Endoscopic Pouch and Outlet Repair for Patients Regaining Weight after Weight Loss Surgery

Endoscopic Pouch and Outlet Repair for Patients Regaining Weight after Weight Loss Surgery

Holly Smith, a 38-year old accountant, and mother of three, struggled with her weight her entire life until she had weight loss surgery four years ago. Within a year, she had lost almost one-third of her weight and felt like she was finally looking and feeling great. But recently, the pounds started to come back. After getting down to 160 lbs, Smith had regained 50 and was incredibly frustrated. Then she learned about a new procedure offered at IBI Healthcare Institute.

“Regaining weight after my initial weight loss surgery left me feeling defeated and disappointed in myself. I thought I was alone and had no options until I heard about endoscopic outlet and pouch repairs offered at IBI,” said Holly Smith. “I underwent the procedure and have already lost 40 pounds. The procedure allowed me to lose the extra weight and regain control of my life with no scarring, drastically less pain and shorter recovery time than my initial weight loss surgery. I was able to return home to my family the same day and was back to my normal activities almost immediately.”

Several studies suggest the majority of patients regain significant weight after weight loss surgery.  A common cause includes gradual stretching of the stomach pouch or outlet.  When the standard-of-care weight loss surgery procedures are performed, the stomach and outlet are made very small to reduce the amount of food consumed and slow the passage of food through the digestive tract.  Together, this helps patients feel fuller longer after eating just a small amount.  As a result, weight loss occurs from a dramatic decrease in calories.  Many clinicians have shown when the stomach pouch and/or outlet gradually stretch, it takes longer for the patient to feel full. As a result, patients may begin to regain the weight.


Until recently, there weren’t many options for patients like Holly. But now, Dr. Postoev at IBI Healthcare Institute has offered a solution. With new endoscopic devices that work with a standard endoscope, surgeons at IBI can reduce the volume of an enlarged pouch and the diameter of the outlet to their original post-operative proportions.

This procedure is performed using a small flexible endoscope and specialized devices that allows sutures to be placed through the endoscope. The scope and suturing devices are inserted through the mouth into the stomach pouch the same way as a standard endoscope. Sutures are then placed around the outlet to reduce the diameter, typically from the size of a silver dollar to the size of a dime. The same technique may then be used to place additional sutures in the stomach pouch to reduce its volume capacity.

IBI Healthcare Institute is the only site in Georgia to offer an endoscopic procedure to repair pouches and outlets in patients who are regaining weight after weight loss surgery.

“This new endoscopic procedure offers my patients a treatment option for post-weight loss surgery weight regain that they’ve never had before,” said Dr. Postoev. “The potential advantages are significant: lowered risk of infection, limited post-operative pain, no visible scars, and faster recovery times. Patients can usually go home the same day of the procedure, which is a substantial improvement over the lengthy recovery times associated with traditional surgical procedures.”