Trans-Oral Outlet Revision (TORe)

What is Trans-oral Outlet Revision (TORe)?

Weight loss or bariatric surgery is considered the gold standard for management of overweight and obesity.  Surgical options include the sleeve gastrectomy or the Roux-en-Y gastric bypass (RYGB).

Unfortunately, long term studies show that patients can regain weight following any bariatric surgery, and this can occur for many reasons.  One of the common causes for weight regain in RYGB patients is widening of the surgical join between the stomach and the intestine, also known as the gastro-jejunostomy (GJ) anastomosis.  It can result in loss of the fullness or satiety feeling and faster emptying of the stomach contents into the intestine.

Surgical correction of the GJ anastomosis can be technically very difficult and complicated.

Newer endoscopic therapies for revision of the GJ anastomosis have been developed over the recent years, called the TORe procedure, where the GJ anastomosis diameter can be reduced endoscopically down to <1cm.  This can successfully recapture the satiety feeling and re-initiate further weight loss in combination with a multidisciplinary team approach.

How does TORe work?

Trans-oral outlet revision (TORe) is an outpatient procedure performed by our highly trained specialists under intravenous sedation using a dedicated endoscopic suturing device.  It has a much more favourable risk profile to revisional surgery and several studies have shown excellent long term results in carefully selected patients.  The procedure can be repeated down the track if required.

Further Information


  1. Transoral outlet reduction for weight regain after gastric bypass: long-term follow-up. Nitin Kumar and Chris Thompson. Gastrointestinal Endoscopy 2016, Vol 83 Issue 4
  2. Transoral outlet reduction with full thickness endoscopic suturing for weight regain after gastric bypass: A large multicenter international experience and meta-analysis.Vargas EJ et al. Surgical Endoscopy. 2018 Vol 32.

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