Regaining Weight after Gastric Bypass?
Frequently asked questions Read about ROSE as reported on MedWatchToday.com
Clovis Community now offers a new technology that allows surgeons to treat one of the potential sources of weight regain. The ROSE procedure (Restorative Obesity Surgery, Endolumenal) is an incisionless way to restore the results of gastric bypass surgery.
Three to five years after gastric bypass surgery, some patients might start to regain weight because the size of their stoma (the opening at the bottom of the stomach pouch) or their stomach pouch itself has increased. This can keep people from feeling full after small meals.
To resolve this problem, surgeons use new surgical tools to create and suture folds into the pouch, reducing its volume and at the stoma to decrease its diameter. The surgeon performs the procedure entirely through the mouth with no external incisions into the body.
Because there are no external incisions, the ROSE procedure provides important advantages, including lower risk than traditional surgery, minimal postoperative pain, fast recovery time, and no scarring.
Keeping your weight down after gastric bypass is vital to improving your health and reducing the co-morbidities associated with obesity such as Type II diabetes, heart disease, joint disease, and respiratory conditions. If you have started to regain weight since your initial surgery, ask your surgeon if the ROSE procedure might be right for you.
In the past, revision surgery to reduce the size of the pouch or stoma meant a longer surgery with a higher rate of complications than the original bypass surgery. Today there are new, non-surgical options to reduce the size of the pouch and stoma, a procedure that involves the use of an endoscope which is inserted into the stomach via the mouth while the patient is under heavy sedation. The ROSE procedure usually takes less than an hour and because there are no incisions, patients can return home the same day after a short recovery and observation period.
What is the ROSE PROCEDURE?
New surgical tools now allow surgeons to reduce the size of the pouch and stoma through the patient’s mouth without making external cuts into the body. Your doctor may refer to this as the “ROSE” procedure, which stands for restorative obesity surgery, endoscopic.
Before the ROSE incisionless procedure, patients who regained weight after gastric bypass generally had few treatment options. Scarring and adhesions related to the initial bypass procedure make open or laparoscopic revision surgery very challenging. Revision surgery procedure time is typically longer than the original bypass procedure and patients can be up to three times more likely to develop a complication following revision surgery. Therefore, most patients who regain weight after gastric bypass opt not to undergo open or laparoscopic surgical revision after weighing the risks and benefits. back to FAQ
Why would I gain weight after gastric bypass?
A number of studies suggest that patients regain weight because of the gradual enlargement of the surgically altered small stomach pouch and stoma, (connection between the stomach and small intestine). When the Roux-en-Y procedure is performed, the stomach and stoma are made very small, which slows the passage of food and creates a feeling of fullness after just a small volume of food is eaten. It is believed that when the stomach pouch and stoma gradually enlarge, the feeling of fullness is no longer present, patients can eat larger meals, and weight regain occurs. back to FAQ
How do I find out if I’m eligible for this new incisionless, restorative ROSE procedure?
Patients who had a Roux-en-Y gastric bypass more than two years ago, lost over 50% of their excess weight and have now regained 15% or more of their weight is an ideal candidate for this procedure.
After an initial screening, you will undergo a series of evaluations including nutritional and dietary counseling, a full medical exam and endoscopy to determine if you are a good candidate. back to FAQ
Where will the procedure be performed?
The ROSE procedure will be performed at Clovis Community’s Outpatient Surgery Center. back to FAQ
How long will I need to stay in the hospital?
Typically, patients stay less than 23 hours. You may be discharged the same day if the procedure was done early in the morning, or you may stay overnight. Your surgeon will make the determination following your procedure. back to FAQ
What are the benefits of an incisionless procedure?
By eliminating skin incisions, this new procedure may provide important advantages to patients, including, reduced risk of infection and associated complications, less post-operative pain, faster recovery time and no abdominal scars. back to FAQ
What type of side effects can I expect?
It is anticipated that patients will feel little or no discomfort from the procedure. To date, the only noted side effects have been short-term sore throat, swollen tongue and lip pain from the insertion of the instruments into the mouth. back to FAQ
Is it safe?
As with any surgery there is risk involved. This less invasive approach should reduce the likelihood of many of the complications associated with the open or laparoscopic revision surgery. back to FAQ
What is the recovery process?
Typically patients return to normal activity within a few days of their procedure. Your doctor will give you specific instructions. Patients are asked to follow a post bariatric surgery diet and exercise plan, similar to the regimen prescribed following the initial bypass surgery. Follow-up appointments with your doctor and regular visits with bariatric support staff will be required. back to FAQ
Will it be covered by insurance?
Since the ROSE endolumenal revision procedure is a recent advancement, many insurance companies may not provide coverage. We can contact your insurance provider to determine if there is coverage for this procedure. If we determine that there isn’t coverage we have convenient payment options available to help you to move forward. back to FAQ
Is incisionless surgery just for gastric bypass restorations?
This procedure is one of the first of many potential applications for incisionless surgery. Incisionless surgery is considered the next wave in minimally invasive procedures and, in addition to obesity; it has generated interest among physicians in areas such as GERD, GI cancer and natural orifice translumenal endoscopic surgery. back to FAQ
