Bariatric Surgery

Endo Bariatrics

Endoscopic Sleeve Gastroplasty:

The surgeons at Advanced Surgical & Bariatrics are the first in New Jersey to have performed endoscopic sleeve gastroplasty, a new non-surgical option for weight loss involving plicating, or suturing, the stomach with full-thickness sutures which are placed using an endoscopic suturing device. The result is the creation of a thin, sleeve-shaped stomach similar to sleeve gastrectomy but without surgery and without cutting across or removing the stomach tissue. If you are interested in this option, please call to set up your consultation visit and one of our non-surgical weight loss experts can determine whether you are a candidate for this procedure.

Endoscopic Suturing:

Patients that have regained weight despite having success from original weight loss surgery, now have multiple options to get back on back on track with their weight loss efforts.

After the initial success from weight loss surgery, have you had trouble keeping the weight off and even start to regain some of it back? Over time, the stomach pouch or outlet that connects to the small intestine can stretch and cause patients to eat more than normal before feeling full or satisfied. Advanced Surgical & Bariatrics of New Jersey now offers an endoscopic procedure that is effective and safe for patients. This procedure can significantly reduce the enlarged pouch and outlet to its initial post-operative size, and in doing so, help you lose more weight

Why would I regain weight after weight loss surgery? (WLS)

According to numerous studies, a significant number of patients that undergo weight loss surgery regain weight after the procedure. One common contributing factor is 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, potentially leading to weight regain. The standard-of-care WLS procedure includes a reduction of the stomach and outlet size to decrease the amount of food that a patient can eat. The new smaller sizedstomach and outlet can help the patient to achieve satiety, or the feeling of fullness, earlier.  These changes contribute to decreased caloric intake which in turn can help with weight loss.

Endoscopic outlet and pouch repair

Advanced Surgical & Bariatrics of New Jersey now offers qualified patients an endoscopic procedure than will reduce the capacity of which food can enter the stomach. A small flexible endoscope and other specialized devices will allow for sutures to be properly placed through the endoscope. Similar to a standard endoscope, the scope and suturing devices are inserted through the mouth and into the stomach pouch. The sutures are placed around the outlet to reduce the diameter from approximately the size of a silver dollar to the size of a dime. Additional sutures may be placed in the stomach pouch to reduce its volume furtherif needed.

What are the benefits of the endoscopic procedure?

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 than during their original WLS. In comparison to abdominal revision surgery, a revision through an endoscopic procedure decreases the patient’s risks of complication as well as minimizing pain, allowing for a quicker recovery, and avoiding 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.

What are the side effects?

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.*

What is the recovery process?

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.

Will it be covered by insurance?

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.

Fistula Repair:

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 abnormal connection between the old stomach remnant and the new stomach pouch. A larger amount of food can be eaten without restriction due to thisdefect because it will allow ingested food to be passed from the new stomach pouch to the old stomach. With an increased volume of food and beverage intake, the gastric bypass surgery becomes less effective.

Symptoms of a gastro-gastric fistula may include:

  • 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

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. With this procedure there is virtually no pain, no external cuts, and minimal to no blood loss.

Benefits of this procedure:

  • 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
  • No antibiotics required
  • Patients are back to work in 2-3 days

Advanced Surgical & Bariatrics of New Jersey specializes in endoscopic procedures that are minimally invasive and provide numerous benefits over traditional surgical procedure.

Advanced Surgical Bariatrics of New Jersey supports the performance of endoscopic procedures because they are associated with minimal post-operative discomfort and little to no pain. By providing endoscope procedures that are minimally invasive, our physicians do not cause major damage to any tissues and do not generally require an overnight stay at the hospital. Procedures performed endoscopicaly involve fewer complications and side effects, no external cuts, minimal to no blood loss, a significant decrease of risk of infection, and an overall quicker recovery.


This page was modified on May 20, 2021 by Dr. Sadek (Surgeon) of Advanced Surgical & Bariatrics
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