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Endoscopic Gastric Outlet Repair

Some people who have had bariatric surgery do not lose as much weight as they would like, or they sometimes regain weight years later. For people who have had a gastric bypass and have regained weight, endoscopic gastric outlet repair can help jump-start their weight loss.

Washington University physicians at Barnes-Jewish West County Hospital and Barnes-Jewish Hospital work together to offer endoscopic gastric outlet repair in a comprehensive 12-month, medically supervised weight loss program.

Endoscopic Gastric Outlet Repair: How It Works

After a gastric bypass surgery, the stomach pouch (or the connection from the stomach to the small intestine, the stoma) that was created can sometimes stretch out after a few years. An enlarged stomach pouch or stoma can prevent further weight loss or cause weight regain.

An endoscopic gastric outlet repair is a nonsurgical procedure to reduce an enlarged stomach pouch or stoma after a previous gastric bypass surgery. The physician uses an endoscopic device (thin, flexible tube) with a tiny lighted camera to create a smaller stomach pouch or stoma. 

You receive all care and visits at Barnes-Jewish West County Hospital except for the procedure itself, which our physicians offer at Barnes-Jewish Hospital. Our comprehensive program includes behavior coaching group sessions.

Endoscopic Gastric Outlet Repair: The Procedure

The outpatient procedure for endoscopic gastric outlet repair involves just two steps:

  1. Endoscopy: While you are under general anesthesia, the physician inserts an endoscope with an attached suturing device down your throat into the stomach. 
  2. Suture placement: The physician places sutures in your stomach and/or the stoma to reduce their size.

Endoscopic Gastric Outlet Repair: What You Can Expect

Although each person is different and may have different results, the experience for most people includes:

  • Eligibility requirements: Endoscopic gastric outlet repair is for people who have had a previous gastric bypass and whose stomach pouch or stoma has stretched. You may need to have an endoscopy to check the size of the stomach or stoma, to make sure you are eligible for the procedure.
  • Significant weight loss results: People who had an endoscopic gastric outlet repair lost about 25 percent of their excess body weight.
    • The primary goal of the endoscopic gastric outlet repair, also known as endoscopic revision, is to stop weight regain.
  • Short recovery: Most people can go back to work or similar activities within three to five days after the procedure. You may experience some abdominal discomfort and nausea for a day or two, which we can help you manage with medication.
  • Follow-up visits: We provide ongoing care typically at one, five, eight, 12, 26 and 52 weeks (or when needed), then quarterly after the first year.
  • Program support: With endoscopic gastric outlet repair, you receive monthly lifestyle behavior coaching groups in the 12 months after your procedure. If you need nutrition support for weight loss, you may want to add visits with a registered dietitian, which are available for an additional fee.

Lifestyle changes for healthy weight maintenance

During the first several weeks after the procedure, your body is adjusting to restricted stomach capacity. Our post-procedure diet recommendations help with that adjustment.

  • Clear liquids for the first day
  • Full liquids for two weeks
  • Pureed foods for weeks three and four
  • Soft foods for weeks five and six
  • Regular foods, per your dietitian’s calorie prescription, as you feel comfortable

Once you have transitioned back to regular foods, it’s important that you commit to some lifestyle behavior changes for successful long-term weight management. We suggest that you: 

  • Eat healthy foods in smaller portion sizes
  • Get regular physical exercise 
  • Participate actively in the lifestyle behavior coaching component, which includes Virtual Group behavior coaching sessions monthly, including psychosocial behavior change strategies to help support you during treatment

Financing for Endoscopic Gastric Outlet Repair

Many health insurance plans don’t cover the cost of endoscopic gastric outlet repair. We work with you and your insurer to determine what your plan will cover and what your out-of-pocket costs will be. 

Our program coordinator will discuss payment options with you at your initial office visit.

Other Procedures for Weight Loss

Barnes-Jewish West County Hospital and Barnes-Jewish Hospital offer a full range of options for weight loss, including nonsurgical endoscopic and surgical procedures. Our options include:

Surgical Weight Loss Procedures: If you are interested in having a surgical weight loss procedure, you must first attend Bariatric surgery information session. A Washington University physician will discuss our procedures and explain eligibility.

Contact Us for Weight Loss Treatment

For more information or to schedule an appointment with a bariatric endoscopy physician, please call toll-free at 844-542-9378

Referring physicians can call the BJC Transfer Center at 800.252.DOCS (3627) 24 hours a day, seven days a week. You can also visit our referring physicians page.


Washington University Bariatric Endoscopic Therapy
Medical Office Building 4
1044 N. Mason Road, Suite 330
Creve Coeur, MO 63141

Get directions and maps.


Washington University Bariatric Endoscopic Therapy
Center for Advanced Medicine
4921 Parkview Place, Suite 10B
St. Louis, MO 63110

Get parking information and maps.


Washington University Physicians accepting new patients:

Michael C. Bennett, MD
Dayna S. Early, MD
Vladimir M. Kushnir, MD

Washington University care team:

Rachel Maday, FNP


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Find a doctor or make an appointment: 314.542.WEST (9378) OR TOLL-FREE 1.844.542.9378
General Information: (314) 996.8000
12634 Olive Boulevard
Creve Coeur, Missouri 63141
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