Apollo Procedure – Transoral Endoscopic Overstitch

Apollo Procedure – Transoral Endoscopic Overstitch

A gastric bypass is created with two components: the restrictive portions consisting of the short gastric pouch and a narrow connection to the small bowel known as the stoma (restrictive element) and a portion of small bowel creating the malabsorptive component. Over time the stoma may dilate, reducing the restrictive component of the gastric bypass allowing a patient to eat more, faster, and re-gain some weight years after a gastric bypass. That is why it is so important to “follow the principles” of dietary intake for the rest of one’s life after surgery.

We now have a method that can help restore restriction of the stoma if weight gain becomes a significant problem. This allows the patient to return to that initial sensation after gastric bypass with small portions and getting full quickly. 

Apollo Endosurgery offers the transoral endoscopic Overstitch which can be used to place sutures to narrow the stoma. This is a device that attaches to the end of an endoscope allowing sutures to be placed into the stoma without a surgical incision.

Prior to the Overstitch procedure, there have been other devices that have attempted to reduce stoma size. These devices have failed over time as they only allowed a partial thickness closure of the stomach wall which would not hold.

The needle at the end of the endoscope toggles to allow the surgeon to place a stitch through all layers of the gastric wall. This provides a more durable approach and is more likely to lead to a permanent reduction of the size of the stoma. Accompanied by a healthy diet and regular exercise, this procedure can help patients reverse the trend of weight gain after gastric bypass.

Not all patients who develop weight gain after gastric bypass are candidates for the Apollo Overstitch procedure. An endoscopy is first performed to identify if there is enough room (pouch size is large enough) for the endoscopic needle to toggle and create the sutures that are necessary.

Typically, this procedure is excluded from coverage from most insurance policies. The major cost of the procedure is for the disposable instrument that is required for the procedure. This procedure is performed under general anesthesia in order to keep the patient comfortable and decrease operative risks. All components of the procedure are included in the cash option that is offered. Financial options are discussed in the cash pay tab.