Endoscopic Weight Loss Options

We understand how difficult and frustrating it can be to want to lose weight and to struggle with meeting your weight loss goals. There are several factors that make it hard for many people to lose weight and keep it off. If you don’t qualify for weight loss surgery, but want a safe option that offers great results and a faster recovery, there may be an endoscopic weight loss procedure that’s right for you.

What is an endoscopic weight loss procedure?

Endoscopic weight loss procedures are non-surgical procedures that are performed using an endoscope. An endoscope is a thin, flexible tube that is typically inserted through the mouth. It allows your doctor to view your digestive system and perform procedures without making any surgical incisions (cuts) through your skin. The advantage of endoscopic treatments is that they are minimally invasive and recovery time is compared to traditional surgery. Also, unless it’s your second weight loss procedure, you typically don’t need to stay overnight at the hospital. The procedures are quick and most people return home the same day as treatment.

The Endoscopy Center at Brigham and Women’s Hospital is named a Center of Excellence by the World Organization of Digestive Endoscopy. We are one of only 17 gastrointestinal endoscopy programs in the world to receive this honor, and we are proud to offer you the best possible care. We also take a very collaborative and integrated approach to treatment that combines the expertise of different specialists. This helps us ensure that your treatment plan is comprehensive and that we address your needs in a well-rounded way.

Our Experience

Brigham and Women’s Hospital was the first hospital in the U.S. to have a bariatric endoscopy program and we have performed endoscopic weight loss procedures since 2003. We were the first in the world to perform endoscopic suturing to treat weight regain after gastric bypass in 2003. We were also the first center in the U.S. to perform endoscopic suturing of the stomach for weight loss in patients without prior bariatric surgery in 2008. This procedure later became known as Endoscopic Sleeve Gastroplasty (ESG). Our team was also first to perform ESG with the current suturing platform (in India in 2012) and later that year was first to perform ESG in the U.S. We also participated and led several FDA trials that resulted in weight loss device approval including aspiration therapy and the Spatz adjustable intragastric balloon most recently.

We are one of the few centers in the U.S. to offer the full spectrum of endoscopic weight loss procedures. Our multidisciplinary team has extensive experience having performed over 3,000 endoscopic weight loss procedures and is well prepared to help you achieve your personal weight loss goals.

Procedures Offered

• Endoscopic Sleeve Gastroplasty: This procedure involves using an endoscope with an attached suturing device to place sutures in the stomach, creating folds like an accordion. These sutures shrink the stomach. As a result, the stomach holds less food and you feel fuller faster and stay full longer.
• Endoscopic Gastric Plication (Distal POSE): This procedure uses an endoscope with a plication device to fold the stomach in on itself to make the stomach smaller and shorter. This makes you feel fuller faster and stay full longer.
• Intragastric Balloons: In this procedure, a silicone balloon is placed in the stomach using an endoscope. After placement, the balloon is filled with saline. Since the balloon takes up space in the stomach, the stomach holds less food helping you feel full. The balloon is removed at 6 months and there is no permanent change to the stomach.
• Aspiration Therapy: This procedure involves placing a small tube in your stomach that connects to a port (device) placed in your abdomen. Using this system, you can remove a portion of your meals through the tube shortly after you eat. This method allows you to eat a normal sized meal, while still reducing your calorie intake.

Revision Treatments

Endoscopic Revision of Gastric Bypass:

• Transoral Outlet Reduction (TORe) procedure: This procedure is for people who’ve already had gastric bypass surgery but regained weight. This can happen if the gastric outlet that connects your stomach and small bowel stretches and expands over time. TORe tightens the size of the gastric outlet, restores feelings of fullness after eating and helps you lose weight.
• Restorative Obesity Surgery, Endoluminal (ROSE): This procedure is for people who’ve already had gastric bypass surgery but regained weight. This can happen if there is a stretching of the outlet, which is where your stomach and small intestine meet. ROSE reduces the outlet and stomach pouch to the size they were following gastric bypass, which restores feelings of fullness after eating and helps you lose weight.
• Argon Plasma Coagulation (APC): This procedure is for people who’ve already had gastric bypass surgery but regained weight. A laser-like beam is applied around the outlet, which is where your stomach and small intestine meet, to shrink its size. This procedure does not require anesthesia and several sessions may be required.

Endoscopic Revision of Sleeve Gastrectomy:

• Sleeve in Sleeve (SIS): This procedure is for people who’ve already had surgical sleeve gastrectomy but regained weight. This can happen if the sleeve becomes more dilated. The procedure uses a plication device to tighten the sleeve, restoring feelings of fullness after eating and helping you lose weight.

Endoscopic Revision of Bariatric Surgery Complications

Our team has extensive experience managing complications of various bariatric surgeries endoscopically. We have an international referral base and deal with the most complex conditions, including staple line leaks, gastrogastric fistula, ulcers, strictures, outlet stenoses, band erosions and sleeve stenoses.

Weight Loss Medications Offered:

We also offer all FDA-approved weight loss medications for patients with and without prior bariatric surgery. These medications can be used alone or in combination with the above procedures. The decision on which medication to take is individualized based on each patient’s health history. Patients are monitored closely in our clinic for the duration of medical therapy.