Transoral Outlet Reduction Endoscopy (TORe) is an endoscopic procedure designed to treat weight regain after Roux-en-Y gastric bypass surgery. Over time, the gastric pouch and the anastomosis (connection between the stomach pouch and small intestine) can stretch, leading to weight regain.
TORe uses endoscopic suturing to reduce the size of the dilated gastric outlet (anastomosis), restoring the restrictive effect of the original bypass surgery.
TORe may be suitable for:
A thorough evaluation is performed to confirm that outlet dilation is the cause of weight regain.
Pre-procedure assessment including endoscopy to measure the outlet size.
You will follow a liquid diet for 2–3 days before the procedure.
You must have nothing to eat for 8 hours and nothing to drink for 4 hours before the procedure.
Inform your doctor of all medications, especially blood thinners.
The procedure is performed under general anaesthetic and takes 45 to 60 minutes. An endoscope with a suturing device is passed through the mouth into the gastric pouch.
Sutures are placed around the dilated anastomosis to reduce its diameter, typically to 8–10mm. This restores the feeling of fullness after small meals.
There are no incisions. Most patients are discharged the same day.
Mild nausea and throat discomfort for 1–2 days is normal.
A staged diet (liquids to soft foods to regular diet) is followed over 2–4 weeks.
Follow-up with the dietetic and medical team is important for sustained results.
Patients typically lose 8–10% of their total body weight following TORe.
Best results are achieved when combined with dietary counselling and regular exercise.
TORe is generally safe. Possible risks include:
Seek medical attention if you develop severe abdominal pain, fever, vomiting blood, or difficulty swallowing after the procedure.
