TORe- Bypass Revision
TORe offers a minimally invasive option for eligible patients who have experienced weight regain after Roux-en-Y gastric bypass.
Procedure:
Transoral Outlet Reduction
AKA:
TORe / Endoscopic Gastric Bypass Revision
Starting Cost:
$14,500
Synopsis of Surgery:
Endoscopic revision that uses internal sutures to reduce an enlarged gastric outlet after gastric bypass, helping restore restriction and support renewed weight loss.
Anesthesia:
General
Take Off Work:
2–3 days
Before Resuming Strenuous Exercise:
2–4 Weeks
Aftercare Program
aftercare Included
Benefits
Surgery Steps
Before & After
Cost
Recovery
FAQs
What Is TORe?
TORe, or Transoral Outlet Reduction, is an endoscopic procedure designed for selected patients who have previously undergone Roux-en-Y gastric bypass and later experienced weight regain.
Over time, the opening between the stomach pouch and small intestine, known as the gastrojejunal anastomosis, can become enlarged. This may allow food to pass through the pouch more quickly and reduce the feeling of fullness after eating.
TORe uses an endoscope and internal sutures to reduce the size of this opening. This can help restore restriction, increase feelings of fullness and support renewed weight loss without traditional abdominal surgery.
Is TORe Right For Me?
TORe may be considered if you:
- Previously had Roux-en-Y gastric bypass
- Have experienced weight regain or insufficient long-term weight loss
- Have an enlarged connection between the stomach pouch and small intestine
- Notice that you can eat larger portions than you could after your original bypass
- Feel less restriction or fullness after meals
- Have not achieved sufficient improvement with nutrition and lifestyle changes alone
- Prefer a less invasive option than surgical gastric bypass revision
- Are willing to follow a structured post-procedure diet
- Are committed to ongoing nutrition, lifestyle and medical follow-up
- Are medically suitable for an endoscopic procedure
TORe is not a revision treatment for gastric sleeve or gastric band patients. Your previous surgery and current anatomy must be assessed before determining whether TORe is appropriate.
Regained Weight After Gastric Bypass?
Weight regain does not necessarily mean you need another major operation. If changes to your gastric bypass anatomy are contributing to reduced restriction, TORe may provide a minimally invasive revision option.
Schedule a consultation with the 360 Sleeve team to determine whether TORe is appropriate for you.
Benefits of TORe
No Abdominal Incisions
The procedure is performed through the mouth using an endoscope, leaving no external surgical scars.
Less Invasive Than Surgical Revision
TORe modifies the existing gastric bypass anatomy without reopening the abdomen.
Restores Restriction
Reducing an enlarged gastric outlet may help food remain in the stomach pouch longer and improve feelings of fullness.
Supports Renewed Weight Loss
TORe can help selected patients restart weight loss after weight regain following gastric bypass.
Shorter Recovery
Many patients can return to normal daily activities within several days, although individual recovery varies.
Preserves Your Existing Gastric Bypass
Rather than creating an entirely new bariatric anatomy, TORe works by tightening the existing connection created during your gastric bypass.
Meet Your TORe Surgeon
Meet Dr. Gary Gamme
Dr. Gary Gammie is a bariatric and advanced endoscopy surgeon with specialized training in minimally invasive weight-loss procedures and complex bariatric care. His expertise in advanced endoscopic techniques allows him to offer procedures such as TORe for selected patients who have experienced weight regain after gastric bypass.
Dr. Gammie takes a personalized approach to care, carefully assessing each patient’s previous surgery, current anatomy, health, and long-term weight-loss goals before recommending treatment.
Your TORe Journey at 360 Sleeve
How Is TORe Performed?
Considering Weight Loss Procedure?
Learn whether TORe- Bypass Revision is right for your goals. Discuss expected results, recovery, and provide a personalized surgical plan and quote.
TORe is designed to help restore some of the restriction created by your original gastric bypass.
As healing progresses, you may notice:
- Feeling full with smaller portions
- Increased satiety after meals
- Less ability to eat larger portions
- Improved control over food intake
- Renewed weight loss
Improved weight maintenance
Weight loss varies significantly between patients. TORe should be viewed as one part of long-term obesity management, rather than a stand-alone solution. Published research supports its use for weight regain after gastric bypass, including evidence of longer-term benefit in appropriately selected patients.
Your results will depend on factors including your anatomy, amount of previous weight regain, eating patterns, activity level and commitment to ongoing follow-up.
Individual results vary and weight-loss outcomes cannot be guaranteed.
What Can I Expect After TORe?
TORe Recovery
Recovery after TORe is generally shorter than recovery from surgical gastric bypass revision. Temporary nausea, abdominal discomfort, soreness, bloating, or fatigue may occur during the first few days.
Many patients can return to normal daily activities within a few days, depending on how they feel and their physician’s recommendations. While the internal sutures heal, you’ll follow a structured diet that typically begins with liquids and gradually progresses to soft and regular foods over several weeks.
TORe Risks
TORe is less invasive than surgical gastric bypass revision, but all medical procedures carry potential risks. These may include bleeding, infection, nausea, abdominal discomfort, narrowing of the gastric outlet, or, rarely, perforation. The outlet may also enlarge again over time, and some patients may require additional treatment. Serious complications are considered uncommon.
Your surgeon will review the potential risks and benefits with you before the procedure and determine whether TORe is appropriate for your health and anatomy.
Before & After
Explore real before-and-after results from weight loss patients at Clinic 360 and see the transformations achieved through personalized care.
How Much Does a TORe Procedure Cost?
TORe at 360 Sleeve is $14,500 (tax included) and includes our comprehensive 6-year aftercare program, providing ongoing support throughout your weight-loss journey.
Flexible financing options are also available for eligible patients to help make the cost of treatment more manageable.
TORe FAQs
Is TORe another gastric bypass surgery?
No. TORe is an endoscopic revision of an existing Roux-en-Y gastric bypass. The procedure is performed through the mouth without abdominal incisions.
Who is TORe designed for?
TORe is primarily intended for selected patients who previously underwent Roux-en-Y gastric bypass and have experienced weight regain associated with an enlarged gastric outlet.
How does TORe help with weight loss?
The procedure reduces the size of the opening between the stomach pouch and small intestine. This can slow gastric emptying and increase satiety, helping patients feel satisfied with smaller portions.
Will I have scars?
No external surgical scars are created because the procedure is performed through the mouth using an endoscope.
How long does TORe take?
The procedure often takes approximately 60 minutes, although treatment time may vary based on your anatomy and the technique required.
Do I stay overnight?
Many TORe procedures are performed on an outpatient basis and patients may return home the same day. In some programs or depending on individual circumstances, overnight observation may be recommended.
When can I return to work?
Many patients take a few days away from work. Your exact return will depend on how you feel, the type of work you perform and your physician's recommendations.
What can I eat after TORe?
You will initially follow a liquid diet and gradually transition to soft foods as the outlet heals. A structured progression over approximately four weeks is commonly used, but your individual plan may differ.
Can TORe be used after gastric sleeve?
No. TORe is specifically designed to revise the outlet created during Roux-en-Y gastric bypass. Different revision options are used following gastric sleeve surgery.
Is TORe safer than surgical revision?
TORe avoids abdominal surgery and is generally less invasive than a traditional surgical gastric bypass revision. However, it still carries potential risks, including bleeding, infection, narrowing of the outlet and, rarely, perforation. Your physician will review the potential benefits and risks with you before treatment.