Restore Your Success!

Have you regained a portion of the weight you originally lost after your gastric bypass?

Do you feel less full after meals?

Although gastric bypass surgery is successful in achieving weight loss, some patients start to regain weight a few years after surgery. The stomach pouch and stoma (the connection to your small intestine) may have gradually stretched out over time allowing you to eat more because you feel less full during meals.

The Surgical Specialists of Louisiana now offer a procedure that helps restore gastric bypass patients’ stoma and pouch to the original post bypass surgery proportions, limiting food intake. The results are more weight loss and achieving that feeling of fullness with eating smaller meal portions. Our surgeons perform the ROSE Procedure (Restorative Obesity Surgery, Endoscopic) entirely through the mouth without making any external incisions into the body.

What is the ROSE procedure?

New surgical tools now allow surgeons to reduce the size of your pouch through the patient’s mouth without making external cuts to the body. This procedure is sometimes referred to as the ROSE procedure, which stands for Restorative Obesity Surgery Endoscopic.

Special instruments are used to create suture folds into the pouch in order to reduce its volume and, at the stoma, to reduce it’s diameter to post Roux-en-y bypass proportions. The surgeon performs the procedure entirely through the mouth without any external incisions into the body.

Why would I gain weight after gastric bypass?

Studies have shown that some patients who initially had significant weight loss after their original gastric bypass procedure may begin to regain weight several years after. The weight gain may be the result of the gradual enlargement of the surgically altered small stomach pouch and/or enlargement of the stoma (connection between the stomach and small intestine). When the gastric bypass 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 amount 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 may occur.

Who is eligible for the ROSE procedure?

Patients who originally lost significant weight following gastric bypass but who now find themselves regaining weight may be 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.

Tell me about the ROSE procedure.

The ROSE procedure is performed under anesthesia using a small flexible endoscope using a four-channel tube. The surgeon advances the flexible tube and a small endoscope through the patient’s mouth, into the stomach pouch. The surgeon will then insert the surgical tools through the channels of the tube. Uniquely shaped sutures called anchors are used to create multiple tissue folds around the stoma to reduce the diameter. The surgeon will then use the same technique to place anchors in the stomach pouch to reduce its volume capacity. After the procedure, a follow-up program of nutritional counseling will be prescribed, similar to the original gastric bypass surgery.

How long will I need to stay in the hospital?

This is an out patient procedure and you should go home on the same day of your procedure.

What are the benefits of the ROSE procedure?

Since the ROSE procedure is incisionless, the overall risks are much lower than with traditional surgery. Some important advantages to the patient include: reduced risk of infection and associated complications, less post-operative pain, faster recovery time, ability to offer this as an outpatient procedure (no overnight hospital stay) and the absence of 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 sore throat, swollen tongue and short-term lip pain from the insertion of the endoscopic instruments into the mouth.

Is it safe?

As with any surgery there is risk involved. This less invasive approach should reduce the likelihood of many of the complications associated with the other open or laparoscopic revision procedures.

What is the success rate?

As with any weight loss procedure, results vary with each patient. Initial findings indicate that the ROSE procedure has been well tolerated and most patients immediately lose weight as they eat less. The feeling of fullness returns due to the restriction of the new, smaller pouch or stoma. The ROSE procedure is new and long-term data is not yet available.

What is the recovery process?

The recovery period is minimal. Typically patients return to normal activity within a few days of the procedure. In addition, you will be required to follow a post-procedure diet and exercise plan, similar to the regimen prescribed following your initial bypass surgery. This generally means that patients will need to consume only liquids for a few days after the surgery, and then slowly add soft, pureed foods for a few weeks before resuming a regular diet. To help you on your journey, follow-up appointments with your doctor and regular visits with our bariatric support staff will be required.

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, swelling of the tongue or lip discomfort from the insertion of the instruments into the mouth. These issues usually go away in one or two days.

Will the ROSE procedure be covered by insurance?

As with gastric bypass surgery, coverage will vary depending upon the insurance provider. Since ROSE is a new procedure, most insurance companies will not cover the cost of the procedure. Our patient advocates can assist you with verifying your insurance. In the event insurance will not cover the procedure, financing options are 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.

What will the ROSE procedure cost?

The cost of the procedure is $13,600. This includes anesthesia, hospital and surgeon fees.

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