The effect of endoscopic transoral outlet reduction (TORe) on weight recidivism and insufficient weight loss following one-anastomosis gastric bypass (OAGB).

Obesity remains a global health challenge. One-anastomosis gastric bypass (OAGB) has gained popularity for its advantages, including significant weight loss. However, concerns have arisen regarding weight regain and other complications. This study aims to assess the effectiveness and safety of endoscopic transoral outlet reduction (TORe) as a treatment for weight regain after OAGB. In this retrospective study, consecutive patients from two bariatric centers with weight regain following OAGB were evaluated. Eligible patients were those with an increase in weight of 10% or a BMI = > 30. Diagnostic gastroscopy determined anastomosis diameter and rule out contraindications for TORe. The procedure involved full thickness suturing over the anastomosis, following circumferential argon plasma coagulation. Patients data were collected, outcomes assessed in accordance with ethical standards. 64 patients were treated over a period of 4 years and were followed up for a minimum of 1 year. Mean age was 45.2 ± 1.4. Percentages of females were 47%. Mean pre-treatment BMI was 35.5 ± 0.5. Average weight regain from post OAGB nadir was19.4% (112.5Kg from 90.7Kg). Average weight loss following TORe was 7% of total body weight (TBW) after 6 months and 8% after 12 months (p = 0.03). Additional treatments were needed in 11 (17%) patients. Two patients suffered a perforation, one of which required surgical intervention. TORe appears moderately effective for the treatment of weight regain post OAGB, with a 97% safety rate. Sustained weight loss was seen during 1 year of follow up. Further investigation is needed to assess long term durability.