Background

Dilation of the gastrojejunal anastomosis and enlargement of the gastric pouch has been attributed to weight regain after Roux-en-Y gastric bypass (RYGB).The objective of this study was to analyze the weight loss and major complications of endoscopic revisions (EGRs) after RYGB at a community hospital with Center of Excellence designation by American Metabolic and Bariatric Surgery and American College of Surgeons.

Methods

From March 2017 to Nov 2021, 49 patients underwent EGR with the OverStitch suturing device for weight regain at UPMC Hamot Medical Center in Erie, PA. The procedures were performed in the endoscopy suite under general anesthesia by three separate bariatric surgeons. The data was entered in a commercially available software (Lapbase ). Demographics and weight loss at every follow up visit were recorded in the database.

Results

There were 45 patients (M:F = 2:43) treated with EGR procedures for weight regain, with mean age 52.54 years (R 29-76) and mean BMI 38.21 kg/m2 (26.5-54.6) at the time of the procedure. The data was analyzed to determine the highest weight loss during the first 12 months after the procedure. The average of the highest weight loss after the procedure was 25.83 lbs (R 4.9-67 lbs). The highest weight loss was recorded at an average of 5.1 months. 4 patients were excluded for lack of postop follow-up. There were three leaks/intra-abdominal abscesses requiring intervention and no mortality.

Conclusions

EGR is feasible and safe for weight regain after RYGB. It can be used to stabilize weight regain.