouraging online support group and community. We are committed to helping every patient achieve their weight loss goals.

How Does Endoscopic Gastric Bypass Revision Work?

Endoscopic gastric bypass revision is an outpatient procedure performed under sedation. Once you are asleep, your physician will place the endoscope into your mouth and thread it down to your stomach. The endoscope has a light and camera that allows your doctor to clearly visualize the treatment area via video without the need for any incisions. 

The endoscope also has a revolutionary suturing device that gives your doctor the ability to place sutures directly into the enlarged gastric pouch and its outlet to reduce their size. The treatment takes less than 30 minutes to complete in our office. You’ll be able to return home the same day as your procedure, allowing you to rest and recover in familiar surroundings rather than a hospital room. Most patients return to work and other activities within two to three days after their procedure.

How Much Weight Can I Expect to Lose?

The revision of your gastric bypass will help you feel full with smaller portions and it also allows you to stay full for longer. By reducing your hunger and food intake, you’ll be able to stop weight regain and quickly start losing weight again. Most of our patients lose around 10-20% of their total body weight. While this amount may not be as substantial as what you lost after your original bypass surgery, this weight loss should be more long-lasting.

Total weight loss varies from patient to patient and depends on many factors – including your commitment to adhering to the True You Weight Loss program and following dietary and exercise recommendations. We provide ongoing support and education, including one-on-one nutrition counseling, after your procedure to keep you on track and help you realize your weight loss goals.

Gastric Bypass Revision: How it Works

Stretched Gastric Pouch
Revised Gastric Pouch
Endoscopic gastric bypass revision restores a stretched gastric pouch to its original size, or smaller.

Gastric Bypass Revision Video Library

Why Choose True You for Gastric Bypass Revision?

Endoscopic Expertise
Endoscopic gastric bypass revision is a technically challenging procedure that requires a high level of endoscopic skill and experience. Dr. Daniel Maselli and Dr. Christopher McGowan are among the few physicians in the nation who are triple board-certified in internal medicine, gastroenterology, and obesity medicine, and leaders in the area of endobariatrics. Combined, they have performed more endoscopic sleeve revisions than any physician in the country, ensuring that you will receive the absolute best care and results. And as a patient at True You, you will receive a comprehensive after care program, and your True You Weight Loss team will support you on your journey.
The Nation’s Most Comprehensive Aftercare
We understand the importance of aftercare and support, especially when embarking on a second chance at a healthier you. That’s why we take pride in offering the nation’s most comprehensive aftercare program tailored to meet your needs. With our expert medical team and registered dietitians, you’ll receive unparalleled support and guidance throughout your weight loss journey. We are here for you every step of the way.
24/7 Physician Access
Whether you live in North Carolina or Georgia, or are traveling from another state altogether, you will receive the highest level of concierge care, with 24/7 direct access to your physician via personal cell phone, text, email, and video chat. We remain committed to your success throughout your weight loss journey.
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Gastric Bypass Revision


Financing Available*
As low as $217/Mo.
*Financing offers subject to credit approval and may vary based on individual credit history.
  • Initial Consultation
  • Pre-Procedure Labs
  • Comprehensive Bariatric Nutrition Consultation
  • Revision Procedure (inclusive of all facility, anesthesia, and physician fees)
  • Unlimited Medical Follow-Up
  • 24/7 Direct Physician Access
  • Post-Procedure Nurse Visit With IV Hydration
  • 1 year of one-on-one nutrition counseling
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Self-Pay Pricing
Many of our patients simply don’t want surgery. At the same time, they feel hopeless because the lifestyle modifications of diet and exercise simply aren’t effective. True You provides solutions when you feel as though you’re out of options. While the gastric bypass revision procedure is not covered by insurance, we offer several financing options.
Traveling From Out of State?
Patients have traveled to True You from more than 45 states and 10 countries. Our locations are near international airports for ease of travel and we have made arrangements with several local hotels for your convenience. Please note that all patients must be accompanied by a responsible adult when traveling from out of state.
Success Stories

From Mother to Daughter: Love, Support, and Lessons Learned

Kat’s Gastric Bypass Revision Journey Throughout her childhood and high school years, Kat shared a close relationship with her mother, but they also shared an unhealthy lifestyle of overeating and yo-yo dieting.  Today, at age 67, Kat remembers steadily gaining weight during her youth and commonly being called the “fat kid.” Since it was the […]

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Lisa Larger

Gastric Bypass Revision FAQs

How much does gastric bypass revision cost?

At True You Weight Loss, we believe in price transparency so our patients know exactly what their procedure and accompanying services will cost them. Currently, the price of our endoscopic gastric bypass revision is $11,995. This amount includes your initial consultation and any pre-procedure labs ordered by your doctor. 

Unlimited medical follow-up and 24/7 direct access to your physician are also included. Plus, we provide 12 months of one-on-one nutrition counseling, so you have all the support you need to achieve your weight loss goals and maintain them. 

Unfortunately, insurance does not cover the cost of endoscopic bariatric revision at this time. We offer a variety of financing options to ensure your weight loss treatment is affordable for you.

What is endoscopic bariatric revision?

Endoscopic gastric bypass revision is a non-invasive technique used to restore a gastric bypass to its original size, or smaller. Beginning several years after gastric bypass surgery, the size of the pouch may begin to enlarge. Likewise, the connection between the pouch and the small intestine (known as the anastomosis or “outlet”) may also begin to dilate and enlarge. The result is less restriction or feeling of fullness and subsequent weight gain. With endoscopic bariatric revision, we can tighten the outlet or pouch to restore this restriction and help you lose the weight that you regained.

Who is eligible for bariatric revision?

This procedure is designed for patients who have had a gastric bypass procedure and are now experiencing weight regain and a reduced feeling of fullness after eating.

Who is not eligible for bariatric revision?

Bariatric revision is only for those who have had prior gastric bypass surgery. If you have regained weight after a prior gastric bypass for reasons other than dilation of your pouch or outlet, you may also not be a candidate. If you have ulcers or complications from your gastric bypass, you may not be a candidate. If you are an active smoker, you are not eligible for bariatric revision.

How does gastric bypass revision differ from a surgical revision?

Surgical revision is a complex operation where the gastric pouch is either made smaller or the bypass is surgically altered. Because of its complexity, surgical revision carries a risk of major complications of up to 30%.

In contrast, endoscopic bariatric revision is performed entirely through the mouth, with a suturing system (Overstitch) mounted to the end of an endoscope. The procedure is brief and safe, with a risk of complication of 1% or less.

Because endoscopic bariatric revision is performed through the mouth and without incisions, the recovery is very fast. The procedure is performed same-day, and most patients return to work within two to three days.

How long does the gastric bypass revision procedure take?

The procedure is performed in an outpatient setting in less than 30 minutes. You are sedated during the procedure. After the procedure, you will wake up, recover, then you will be discharged home.

What are the risks associated with gastric bypass revision?

Most patients will experience a feeling of indigestion, mild nausea, and possibly upper abdominal pressure or pain. The risk of major complications, such as infection, bleeding, or stomach injury, is less than 1%.

How much weight will I lose after gastric bypass revision?

In addition to stopping weight regain, most patients will lose an average of 10% of their total body weight, and up to 20% of their total body weight. While the total weight loss is generally less than experienced following the gastric bypass, the weight that you lose after endoscopic gastric bypass revision is typically sustained for many years. While individual results may vary, adhering to a structured diet and exercise regimen will enhance your success.

How do I keep the weight off after endoscopic bariatric revision?

Similar to gastric bypass surgery, patients are urged to adopt healthy eating habits after undergoing bariatric revision. Eating slowly and avoiding overeating can help promote long-term success. And, incorporating exercise and/or movement into your lifestyle will help support long-term weight maintenance.

What evaluation is required before gastric bypass revision?

We may recommend an upper endoscopy or barium test to evaluate your pouch and outlet if you have not had a recent evaluation. This is to confirm that it is enlarged and can be revised endoscopically.

I gained weight after a sleeve gastrectomy. Am I a candidate for endoscopic bariatric revision?

Yes. 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 to the endoscopic sleeve gastroplasty procedure. Contact us to learn if you may be a candidate.

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