Gaining weight after gastric bypass surgery is extremely frustrating, but not uncommon. This article provides an overview of the ROSE procedure, a newer and safer incision-free gastric bypass revision, which can help gastric bypass patients with weight regain get back on track with weight loss.

About the ROSE Procedure

ROSE, which stands for Restorative Obesity Surgery Endolumenal, is a follow-up weight loss procedure specifically designed for gastric bypass patients with weight gain. It is not a primary method of weight loss surgery, but a gastric bypass revision. The ROSE procedure is performed to reduce the size of a stretched out stomach pouch and stoma in previously altered gastric bypass stomachs in order to promote greater food restriction, earlier satiety, and additional weight loss.

Weight Gain after Gastric Bypass Surgery

Gastric bypass surgery is one of the most successful methods of treating morbid obesity. Even with it’s high success rate, however, weight regain after gastric bypass surgery is not all that uncommon. It is estimated that more than 20 percent of gastric bypass patients will gain back a significant amount of the lost excess weight after initially succeeding with weight loss.

Weight regain after gastric bypass surgery usually occurs because the stomach pouch stretches out over time and no longer effectively restricts food consumption or controls hunger sensations. Then, more calories are consumed and the patient starts to regain weight. The ROSE procedure is performed to return a stretched stomach pouch and stoma to a size more closely resembling the initial gastric bypass surgery, increasing food restriction, satiety, and weight loss.

How the ROSE Procedure is Performed

The ROSE procedure is performed endoscopically (through the mouth) and does not require any external cuts or incisions. It takes about one hour to complete the operation, which is often performed on an out-patient basis. Most patients will feel little or no discomfort.

First, patients will be put under general anesthesia. Then, the doctor will insert a specially designed and FDA-approved medical device through the mouth, down the esophagus, and into the stomach pouch. The device gathers together sections of stomach tissue to create a pleat which it then fastens together. By repeating this process, the stomach volume and stoma diameter can be reduced to increase restriction and encourage weight loss.

Recovery and Post-Operative Diet

Post-operative symptoms are usually minimal and recovery is fairly quick. Most patients are able to go home within one day and then resume a normal schedule within a few days. Since the procedure does not involve traditional surgical incisions, the risk of infection and other complications typically associated with surgery is low. Patients may experience a few days with a mild sore throat, hoarseness, and swollen, sore lips due to the endoscopic instruments that were inserted into the mouth.

To give the stomach time to heal, patients will be expected to follow a modified diet for several weeks following the procedure. The first week will be limited to liquids, followed by two weeks of soft foods, before solid foods are slowly added back into the diet. It will be important to consistently limit portion sizes to reduce the risk of restretching the stomach and stoma.

Weight Loss Results

The ROSE procedure helps with weight loss by recreating the restriction of the initial gastric bypass surgery so that a patient eats less and consumes less calories. The reduced stomach volume limits meal portions and food intake and the smaller stoma slows down the movement of food into the small intestine, prolonging the feeling of fullness and lessening hunger sensations.

The ROSE procedure is still fairly new, but early weight loss results have been positive. Patients can expect immediate results, at a weight loss rate of one to two pounds per week.

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