Gastric Bypass Revision: ROSE Procedure / StomaphyX
Fort Worth LAP-BAND® is pleased to offer two procedure options for Gastric Bypass Revision: the ROSE procedure and the StomaphyX procedure. Both procedures address the same issues, but vary slightly in method. They allow those who have had a Gastric Bypass and have experienced weight regain to restore their stomach back to post gastric bypass its initial size. Restoring the stomach pouch size allows post gastric bypass patients to resume a healthy rate of weight loss.
Both the ROSE and StomaphyX are safe and effective revisional options. You and your surgeon will decide which method works best for you and your individual situation. To learn more about the gastric bypass revisions, call our office today at (866)414-7022!
Frequently Asked Questions
- What are the procedures?
- Why is the procedure performed?
- How do I know if my stomach pouch or stoma has stretched?
- How is the procedure performed?
- How long does the revision take?
- How long is the recovery period?
- What will I eat after the procedure?
- What are the benefits of the revisional procedure?
- What does it cost?
- How do I schedule an appointment?
What are the procedures?
Both the StomaphyX and the ROSE (or Restorative Obesity Surgery, Endolumenal) are new and innovative revision procedures for individuals who have had Roux-en-Y gastric bypass surgery and have regained weight due to a stretched stomach pouch and/or enlarged stomach outlet (stoma).
The minimally invasive procedures reduce the stomach pouch without traditional surgery or incisions and with minimal recovery time. They are not performed as primary methods of weight loss surgery, but as types of revisions for gastric bypass patients who have regained weight.
Why is the procedure performed?
Although gastric bypass surgery is successful in achieving an average of 60 to 80% excess weight loss, some patients start to regain weight a few years after surgery. The stomach pouch and stoma can gradually stretch over time as the body’s digestive system becomes accustomed to the changes and the patient returns to unhealthy eating patterns.
Stoma Too Large:
If a patient has a stoma that has stretched, food will not stay in the stomach very long. It will pass out of the stomach and into the small intestine rather quickly resulting in feeling hungry soon after a meal.
Pouch Too Large:
If a patient has a pouch that is too large or has stretched over time more food is required before feeling full. This increased intake leads to weight re-gain over time.
The StomaphyX and ROSE procedures reduce the stomach pouch and stoma to a size similar to the original gastric bypass surgery, once again limiting food intake and slowing the emptying of the stomach into the small intestine. This results in earlier satiety (feeling of fullness) and more weight loss. Without having to undergo additional traditional surgery, revisional procedures help gastric bypass patients eat less and lose more weight.
How do I know if my stomach pouch or stoma has stretched?
If you and Dr. Smith suspect that your stomach pouch or stoma may have stretched, there is a simple procedure known as an upper endoscopy (EGD) that can be performed to find out for certain. This is a quick and easy procedure and uses a small scope with a video camera to measure the stomach pouch and stoma. For the procedure you will be lightly sedated, then the doctor will guide the scope down through the mouth and into the stomach pouch to take measurements.
How is the procedure performed?
Both the ROSE and StomaphyX procedures are highly similar. The two procedures differ in the type of tools and fastener/anchors used.
StomaphyX:
First, you will be put under anesthesia. Then, Dr. Smith will gently guide the StomaphyX device through the mouth and into the stomach pouch inside a long, thin tube and perform the procedure using endoscopic visualization (miniature light source and camera). Once inside the stomach pouch, sections of stomach tissue are suctioned into a small opening in the StomaphyX device, which creates folds of tissue that, resemble a pleat. The folds of tissue are then fastened together with little blue staples to hold them in place, making the pouch smaller. The amount of folds required depends on a patient's anatomy; typically 10 to 20 folds are required.
ROSE:
The ROSE is also an endoscopic procedure, but is performed by inserting a small flexible endoscope and an Endosurgical Operating System (EOS) through the throat and into the stomach. These tools are used to grab, fold, and stitch the stomach tissue much like during the StomaphyX. The tissue is folded into multiple sections around the stoma's circumference using tissue anchors to reduce its diameter. This same technique is then used to reduce the stomach pouch volume.
How long does the revision take?
The procedures take approximately 60 minutes, depending on the size of the stomach pouch and how much revision needs to be done. Typically, the procedures are performed on an outpatient basis.
How long is the recovery period?
Since the procedures are performed through the mouth and do not involve any cutting or visible scarring, the recovery period is very minimal. Compared to traditional surgery, the recovery period following a ROSE or StomaphyX revision is less painful due to reduced risk of infection and associated complications. Normally, side effects experienced by patients are minor such as a short-term sore throat, swollen tongue, or lip pain from the insertion of the instruments into the mouth.
Most patients feel well enough to return to normal work activities after 1-2 days, however, heavy lifting is not advisable for one month afterward. Dr. Smith will discuss your individual activities beforehand, so we can customize the program to be safe and best fit your needs.
What will I eat after the procedure?
In order to allow the tissue pleats to bond to each other, patients are put on a liquid diet for two weeks. We recommend the Bariatric Advantage Meal Replacement as a healthy liquid diet option. After the first two weeks, you will progress to mushy protein and then ease into soft and high protein foods thereafter.
What are the benefits of gastric bypass revisional procedures?
Fewer overall risks than with traditional surgery
No incisions (abdominal or internal)
No visible scars
Reduced risk of infection from surgical incisions
Reduced size of stomach pouch (limiting food intake)
Reduced enlarged stoma,slowing the passage of food into the small intestine (causing earlier satiety or "fullness")
Usually performed on an outpatient basis
Quick recovery (1 to 2 days vs. 2 to 8 weeks for traditional revision surgery)
Relatively painless
Adjustable and/or revisable
Preserves future treatment options
Adaptable for different body types
What does it cost?
The all inclusive cash price for StomaphyX and the ROSE procedure are on average $9,750. This includes surgeon fee, facility anesthesia, visits with the dietician, and the psychological consulation.
Unfortunately, the procedures are not covered by insurance, but financing options are available. Contact Heather Earheart, our Finance Advocate, for more details at (866) 414-7022.
Your insurance plan may cover your initial endoscopy and consultation visit that are done to determine whether you are a candidate for the procedures. Our staff will gladly help you determine your insurance benefits and answer any finance or insurance questions you may have.
How do I get started?
You can start the process by contacting our office today at (866)414-7022. One of our highly trained
staff members can guide you through the process and answer any questions you may have.