Endoscopic revision of gastric bypass: transoral outlet reduction
Weight regain after gastric bypass
Gastric bypass is an effective operation for weight loss. However, regaining some weight is common. In some cases, patients regain significant weight. This may happen after the pouch and outlet have dilated (stretched out). Diet and lifestyle may play a role as well.
Endoscopic revision of gastric bypass
If the outlet is found to be dilated during endoscopy, it can be restored endoscopically (without surgery). This is called transoral outlet reduction (TORe). The outlet is sutured to a smaller size – the size it was after the gastric bypass – which can restore satiety (fullness). The procedure has proven effective for stopping weight regain or inducing weight loss in a high-quality randomized trial (RESTORe). More recently, with more advanced devices, the procedure has shown meaningful weight loss.
Dr. Kumar has performed well over 100 endoscopic revisions of gastric bypass with Dr. Christopher Thompson at Harvard Medical School (Brigham & Women’s Hospital). Dr. Thompson holds a U.S. patent on TORe. Drs. Kumar and Thompson have spoken about the procedure at national and international conferences, and taught the procedure technique to many other physicians around the United States.
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Dr. Kumar’s publications related to transoral outlet reduction
Transoral outlet reduction for weight regain after gastric bypass: long-term follow-up
Nitin Kumar, Christopher C. Thompson. Gastrointestinal Endoscopy. 2015, in press.
The pursestring technique for endoscopic revision of gastric bypass
Nitin Kumar, Christopher C Thompson. Gastrointestinal Endoscopy. November 2015.
Endoscopic therapy for weight loss: Gastroplasty, duodenal sleeves, intragastric balloons, and aspiration
Nitin Kumar. World Journal of Gastrointestinal Endoscopy. July 2015.
Comparison of a superficial suturing device with a full-thickness suturing device for transoral outlet reduction
Nitin Kumar, Christopher C Thompson. Gastrointestinal Endoscopy. June 2014.
Utilization of endoscopic suturing for management of weight regain: transoral outlet reduction
Nitin Kumar, Erik B Wilson, Christopher C Thompson. Bariatric Times. 2013.
Endoscopic management of complications after weight loss surgery
Nitin Kumar, Christopher C Thompson. Clinical Gastroenterology and Hepatology. April 2013.
Endoscopic Solutions for Weight Loss
Nitin Kumar, Christopher C Thompson. Current Opinion in Gastroenterology. September 2011.
