Sleeve

About

The endoscopic sleeve revision is a same-day, outpatient, non-surgical procedure that tightens a sleeve gastrectomy to provide restored fullness and satiety. This procedure is best suited for patients who had a surgical sleeve gastrectomy and have since re-gained weight and can eat larger portions. With an endoscopic sleeve revision, the sleeve is made small again through a brief, outpatient, 15-minute procedure. The result? Patients will find they have a restored sense of fullness, can feel satisfied with much smaller portions, and can get their lifestyle—and life—back on track.

Who It's For

Endoscopic sleeve revision is best suited for patients who had a sleeve gastrectomy surgery more than two years prior, lost weight initially, but have since regained weight. This procedure is ideal for those who feel they can eat larger portions and now have a more difficult time keeping their diet on track.

How The Procedure Works

Endoscopic sleeve revision is a same-day, outpatient procedure. Your physician will utilize an endoscopic suturing system—a device mounted to a flexible endoscope—which is then passed into the stomach through the mouth. With this technique, your physician can tighten your sleeve from the inside, without any incisions. The entire procedure takes 15 minutes under anesthesia, and results in a shorter and tighter sleeve, often smaller than it initially began. Endoscopic sleeve revision is closely related to the Endoscopic Sleeve Gastroplasty—an advanced non-surgical procedure for patients who want the benefits of weight loss surgery, without the surgery. Because there are no incisions, most patients will return to work and routine activities within 2-3 days.

How Much Weight You’ll Lose

The average weight loss following an endoscopic sleeve revision is 15-20% of body weight. While not as drastic as the original surgery, an endoscopic revision can safely restore restriction and allow patients to get back on track. Patients with the greatest results utilize this new tool, or “second chance,” to completely rejuvenate their lifestyle.

Sleeve Revision: How it Works

gastric sleeve
stretched sleeve
revised sleeve
Endoscopic sleeve revision restores a stretched gastric sleeve to its original size, or smaller.

Why Choose True You for Sleeve Revision?

Endoscopic Expertise
Endoscopic sleeve revision is an advanced technique that requires a very high level of endoscopic skill. 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. Dr. McGowan has 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, with a dedicated bariatric dietitian assisting you on your journey.
24/7 Physician Access
Whether you live in North Carolina, or are traveling from another state, 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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Success Stories

Natitia's Second Chance Thanks to the Sleeve Revision

Like so many people, Natitia struggled with her weight for much of her life. As a child, her nickname was “Fatso,” which was used as a “term of endearment,” but it ultimately became how she viewed herself. For years, Natitia put herself and her health second to others, and was “losing this obesity fight every […]

Read More
Lisa Larger

Pricing

Sleeve Revision

$7,995

Includes:
  • Initial Physician Consultation
  • Revision Procedure, Inclusive of All Facility, Anesthesia, and Physician Fees
  • Bariatric Dietitian Consultation and 6-months Follow-up
  • Quarterly Physician Follow-up
  • 24/7 Physician Access

Enhanced Sleeve Revision

$8,995

Includes All Components of Sleeve Revision, PLUS:
  • Post-procedure IV Hydration and Nurse Assessment
  • True You App Account
  • Smart Fitness Tracker
  • Enrollment in Medical Nutrition Therapy
  • Athletic Lab Customized Exercise Plan
  • Unlimited Dietitian and Physician Follow-up
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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 for more than 45 states and 8 countries. Raleigh-Durham International Airport is only 10 minutes from True You Weight Loss. We also have made arrangements with several local hotels for your convenience. Our travel resources, along with recommendations from our program director, will position you for success.

Frequently Asked Questions

WHAT IS ENDOSCOPIC GASTRIC SLEEVE REVISION?

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 (ESG).

WHO IS ELIGIBLE FOR ENDOSCOPIC SLEEVE REVISION?

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.

WHO IS NOT ELIGIBLE FOR ENDOSCOPIC SLEEVE REVISION?

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.

HOW DOES THIS DIFFER FROM A SURGICAL 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.

HOW LONG DOES THE 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 OF THE PROCEDURE?

Most patients will experience abdominal discomfort, mild nausea, chest pressure, and stomach spasm. These symptoms are well-tolerated and resolve within 1-2 days. The risk of major complication, such as infection, bleeding, or stomach injury, is less than 1%.

HOW MUCH WEIGHT WILL I LOSE?

Most patients will lose an average of 10% to 20% of their total body weight. This is not the same amount of weight that was lost after the original gastric sleeve surgery, though it will allow patients to get back on track, and enjoy a second chance with their sleeve. While individual results may vary, adhering to a structured diet and exercise regimen will increase the likelihood of long-term success.

HOW DO I KEEP THE WEIGHT OFF AFTER ENDOSCOPIC SLEEVE REVISION?

Patients are urged to adopt healthier eating habits after undergoing endoscopic sleeve revision. Eating slowly and avoiding over-eating are keys to long-term success.

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