Learning About Transoral Outlet Reduction

Transoral outlet reduction is surgery to make the gastric outlet smaller. The gastric outlet is the part of the stomach that connects to the small intestine. It's done for people with obesity who regained weight after having a gastric bypass. A gastric bypass makes the stomach smaller and bypasses part of the small intestine. That means fewer calories are absorbed from food and drink.

Sometimes people lose weight after having a gastric bypass but gain it back over time. In those cases, doctors might suggest this surgery so food passes more slowly from the stomach into the small intestine. The longer that food stays in the stomach, the longer you feel full. This can help you eat less and lose weight.

This surgery also may be done to help people who have “dumping syndrome” (also called rapid gastric emptying) after having a gastric bypass. Dumping syndrome means that food moves too quickly from the stomach to the intestine. This causes stomach cramps, diarrhea, vomiting, or dizziness.

You’ll be asleep during the surgery (under general anesthesia). You won’t feel any pain.

It's done without making cuts to your skin. Instead, the doctor inserts a thin, flexible tube called an endoscope through your mouth and into your stomach. The endoscope has a camera to allow the doctor to see inside your stomach while they work.

First, a heat treatment is applied to the edge of the gastric outlet to make it shrink. Then a surgical tool is attached to the endoscope to place stitches around the gastric outlet to make it smaller.

Most people go home from the hospital the same day. You might have some stomach pain, nausea, or a sore throat for a few days. Talk with your doctor about medicines that can help.

While your stomach heals, you’ll have to follow a special diet. You’ll start with a liquid diet and move on to soft foods. After a few weeks, you’ll be able to have solid foods again.

For 24 hours, don't do anything that requires attention to detail, such as going to work, making important decisions, or signing any legal documents. It takes time for the anesthesia's effects to completely wear off.

For your safety, do not drive or operate any machinery that could be dangerous until your doctor says it is okay.

Most people recover well. But like every surgery, it has possible risks. These include:

• Bleeding.
• Infections.
• Problems from the anesthesia.
• Stenosis (abnormal narrowing) of the gastric outlet.

Also, the gastric outlet can stretch over time, so there’s a chance you might need to have the surgery again later.