ENDO-BARIATRIC REVISION

Dr. Chiasson has had a longstanding interest in the development of therapeutic revision endo-bariatric weight loss procedures. The U.S. Food and Drug Administration’s (FDA) recent authorization of the “Apollo REVISE System” to perform endoscopic revisions of prior bariatric procedures is an essential step in this process. He is excited to offer these latest procedures to his practice.

Who is a candidate for these Apollo REVISE procedures?

Individuals who have had a prior weight loss operation may experience inadequate weight loss or weight regain over time.  Endo-bariatric revision procedures are generally intended for those individuals who still need to lose additional weight to reach their goals.  These procedures are used in conjunction with our supervised weight loss program, which offers both dietary counseling and the addition of newer weight loss medications.

 

What are the Apollo REVISE Weight Loss Procedures?

  1. Endoscopic Revision of Sleeve Gastroplasty (RE-ESG)

In rare cases, the sutures placed during the Endoscopic Sleeve Gastroplasty  (ESG) procedure can break.  This usually occurs in the setting of a significant vomiting episode.  In this setting, the prior ESG anatomy can be re-established using a flexible endoscope and the Apollo REVISE System. The scope and the Suturing System are inserted through the mouth into the gastric sleeve the same way as a standard endoscope. Sutures are used to re-create tissue folds to reinforce the area where prior the broken sutures are identified in order to reduce the diameter of the sleeve tube.

  1. Endoscopic Revision of Sleeve Gastrectomy (Re-Sleeve)

This is an endoscopic incision-less technique using new advanced tools to reduce the size of the gastric sleeve portion of the stomach through the patient’s mouth without making any external cuts to the body.  This procedure is performed using a flexible endoscope and the Apollo REVISE System. The scope and the Suturing System are inserted through the mouth into the gastric sleeve the same way as a standard endoscope. Sutures are used to create tissue folds along the sleeve portion of the stomach to reduce the diameter of the sleeve tube.

  1. Endoscopic Revision of Gastric Bypass (Stoma & Pouch Reduction)

This is an endoscopic incision-less technique using new advanced tools to reduce the size of the gastric pouch and gastric pouch outlet.  This may be due to the gradual stretching of the gastric pouch (the new small stomach pouch) and/or the stoma (the connection between the gastric pouch and the small intestine).  It is performed through the patient’s mouth without making any external cuts to the body.  This procedure is performed using a flexible endoscope and the Apollo REVISE System. The scope and the Suturing System are inserted through the mouth into the gastric pouch.  Initially, an Argon laser is used to cauterize the outlet of the gastric pouch.  Following this, the outlet is narrowed with placement of sutures.  After the procedure, the patient will enter our standard bariatric surgery follow-up program of nutritional counseling and exercise.

  1. Endoscopic Revision of Duodenal Switch (Re-Sleeve)

This is an endoscopic incision-less technique using new advanced tools to reduce the size of the gastric sleeve portion of the stomach through the patient’s mouth without making any external cuts to the body.  This procedure is performed using a flexible endoscope and the Apollo REVISE System. The scope and the Suturing System are inserted through the mouth into the gastric sleeve the same way as a standard endoscope. Sutures are used to create tissue folds along the sleeve portion of the stomach to reduce the diameter of the sleeve tube.

 

What should you expect after an Endoscopic Apollo REVISE procedure?

Endoscopic Apollo REVISE procedures do not involve incisions and are performed in the out-patient setting.  They are performed under general anesthesia and generally take less than one hour.  Patients experience minimal discomfort and nausea after the procedure.  Most are able to return to their normal activities within a few days.

 

Advantages of an Endoscopic Apollo REVISE procedure? 

These procedures provide the opportunity to re-establish a patient’s prior bariatric weight loss surgery anatomy without experiencing pain or having incisions.  There is good long-term data that suggests that these procedures are not associated with serious complications.  These procedures offer the patient another opportunity to embark on their weight loss journey to reach their goals.

READY TO GET STARTED WITH DR. CHIASSON?

In 2016, more than 1.9 billion adults, 18 years and older, were overweight. Of these over 650 million were obese. You are not alone and you do not need to feel any less of a person if you are overweight or obese. Take action now and increase your quality of life.