Endoscopic gastric sleeve revision is a non-invasive technique used to restore a gastric sleeve to its original, or smaller size. Sleeve gastrectomy is currently the most common bariatric surgery performed worldwide. It involves stapling and removing 80% of the stomach, leaving a narrow, banana-shaped stomach. However, beginning several years after sleeve gastrectomy, the stomach can begin to enlarge. The result is greater capacity, the ability to eat more food, and weight regain. With endoscopic sleeve revision, we can tighten a stretched sleeve from the inside, using endoscopically placed sutures, reducing its size and restoring restriction and fullness.
This procedure is closely related to the endoscopic sleeve gastroplasty
This procedure is designed for patients who have had a surgical sleeve gastrectomy, initially lost weight, but are now experiencing weight regain and a reduced feeling of fullness during meals.
Endoscopic sleeve revision is only for those who have had a prior laparoscopic or open sleeve gastrectomy.
If you have regained weight for reasons other than dilation of your sleeve, you may also not be a candidate.
If you have ulcers or complications from your surgery, you may not be a candidate. If you are an active smoker, you are not eligible for endoscopic sleeve revision.
There are few surgical options available to correct an enlarged gastric sleeve. A surgeon could “re-do” the sleeve, in an attempt to make it smaller, though this carries significant risk. Alternatively, a surgeon can convert add a bypass to a sleeve gastrectomy, with a more drastic surgery known as the duodenal switch. This carries additional risk and potential for long-term complications.
In contrast, endoscopic sleeve 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 sleeve revision is performed without incisions, the procedure is same-day, and the recovery is very fast. Most patients return to work within 2-3 days.