Post written by Rakesh Kalapala, MD, DNB, from the Department of Medical Gastroenterology, AIG Hospitals and Asian Institute of Gastroenterology, Hyderabad, Telangana, India.

The combination of the Bariatric Anastomotic Reduction System (BARS) with endoscopic sleeve gastroplasty (ESG) of the residual gastric pouch would cause significant anastomotic lumen reduction, with decrease of the size of the residual gastric pouch further limiting the quantity of food intake and therefore leading to more weight loss.

BARS with ESG of the residual gastric pouch could be a promising, viable, and feasible option in the case of weight regain after gastric bypass.

BARS along with “pouchoplasty” (ESG) in combination would be more effective in treating weight regain post-Roux-en-Y gastric bypass (RYGB). The rate of procedural success in reducing the anastomosis size in a therapeutically effective manner would be high.

To our knowledge, this is the first described dual-approach technique for weight reduction in post-RYGB weight regain patients.

Other endoscopists can learn about a novel, easily doable endoscopic therapy for weight regain in post-RYGB patients.

Resized pouch after tubularization—“pouchoplasty.”

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