With the worldwide obesity epidemic in full swing, instances of serious weight-related health conditions continue to rise. Issues such as heart disease, diabetes, and high blood pressure, to name a few, have become more prevalent in the United States each year.

For many years, bariatric surgery has been regarded as the most effective treatment option for individuals struggling with serious obesity. While surgery has historically been successful in providing significant weight loss, improved metabolic health, and an enhanced quality of life, many individuals experience weight gain after their surgery. In fact, almost one-half of weight loss surgery patients gain a significant amount of their lost weight back within 5 years of their surgery.

Many factors can contribute to this weight gain, but one of the most common is that the restrictive nature of the original bariatric surgery has been compromised. In the not-so-distant past, correcting such issues would have required an additional surgical procedure, but due to the expanding advancements in bariatric endoscopy, much less invasive solutions are possible.

Today, we are going to talk about how using endoscopic suturing for bariatric revision is giving patients a second chance.

When Would An Individual Want To Consider Endoscopic Suturing For Bariatric Revision?

A revision to bariatric surgery may be necessary for various reasons, such as inadequate weight loss, weight regain, or complications from the initial bariatric procedure. These issues generally occur because some of the changes that were made during the initial surgery have lost their effectiveness.

This can happen as a result of the patient continually eating just a bit too much and stretching their stomach out gradually until it can hold a greater amount of food. The patient begins to overeat, and it results in weight gain. Another issue that can happen is that the connection between the stomach pouch and the intestine becomes stretched out, allowing more food to quickly pass from the stomach into the digestive system. This causes the patient to become hungry more often, so they naturally eat more, which results in weight gain or a plateau.

Endoscopic revision procedures can correct anatomical issues that prevent weight loss or promote weight gain and restore the effectiveness of the original bariatric surgery.

How Is Endoscopic Suturing Done?

Endoscopic suturing is performed using specialized instruments and a flexible endoscope, which is a long, thin, tube-like medical instrument housing a light and a camera on one end. The procedure is most often performed as an outpatient and usually takes under an hour.

The specific steps for endoscopic suturing may vary depending on the type of revision being performed and the doctor’s preference, but generally, the procedure follows a similar outline:

While the patient is comfortably sedated, the endoscope is carefully lowered into the stomach or procedure area through the mouth and down the throat. The doctor uses the camera and live video feed from the endoscope to help guide them during the suturing process;
The doctor uses specialized instruments, such as a suturing device, more specifically the Apollo Overstitch device, to place sutures within the stomach or intestine. These sutures may be used to create folds, plications, or stitches to revise the anatomy and achieve the desired outcome;
Once the desired revision has been achieved, the doctor removes the endoscope and any other instruments used during the procedure;
The patient is taken to a recovery area, where they are observed for a period of time before being released into the care of a friend or family member to go home to recover.

How Can Endoscopic Suturing Be Used for Bariatric Revision?

One common use of endoscopic suturing for bariatric revision is to address complications or reduced effectiveness of a previous gastric sleeve surgery. For example, patients who have undergone a gastric sleeve procedure may experience weight regain due to stomach dilation or stretching over time. Endoscopic suturing can be used to reduce the size of the stomach pouch by creating additional sutures to restrict its capacity, helping to restore the effectiveness of the initial procedure.

Another use of endoscopic suturing for bariatric revision is to revise the connection between the stomach and intestine in patients who have undergone gastric bypass surgery. This can be done to address complications such as pouch dilation, outlet obstruction, or gastroesophageal reflux disease (GERD) that may arise after the initial procedure. Endoscopic suturing allows for precise and targeted adjustments to be made to the anatomy to resolve these issues without the need for additional major surgery.

Who Performs Endoscopic Suturing for Bariatric Revision?

Endoscopic suturing for bariatric revision is typically performed by skilled gastroenterologists who have extensive knowledge of obesity medicine. These doctors have expertise in advanced endoscopic techniques and are familiar with the complexities of bariatric anatomy and the potential complications that can arise after initial weight loss surgery. These procedures can also be performed by bariatric surgeons who have undergone specialized training in endoscopy. Both gastroenterologists who are trained in obesity medicine and bariatric surgeons who possess expertise in endoscopy are rare combinations of skill sets to find.

If you do not have a doctor who meets these qualifications nearby, you might wish to consider traveling to a doctor who meets both of these criteria to ensure your safety and an optimal outcome.

Is Endoscopic Suturing Covered by Insurance?

The coverage of endoscopic suturing for bariatric revision by insurance providers may vary depending on several factors, including the patient’s insurance plan, the specific reasons for the revision, and the patient’s geographical location.

In some cases, endoscopic suturing for bariatric revision may be covered by insurance if it is deemed medically necessary and supported by evidence-based guidelines. However, it is essential for patients to thoroughly review their insurance coverage and consult with their healthcare provider to determine the specific coverage details and potential out-of-pocket costs associated with their specific procedure.

At Simmons MD Advanced Weight Loss Solutions, we do not accept insurance for endoscopic weight loss procedures. However, we offer flexible financing plans via CareCredit and United Credit. Please contact us to find out if you are eligible.

Advantages of Endoscopic Suturing for Bariatric Revision

Endoscopic suturing for bariatric revision offers several advantages over traditional surgical revision techniques. Endoscopic suturing is a minimally invasive procedure that does not require any incisions, resulting in less pain. It leaves no visible scarring and offers a much faster recovery compared to a revision surgery. It can also be customized to fit the exact needs of each patient to ensure they get the correction they need.

Is There A Doctor In Miami Who Does Endoscopic Suturing Revision Procedures?

Yes! If you have previously had bariatric gastric sleeve surgery or gastric bypass surgery and are experiencing weight regain or have not lost the amount of weight you desired, contact Simmons MD Advanced Weight Loss Solutions.

Dr. Simmons and his team can help get your weight loss journey restarted with a quick endoscopic suturing procedure. In addition, they may choose to pair a revision procedure with prescription weight loss medications to jumpstart weight loss and make your efforts count for more.

When you partner with Simmons MD Advanced Weight Loss Solutions, you not only receive the highest quality care performed by expertly trained specialists in the field, but you will also have access to a vast network of support to help you reach your weight loss goals. From diet and nutrition to lifestyle coaching and guidance with exercise, our comprehensive Lifestyle program has it all!