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Fistula repair is an endoscopic procedure that can provide solutions to insignificant weight loss or weight gain after gastric bypass surgery.

After gastric bypass surgery, a gastro-gastric fistula can form and become an abdominal connection between the old stomach remnant and the new stomach pouch. A larger amount of food can be eaten without restriction due to this surgical defect because it will allow ingested food to be passed from the new stomach pouch to the old stomach. Through this volume intake of food and beverage, one can render the gastric bypass surgery ineffective.A combination of tests including upper endoscopy, upper GI series, barium swallow, abdominal ultrasound or CT scan can assist a diagnosis of a gastro-gastric fistula.

For this procedure, the patient will be administered general anesthesia. The endoscope, which is a thin, flexible tube, is then inserted through the mouth and into the stomach to search out the defect. Using a combination of sutures, mesh, fibrin glue, clips, and other equipment, the tissue is prepared and repaired endoscopically. Therefore, there is virtually no pain, no external cuts, and minimal to no blood loss.

  • Inadequate or insignificant weight loss after gastric bypass
  • Weight regain after gastric bypass
  • Ability to tolerate normal or large portions of food without issue
  • Abdominal pain
  • New heartburn symptoms months after surgery

  • There are no cuts from the outside of the body
  • It is virtually painless
  • Patients are able to go home the same day as their surgery
  • Procedure can restore feelings of fullness to promote weight loss
  • Does not require antibiotics
  • Patients are back to work in 2-3 days

SCHEDULE A CONSULTATIONIt is becoming more common for people that have struggled with obesity to overcome obstacles with the success of finding new ways to lose weight without having to hide any scars. If you are one of those people, then you are in luck! The Advanced Surgical Bariatrics of New Jersey is introducing the Endoluminal Sleeve or EndoBarrier Gastrointestinal Liner incision free surgery. These procedures reap the same benefits of weight loss surgery but do not require any incisions to be made.**

Despite countless weight loss options, bariatric surgery provides the opportunity to lose stubborn, unwanted weight that is hindering you from reaching your goals. This weight lost option can also decrease the risk of serious life threatening diseases associated with obesity. Only about one to two percent of the people who fall under the obese category will successfully go through with weight loss surgery, due to individual doubts and feelings towards surgery.

As a response to the individuals who have negative thoughts towards surgery, the endolumnial EndoBarrier Gastrointestinal Liner can be the solution they have always desired. This innovative medical procedure is incision free and provides the same results than invasive surgery with incisions or scarring.Enhancing its innovative medical technologies, the EndoBarrier Endoluminal gastric sleeve surgery is a pioneer in incision free bariatric surgery. Once the liner is implanted and removed through the mouth, the sleeve creates a lining on the upper part of the small intestine along the first part of the jejunum and the duodenum. As a result of this surgery, a patient’s response to certain hormones can change their metabolic rate which can ultimately lead to weight loss and possibly a solution for Type 2 diabetes.

The EndoBarrier can provide weight loss before gastric bypass surgery or be used as an independent weight loss method. The gastric sleeve, gastric banding, gastric bypass, or duodenal switch can be done after the initial EndoBarrier procedure if an individual is seeking a pre-surgical method of weight loss. Since bariatric surgery has a higher risk for heavier individuals, this endoluminal procedure can significantly raise the individual’s safety going into the second surgery.The Endoluminal EndoBarrier surgery is completed as an outpatient procedure that can take from roughly 30 minutes to up to 2 hours depending on the patient’s health and situation. The liner can be removed in about 15 minutes once the liner is implanted and left in for up to three months. Experts are currently researching whether or not the EndoBarrier is safe to leave in for six months to ensure a patient’s satisfaction and safety.

Once the EndoBarrier is implanted into the small intestine, there are chances of discomfort for the first week or so. For example, eating too much may cause vomiting. According to numerous endoluminal sleeve studies, there is no risk of the dumping syndrome which can occur when undigested food is discarded into the small intestine too quickly. Symptoms of this include nausea and abdominal cramps.

To maximize the results of the endoluminal sleeve, it is crucial the individual follows a strategic, strict, and multidisciplinary regimen that includes:

  1. A rigorous yet attainable exercise regimen
  2. A healthy diet plan
  3. Behavior modification to change your lifestyle habits

For individuals that have Type 2 diabetes, blood sugar level must be closely monitored before, during, and after the surgery. Your desired results of maximizing weight loss efforts can typically be done faster than you could imagine by following the post-procedure multidisciplinary program.*SCHEDULE A CONSULTATIONAccording to numerous studies, the majority of patients that undergo Weight Loss Surgery regain a significant amount of weight after the procedure. One common cause of this is the gradual stretching of the stomach or pouch outlet. Experts have proven that once the stomach and pouch begin to progressively stretch, it will take the patient longer to feel full and can soon regain the weight. The standard-of-care WLS procedure includes a reduction of the stomach and outlet size to decrease the amount of food a patient can eat. The new small size of the stomach and outlet also slows the digestive track process down by decelerating the passage of food. This can help the patient to feel fuller longer.* This combination can result in a dramatic decrease in calories, which in turn can help with weight loss.
At times open or laparoscopic revision surgery can be very difficult and even impossible due to scarring and adhesions from the original Weight Loss Surgery procedure. During the longer abdominal revision surgery, patients are three times more likely to develop complications during this than original WLS. In comparison to abdominal revision surgery, a revision through an endoscopic procedure decreases the patient’s risks of complication as well as less pain, faster recovery, and no abdominal scarring.* Although it is common for patients to go home the same day, the Advanced Surgical Bariatrics of New Jersey physician’s will discharge patients based on their personal data.
As a result of the endoscopic procedure, patients typically feel little or no discomfort with minor side effects such as gas pain, nausea, sore throat, swollen tongue, and lip pain from the oral insertion of the endoscope.*At the conclusion of the procedure, patients usually return to their normal routine within 48 hours. It is important that patients follow the same diet and exercise regime from their original weight loss surgery after the finish of the outlet and pouch repair.Depending on the patient’s insurance plan, the procedure will be covered. If the plan does not qualify, there are cash pay options available. Further information can be provided upon request at your next appointment with Dr. Sadek.

**The information on this website is not an alternative to medical advice from your regular physician. Our health advice is not intended as medical diagnosis or treatment; consult your regular physician before beginning the bariatric process. This site is for educational purposes only, and does not replace the need for a formal consultation with a surgeon before undergoing a surgical procedure or receiving treatment. The content/images on this website are not a guarantee of individual results. Individual results may vary.


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