SERVICES
TORe (Transoral Outlet Reduction)
What is a TORe procedure?
TORe, or transoral outlet reduction, is a less invasive approach that may benefit individuals who experience weight gain after undergoing gastric bypass surgery. The surgery creates a small pouch in the stomach that is linked to the small intestine, bypassing the remaining stomach. As time passes, the gastric outlet (the opening connecting the gastric pouch and the small intestine) may expand. This results in food moving into the small intestine at a faster rate, leading to hunger. Several studies have revealed a connection between a larger gastric outlet and weight gain.
TORe is performed by using an endoscope, a thin and flexible tube that is inserted through the mouth (transoral) to reach the gastric outlet opening. Then, stitches (sutures) are applied to the opening to constrict it, which slows down the stomach's food emptying rate. This can help an individual feel full for longer periods, resulting in less frequent eating and weight loss.
When is a TORe indicated?
Individuals who have experienced weight regain after undergoing gastric bypass surgery may be considered suitable candidates for the transoral gastric outlet reduction procedure if their body mass index (BMI) indicates obesity, which typically occurs when the BMI is at or above 30.
When diet and lifestyle modifications are unsuccessful in re-initiating weight loss, transoral gastric outlet reduction may be an effective solution by prolonging the feeling of fullness after eating.
On average, individuals who undergo transoral gastric outlet reduction can anticipate losing at least 10% of their extra body weight and, in some cases, achieving a weight lower than their previous weight following gastric bypass. Research has demonstrated that weight loss can be maintained after five years following the procedure.
How is a TORe procedure done?
Transoral outlet reduction is carried out in an endoscopy suite while you are under anaesthesia, with the entire procedure typically taking around 60 minutes. The majority of patients are discharged on the same day of the procedure.
During the procedure, the surgeon inserts an endoscope through your mouth and directs it into the stomach pouch, allowing for examination of the inside of the stomach. Heat treatment is then administered to the edge of the gastric outlet to assist in narrowing and sealing it.
The doctor then utilises a suturing device positioned on the end of the endoscope to constrict the gastric outlet, reducing it to approximately 8 to 10 millimetres in size. Reducing the size of the opening creates a sense of fullness and can aid in weight loss. Finally, the endoscope is removed.