ROSE for Weight Regain
The Illinois Bariatric Center has been committed to providing a comprehensive approach to obesity treatment in Central Illinois for over 8 years. In addition to gastric bypass and adjustable gastric banding, we are excited to offer a new, less invasive option to treat weight regain in patients who have previously undergone gastric bypass. If you were originally successful losing weight following Gastric Bypass and now find yourself regaining weight, you may be an ideal candidates for the “ROSE” procedure, which stands for Restorative Obesity Surgery, Endoscopic.
Your stomach pouch or stoma (the connection between the pouch and small intestine) may have stretched out in the years since your original surgery, reducing the feeling of fullness after you eat. To resolve this problem, we use new surgical tools to create and suture folds into the pouch, reducing its volume and at the stoma to decrease its diameter. The procedure is performed entirely through the mouth without making any external incisions into the body.
Why would I gain weight after gastric bypass?
A number of studies suggest that patients regain weight due to the gradual enlargement of the surgically altered small stomach pouch and stoma, (connection between the stomach and small intestine). When the Roux-en-Y procedure is performed, the stomach and stoma are made very small, which slows the passage of food and creates a feeling of fullness after just a small volume of food is eaten. It is believed that when the stomach pouch and stoma gradually enlarge, the feeling of fullness is no longer present, patients can eat larger meals, and weight regain occurs.
How do I find out if I’m eligible the ROSE procedure?
Patients who had a Roux-en-Y gastric bypass more than 2 years ago, lost over 50% of their excess weight and have now regained 15% or more of this weight are ideal candidates for this procedure.
After an initial screening, you will undergo a series of evaluations including nutritional and dietary counseling, a full medical exam and endoscopy to determine if you are a good candidate.
What does the ROSE procedure entail?
The ROSE procedure is performed using a small flexible endoscope and a new EndoSurgical Operating System (EOS). The scope and the EOS instruments are inserted through the mouth into the stomach pouch the same way as a standard endoscope. Tissue anchors are used to create multiple, circumferential tissue folds around the stoma to reduce the diameter, typically to about 10mm. The surgeon will then use the same technique to place anchors in the stomach pouch to reduce its volume capacity. After the procedure the patient will need to comply with the Illinois Bariatric Center follow-up program of nutritional counseling and exercise, similar to the one prescribed after their original gastric bypass surgery.
Where will the procedure be performed?
The ROSE procedure will be performed at the Olympian Surgical Suites.
How long will I need to stay in the hospital?
Typically, patients go home the same day. Your surgeon will make the determination following your procedure.
What are the benefits of an incisionless procedure?
By eliminating skin incisions, this new procedure may provide important advantages to patients, including, reduced risk of infection and associated complications, less post-operative pain, faster recovery time, and no abdominal scars.
What type of side effects can I expect?
It is anticipated that patients will feel little or no discomfort from the procedure. To date, the only noted side effects have been short-term sore throat, swollen tongue and lip pain from the insertion of the instruments into the mouth. As with any surgery there is risk involved. This less invasive approach should reduce the likelihood of many of the complications associated with the open or laparoscopic revision surgery.
What is the recovery process?
Typically patients return to normal activity within a few days of their procedure. Your doctor will give you specific instructions. In addition, patients are asked to follow a post bariatric surgery diet and exercise plan, similar to the regimen prescribed following the initial bypass surgery. In addition, follow-up appointments with your doctor and regular visits with bariatric support staff will be required.
What is the success rate?
It is too soon to estimate the likely procedure success rate. However, to date, the procedure has been well tolerated and the first few patients have experienced weight loss within the first 4 weeks and a reduction in food volume capacity.
Will it be covered by insurance?
As with gastric bypass surgery, coverage will vary depending upon the insurance provider. A specialist in your physician’s office will discuss your plan with you. In the event insurance will not cover the procedure, financing options may be available. Check with your surgeon’s office for information on possible financing programs as well as potential tax advantages for any expenses you may incur.