Endoscopic Gastric Sleeve Revision

Speak with an expert today!

Request a Free Consultation


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. Endoscopic sleeve revision is intended for patients aged 21 and above, as authorized by the FDA.

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. 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, registered dietitians, and certified health coaches, 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.
Request a Consultation
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


Sleeve 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
Request a Consultation
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.

Frequently Asked Questions


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).


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.


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.


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%.


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.


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.

Come Find Yourself at True You

Freedom is Waiting
Subscribe to our newsletter for exclusive insights, success stories, and expert tips on non-surgical weight loss. Join our community and stay informed on the latest advancements in endobariatric procedures.
 True You Weight Loss | All rights reserved