Learn about the TORe procedure, a minimally invasive endoscopic technique to address weight regain after gastric bypass surgery by reducing enlarged stoma size.

What is a TORe Procedure?

After a Roux-en-Y gastric bypass, a small stomach pouch is created and connected to a new opening, called a stoma or anastomosis, to the small intestine. Over time, this stoma can stretch and widen, causing the stomach to empty faster. This reduces the feeling of fullness and can lead to weight regain.

A TORe (Transoral Outlet Reduction) procedure addresses this problem by shrinking the size of the enlarged stoma through a minimally invasive endoscopic approach.

How It Works

Preparation: The procedure is performed under general anesthesia in an outpatient setting.

Access: The surgeon inserts a thin, flexible tube called an endoscope through the mouth and down into the stomach pouch.

Suturing: Using a specialized suturing device attached to the endoscope, the surgeon places stitches to tighten and reduce the size of the enlarged stoma.

Outlet Narrowing: The goal is to reduce the opening to a size of approximately 8 to 10 millimeters, which restores the feeling of restriction and helps patients feel full sooner.

Heat Treatment (Optional): Sometimes, thermal therapy is also applied to the edges of the outlet to help narrow it and create scar tissue that maintains the size reduction over time.