Transoral Outlet Reduction Endoscopy (TORe)

TORe (Transoral Outlet Reduction Endoscopy) is a non-surgical endoscopic procedure used to help people who have regained weight after Roux-en-Y gastric bypass (RYGB) surgery.

Why TORe is Needed:

After gastric bypass surgery, some patients regain weight due to:

• Stretching of the gastric pouch
• Enlargement of the gastrojejunal anastomosis (GJA) — the outlet between the stomach pouch and the small intestine

When the outlet is too wide, food passes too quickly, reducing feelings of fullness and contributing to overeating.

What TORe Does:

• TORe shrinks the enlarged outlet using an endoscope inserted through the mouth (transoral)—no incisions.
• The doctor uses tools to place sutures and apply thermal energy (like APC) to reduce the outlet’s diameter.
• The smaller outlet slows food passage, restoring satiety and supporting weight loss.

Procedure Overview:

• Done under sedation or general anesthesia
• Takes about 30–60 minutes
• Outpatient (go home the same day)

Benefits:

• Minimally invasive (no cuts or incisions)
• Helps restart weight loss after regain
• Complication rates are very low
• Recovery is generally fast with a minimal recovery and downtime for the patient