Endoscopic Bariatrics at Valley Gastroenterology
A comfortable, incision‑free, evidence‑based approach to weight loss—performed by board‑certified gastroenterologists.
What is endoscopic bariatrics?
Endoscopic bariatrics uses a thin, flexible camera passed through the mouth to reshape the stomach or revise prior bariatric anatomy—without incisions. Most patients go home the same day and return to normal activities within a few days.
Options we offer
  • Endoscopic Sleeve Gastroplasty (ESG): Sutures placed inside the stomach create a sleeve‑like shape and reduce volume.
  • Time: ~60–90 minutes (outpatient)
  • Expected loss: Often 15–20%+ total body weight at 12 months when paired with a structured program (individual results vary)
  • TORe — Transoral Outlet Reduction: For patients who previously had gastric bypass and developed weight regain or dumping due to a widened connection (gastrojejunal anastomosis). Using endoscopic suturing and/or tissue ablation, we reduce the outlet size to slow gastric emptying and improve fullness.
  • Time: ~30–60 minutes (outpatient)
  • Ideal for: Prior gastric bypass with weight regain or troublesome dumping syndrome after medical/nutritional therapy hasn’t been enough
Who is a candidate?
  • Typically BMI 30–40 for ESG
  • TORe: Prior gastric bypass with weight regain and/or post‑prandial symptoms (e.g., dumping) and evidence of outlet dilation
  • Age 18–70 with prior attempts at lifestyle or medical weight loss
  • Medically cleared for anesthesia and committed to nutrition, activity, and follow‑up
Not ideal if: uncontrolled severe reflux, large hiatal hernia, prior major stomach surgery altering anatomy (for ESG), active ulcers/bleeding disorders, pregnancy, or untreated eating disorders. Final eligibility is determined by your GI provider.
Why this matters
  • Clinically meaningful weight loss can improve blood pressure, diabetes control, sleep apnea, joint pain, and quality of life.
  • Endoscopic options are incisionless, outpatient, and can be combined with nutrition and medical therapy for durable results.
Day‑of checklist
  • ❑ Government ID & insurance card
  • ❑ List of medications & allergies
  • ❑ A responsible adult to drive you home
  • ❑ Follow fasting instructions; wear comfortable clothing
What to expect on procedure day
  • Check‑in & nursing assessment (30–45 minutes)
  • Sedation: You’ll be comfortably asleep or deeply relaxed.
  • Procedure: ESG ~60–90 minutes; TORe ~30–60 minutes. Most patients go home the same day.
  • Recovery: 60–120 minutes. You’ll receive written instructions and a staged diet plan.
Most patients remember little or nothing and return to desk work in 2–5 days.
Results & follow‑up
  • Highest weight loss typically occurs in the first 3–6 months (ESG) and continues with program engagement.
  • After TORe, many patients notice improved satiety and reduced dumping symptoms as the outlet narrows.
  • Dietitian visits at 1–2 weeks, 1 month, 3, 6, and 12 months; physician follow‑up as needed.
Safety & risks
Endoscopic bariatrics is very safe, but potential risks include bleeding, ulcers, leaks/perforation, severe nausea/vomiting or dehydration, infection, reactions to sedation, and missed lesions. TORe‑specific risks can include bleeding at the outlet, ulceration/stricture, or need for repeat intervention. Serious complications are uncommon; we’ll review your individual risk and obtain informed consent the day of your procedure.
Medications & special situations
  • Blood thinners: Do not stop on your own—we’ll coordinate with your prescriber.
  • Diabetes/GLP‑1 meds: We’ll provide a safe dosing plan for prep day and the morning of your procedure.
  • Sleep apnea, heart or lung conditions: Bring your CPAP details and medication list; anesthesia is tailored to you.
  • Pregnancy: Please tell us—elective procedures are usually deferred unless urgently needed.
After you go home
  • Expect cramping, nausea, or reflux for a few days—medications will be provided.
  • Follow the staged diet: clear liquids → full liquids → pureed → soft → regular.
  • Call us immediately for severe pain, persistent vomiting, fever >101°F, heavy bleeding, black/tarry stools, chest pain, or shortness of breath.
Costs & insurance
Many plans do not yet cover endoscopic bariatrics. We offer transparent package pricing, financing options, and HSA/FSA receipts. We’ll review any separate charges for medications or nutrition visits in advance.
Contact
Valley Gastroenterology
3190 E Meridian Park Loop, Suite 206
Wasilla, Alaska 99654
Phone: (907) 373-2544
Fax: (844) 689-4240
Web: ValleyGastroAK.com