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Digestive Disease Interventions 2021; 05(02): 162-168
DOI: 10.1055/s-0041-1728656
Special Communication

Endoscopic Management of Weight Regain in the Bariatric Patient

Russell D. Dolan
1   Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women’s Hospital, Boston, Massachusetts
,
Allison R. Schulman
2   Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, Michigan
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Abstract

Despite initial weight loss following bariatric surgery, weight recidivism is common. While weight regain is multifactorial and includes behavioral, psychosocial, and medical causes, changes in anatomy also play a role. Dilation of the gastrojejunal anastomosis following Roux-en-Y gastric bypass and enlargement of the gastric sleeve following sleeve gastrectomy are both important considerations. Historically, surgical revision has been performed to address weight regain; however, morbidity and mortality are not insignificant. Over the past decade, a variety of endoscopic approaches have been described for weight recidivism, several of which have proven to be safe, effective, and durable. This article will review each of these techniques in detail.

Keywords

weight regain - transoral outlet reduction - argon plasma coagulation - endoscopic suturing - endoscopic revision

Guarantor of the Article

Allison R. Schulman, MD, MPH.


Authors' Contributions

R.D.D.: drafting of the manuscript; critical revision of the manuscript for important intellectual content; approving of the final draft submitted (email rddolan@bwh.harvard.edu).


A.R.S.: critical revision of the manuscript for important intellectual content; approving of the final draft submitted (email arschulm@med.umich.edu).


Financial Support/Potential Competing Interests

A.R.S.—Apollo Endosurgery (consultant); Boston Scientific (consultant); MicroTech (consultant); GI Dynamics (research, grant support. R.D.D. has no personal or financial conflicts of interest to disclose).




Publication History

Received: 11 September 2020

Accepted: 02 March 2021

Article published online:
15 April 2021

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