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Dilated Gastric Outlet and Pouch Repair in New Jersey

Have you gained weight after gastric bypass surgery? This weight gain may be caused by a common condition known as gastric outlet, or gastric pouch dilation. Located in Montclair, the Center for Bariatric Endoscopy, the “Premiere Bariatric Surgical Institute in New Jersey”, offers endoscopic dilated gastric outlet and pouch repair to keep patients from around the world on track with their weight management goals.

What is Dilated Gastric Outlet and Pouch Repair?

dilated-gastric-outletpouch-repair-234x300Lifestyle and dietary changes after surgery can gradually alter the shape and size of the stomach pouch and outlet (also known as the stoma). Changes often result in a larger stomach pouch and/or a larger connection between the stomach pouch and intestines. This is referred to as a dilated gastric pouch and dilated gastric outlet, respectively. Changes may be caused by:

  • Gradual increase in the volume of food or drink intake
  • Lack of adherence to dietary recommendations
  • Eating and drinking at the same time
  • Surgical changes

These lifestyle changes can cause stomach tissue to stretch over time. Stretching of the pouch or outlet allows more food to be eaten at each meal or snack, and also allows food to pass through the stomach without restriction. This leads to increased appetite and decreased satiety (feelings of being full after eating), which can then lead to weight gain.

Benefits of Dilated Gastric Outlet and Pouch Repair

After undergoing gastric bypass surgery, it’s possible for the stomach to stretch out. This may allow you to eat more food and contribute to weight gain over time. Endoscopic repair of the defective gastric pouch can stop weight gain and keep you on track to lose weight. Endoscopic procedures are safer than traditional surgical procedures and offer the following benefits:

  • Virtually painless procedure
  • Minimal to no blood loss
  • No cuts from the outside
  • No risk of wound herniation or external wound infection
  • Can restore the feeling of fullness and aid weight loss
  • Same day surgery (able to go home the same day)
  • No re-routing of existing anatomy
  • No need for antibiotics
  • Back to work within 2-3 days

How is Dilated Gastric Outlet and Pouch Repair Performed?

Using anesthesia (you will not feel or remember the procedure), an endoscope (a thin, flexible tube with a camera and a light at the end) with a suturing apparatus is passed through the mouth into the stomach, at which point it will be used to identify and treat the dilated gastric pouch and/or dilated gastric outlet. The tissue is prepared and remodeled endoscopically (through the mouth) to help restore your post-gastric bypass anatomy. In cases where the outlet has dilated, sutures are placed to close the outlet and reduce its size. If the stomach pouch has also stretched, parts of the pouch can be sewn together to reduce the size. This is all done in order to reduce the dilated gastric pouch and outlet to around the size it was after the initial gastric bypass surgery. The procedure is done as an outpatient, same-day procedure.

Preparing for Dilated Gastric Outlet and Pouch Repair

Although this procedure is less invasive than other techniques, general anesthesia is required. You will need to have an appointment with your primary medical doctor for medical clearance prior to the procedure. This will include some blood work and an EKG to ensure that you are healthy enough for the procedure. Dr. Shaikh may recommend imaging tests, such as an endoscopy, to determine if you are a good candidate for endoscopic dilated gastric outlet and pouch repair. You may also be referred to our bariatric Registered Dietitian Nutritionist to learn about the diet you will need to follow after your procedure. Additionally you will need to follow a liquid diet for 1 week prior to your procedure.

Recovery from Dilated Gastric Outlet and Pouch Repair

Endoscopic surgery for dilated gastric outlet and pouch repair is a minimally invasive procedure. The technique used by Dr. Shaikh requires no external incisions and typically causes little to pain. As a result, recovery is faster than with open or laparoscopic surgical approaches to endoscopic bariatric surgery. Most patients return to work in two to three days, and full recovery typically takes less than two weeks.

How Much Does Dilated Gastric Outlet and Pouch Repair Cost?

The cost of endoscopic dilated gastric outlet and pouch repair varies by patient. We recommend that you speak with your medical insurance carrier to find out if the procedure is covered. If you are paying out of pocket or need help with portions not covered by your insurance, we suggest you apply for financing as needed. Most patients can pre-qualify for financing prior to their first appointment. We require payment for any balance prior to your surgery. You may also want to connect with organizations that specialize in helping bariatric patients afford their surgery, such as the Obesity Action Coalition.

Is Dilated Gastric Outlet and Pouch Repair Right for Me?

Endoscopic surgery for dilated gastric outlet and pouch repair may be right for you if you have symptoms associated with gastric outlet and gastric pouch dilation, such as:

  • Weight gain
  • Ability to eat more food at one sitting without feeling full
  • Decreased feelings of fullness after a meal
  • Increased feelings of hunger
  • Ability to eat foods and beverages previously not tolerated
  • Diarrhea, bloating, ‘dumping syndrome’

Why Choose Dr. Sohail N. Shaikh for Dilated Gastric Outlet and Pouch Repair?

Dr. Shaikh is a pioneer and a world leader in the field of bariatric endoscopy. He has performed endoscopic outlet and pouch repair since it’s inception and has helped develop many techniques used today. His training includes two additional fellowships at the University of Arizona and Harvard Medical School to specifically focus on advanced, developmental and bariatric endoscopy.  Dr. Shaikh teaches nationally and internationally and is involved in research to advance the field. He is also an understanding and caring physician who puts his patients’ needs above all else. He recognizes your struggles with weight loss and the anxiety caused by your health problems. Dr. Shaikh’s multidisciplinary practice includes a bariatric dietitian and coordinator who will help guide you every step of the way to ensure you are comfortable and to help you reach your weight loss goals. At the Center for Bariatric Endoscopy, we understand that weight gain may be difficult to control and we are dedicated to giving you the tools you need to succeed.

What to Expect During Your Consultation for Dilated Gastric Outlet and Pouch Repair

A personal consultation with Dr. Shaikh is your first step toward regaining control over your weight regain after bariatric surgery. During this consultation, Dr. Shaikh will discuss your experiences both before and after your bariatric surgery. He will also order tests to diagnose the cause of your weight gain and other symptoms. If he determines that endoscopic dilated gastric outlet and pouch repair is right for you, he will describe the procedure, including recovery, and outline the expected improvements in weight loss and health management.

Have you gained weight after bariatric surgery? If so, you may have a dilated gastric outlet and pouch. Endoscopic dilated gastric outlet and pouch repair corrects anatomical changes that affect your ability to lose weight. Contact Dr. Shaikh today!


“Individual results may vary.  Results are not guaranteed with this or any other procedure. Any weight loss procedure should be accompanied with nutritional counseling and an appropriate diet and exercise program.”