Endobariatric revision procedure

About the Transoral Outlet Reduction (TORe) procedure

Who is Transoral Outlet Reduction for?

TORe procedure is for adults with obesity (body mass index (BMI) higher than 30 kg/m²) who have not been able to lose weight and keep it off through more conservative measures (e.g. diet and exercise).

Your doctor will ask you about your medical history and will also perform a physical examination to determine your eligibility for the TORe procedure. Additionally, at the time of your procedure, the doctor may identify internal factors, such as stomach ulcers or erosive gastritis, which may prevent you from receiving the procedure.

How does the Transoral Outlet Reduction procedure work?

A surgeon or gastroenterologist performs the TORE procedure using a camera inserted down your mouth and a special device to narrow the connection between your stomach and small intestine. This can help you lose weight again or stop you from gaining more weight.

No incisions or scars
Same-day procedure for many patients³

Proven results with TORe

Safety

A retrospective matched cohort study of 62 patients showed similar results and potential for improved safety over laparascopic revision approaches.³

Effectiveness

Patients lost an average of 6% total body weight at 12 months, according to a large meta-analysis.⁴

Latest technique

Newer studies with the latest technique showed 9-12% total body weight loss in study participants at 12 months.^5-6

Durability

Long-term studies showed patients maintained weight loss at 5 and 7 years after a TORe procedure.^5-6

TORe Patient Story: Meet Alessia

“After The TORe definitely I regained self-confidence, I tried again things that I had left in oblivion”

Watch Alessia’s story and discover her Transoral Outlet Reduction (TORe) journey.

Obesity: Related comorbidities

Obesity is defined when you have a body mass index (BMI) of 30 or higher. Studies have found associations between increasing BMIs and the development of various chronic health conditions. The BMI cut points, or thresholds beyond which comorbidity incidence can be accurately detected, are unknown.⁷
Obesity is associated with numerous comorbidities, including:
- hypertension
- hyperlipidemia
- type 2 diabetes mellitus (T2DM)
- coronary artery disease (CAD).⁸

The literature is rich in publications that highlight the implications and dramatic diseases associated with the current steady worldwide increase in the prevalence of obesity.
A major source of concern with this increasing prevalence are the numerous potential adverse outcomes triggered by obesity-associated comorbidities.⁹

Alternative bariatric procedures

Laparoscopic sleeve gastrectomy (LSG), also known as vertical sleeve gastrectomy, is a restrictive surgery. LSG is a weight loss procedure typically performed laparoscopically. During sleeve gastrectomy, approximately 75-85% of the stomach is removed along the greater curvature. LSG generates both neurohormonal and bile signaling alterations that yield metabolic benefits.⁹
Roux-en-Y gastric bypass (RYGB) excludes a portion of the stomach, as well as part of the proximal intestine, and rearranges the distal end of the intestine into a Y-configuration, through which food can flow from the upper stomach pouch through the Roux limb, resulting in weight loss dependent and independent metabolic benefits.⁹

Find a TORe Centre near you

Looking for a Transoral Outlet Reduction (TORe) centre near you? Explore our “ Find a Specialist” service to find a specially trained clinicians in your area.

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References

1. Estimates based on Apollo Endosurgery internal sales data, 2019

2. Data on file.

3. Dolan RD, et al. Endoscopic versus surgical gastrojejunal revision for weight regain in Roux-en-Y gastric bypass patients: 5-year safety and efficacy comparison. Gastrointest Endosc. 2021;94(5):945-950.

4. Jaruvongvanich V, et al. Endoscopic full-thickness suturing plus argon plasma mucosal coagulation versus argon plasma mucosal coagulation alone for weight regain after gastric bypass: a systematic review and meta-analysis. Gastrointest Endosc. 2020; 92(6):1164-1175.e6.

5. Jirapinyo P, et al. Five-year outcomes of transoral outlet reduction for the treatment of weight regain after Roux-en-Y gastric bypass. Gastrointest Endosc. 2020;91(5):1067-1073.

6. Meyers , et al. Gastrointestinal Endoscopy. Volume 95, No. 6S. 2022.

7. Liu N, et al. Obesity and BMI Cut Points for Associated Comorbidities: Electronic Health Record Study. J Med Internet Res. 2021; 23(8): e24017.

8. Panatalone KM, et al. Prevalence and recognition of obesity and its associated comorbidities: cross-sectional analysis of electronic health record data from a large US integrated health system. BMJ Open. 2017;7(11):e017583.

9. IFSO-WGO GUIDELINES ON OBESITY CONTENTS 2022.

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