Transoral Outlet Reduction

This video shows an animation of the transoral outlet reduction, which is an endoscopic revision for weight gain after gastric bypass. This procedure is for patients with dilation in the connection between the gastric pouch and small intestines or dilation in the gastric pouch itself. This is a non-surgical procedure where the Apollo Overstitch Device is attached to an endoscope (a tube with a camera and light at the end of it) and advanced through the mouth to the gastric pouch. The stomach side of the anastomosis (connection between the pouch and small intestine) is first prepped with a  burning technique called “argon plasma coagulation”, which helps reduce bleeding and helps the sutures shrink the anastomosis. Next, sutures are placed in the anastomosis in a purse-string pattern (referred to as the alternate approach) and pulled tight to reduce the size of the opening into the small intestine. Finally, the pouch volume is reduced by placing sutures in the pouch as well. This procedure helps patients feel full earlier in a meal.