What is a Transoral Outlet Reduction (TORe)?
TORe is a minimally invasive, endoscopic procedure aimed at addressing weight regain after gastric bypass surgery. This technique works by tightening the enlarged opening between the stomach pouch and the small intestine. TORe is designed to restore restriction, enabling patients to lose weight once more. It is particularly suitable for individuals who have previously undergone Roux-en-Y gastric bypass and are experiencing weight regain or have a BMI of 30 or higher. Notably, the first TORe procedure in Savannah was performed by our esteemed advanced interventionalist endoscopist, Dr. Isaac Perry, who is currently the only physician in Savannah offering this procedure.
What to expect during a TORe procedure
TORe is a minimally invasive, outpatient procedure conducted under anesthesia without any skin incisions. This approach results in minimal downtime and presents a lower risk compared to traditional revision surgery. The procedure is performed using an endoscope inserted through the throat, taking approximately 30-60 minutes. Doctors utilize a flexible endoscope to place sutures from within the stomach, effectively shrinking the gastrojejunal anastomosis (the connection between the stomach and small intestine). This process helps restore the sensation of fullness and limits food intake. Patients return home on the same day and can often resume normal activities within just a few days.
Gastric Pouch Plication
Gastric pouch plication is a minimally invasive bariatric procedure, performed by an advanced endoscopic interventionalist, that reduces stomach capacity by folding and suturing the stomach walls inward, rather than removing or permanently stapling the tissue. It restricts food intake without incisions in primary cases, and is increasingly used endoscopically to reverse weight regain after gastric bypass (Roux-en-Y).The biggest advantage to Pouch Plication is because the stomach is not cut or stapled, there is a lower risk of leaks and bleeding. It is also completely reversible. Patients typically lose between 15% and 20% of their starting body weight. This is sometimes combined with the TORe to optimize weight loss.