Transoral Outline Reduction (TORe)

This procedure endoscopically addresses a previous gastric bypass.

The TORe procedure

Transoral Outlet Reduction (TORe) is an endoscopic procedure to revise a previous Roux-en-Y gastric bypass and is performed with the OverStitch Endoscopic Suturing System. TORe leaves no scars and helps you get back on track by fixing anatomic changes that may have caused weight gain.

A surgeon or gastroenterologist performs Transoral TORe Reduction using a camera inserted down your mouth and a special device to narrow the connection between your stomach and small intestines. This can help you lose weight again or stop you from gaining more weight.

No incisions or scars
Same-day procedure for many patients
Lower adverse event rate than traditional surgical approaches¹

1. Russell D. Dolan, Pichamol Jirapinyo, Christopher C. Thompson, Endoscopic versus surgical gastrojejunal revision for weight regain in Roux-en-Y gastric bypass patients: 5-year safety and efficacy comparison, Gastrointestinal Endoscopy, Volume 94, Issue 5, 2021, Pages 945-950Dolan, et al. Gastrointestinal Endoscopy. 2021.

Results from different clinical investigations are not directly comparable. Information provided for educational purposes only.

An estimated 15,000 endoscopic revisions of bariatric procedures performed worldwide.²

More than 150 clinical papers and abstracts have been published on TORe.³

OverStitch Endoscopic Suturing System is the first and only device to perform TORe in patients with obesity (BMI 30 – 50 kg/m²).^*

2. Estimates based on Apollo Endosurgery internal sales data.

3. Data on file.

*As of March 2025

A surgeon or gastroenterologist performs Transoral Outlet Reduction using a camera inserted down your mouth and a special device to narrow the connection between your stomach and small intestines. This can help you lose weight again or stop you from gaining more weight.

Clinical evidence

Effectiveness

Patients lost an average of 6% total body weight at 12 months, according to a large (n=1,625 patients) study.⁴

Latest Technique

Newer studies with the latest technique showed 9-12% total body weight loss in study particiants at 12 months.^5,6

Durability

Long-term studies showed patients maintained weight loss at 5 and 7 years after a TORe procedure.^5,7

4.Jarunvongbanich et al. Gastrointestinal Endoscopy. 2020.

5.Jirapinyo, et al. Gastrointestinal Endoscopy. 2020.

6.Meyers, et al. Gastrointestinal Endoscopy. Volume 95, No. 6S. 2022.

7.Jirapinyo, et al.Gastrointestinal Endoscopy. 2020. Subset of patients included in study are also represented in 5-year data.

Results from different clinical investigations are not directly comparable. Information provided for educational purposes only.

"It's been about a year since my procedure; there really isn't an area where my life hasn't dramatically changed"

Bren

Important OverStitch Endoscopic Suturing System Safety Information:

OverStitch Endoscopic Suturing System devices are made to help you lose weight by reducing the size of your stomach and increasing the time it takes for food to pass through your stomach.

For the OverStitch Endoscopic Suturing System you need to follow a healthy diet and exercise program to lose weight. You may not lose weight if you do not adopt healthy habits. Your doctor’s clinical team, including dietitians, nutritionists and/or exercise trainers, should help you on your weight loss journey.

The OverStitch Endoscopic Suturing System is for adults with obesity (BMI 30-50kg/ m₂) who have not been able to lose weight and keep it off through more conservative measures (e.g., diet and exercise).

Your doctor will ask you about your medical history and will also perform a physical examination to determine your eligibility for the OverStitch Endoscopic Suturing System device. Additionally, at the time of your procedure, the doctor may identify internal factors, such as stomach ulcers or erosive gastritis, which may prevent you from receiving the device.

You must not receive the OverStitch Endoscopic Suturing System if you are pregnant.

You must not receive the OverStitch Endoscopic Suturing System if you have an eating disorder (anorexia nervosa, binge eating disorder, etc.).

All procedures have risk. Patients should talk to their doctor and understand all risks before having a procedure.

Nausea and vomiting, abdominal pain, constipation, eructation, constipation, heartburn and diarrhea are common after the TORe procedure. Gastrointestinal bleeding may also be experienced following these procedures. More serious complications have been reported, though these are relatively rare.

While many patients are discharged from hospital on the day of their procedure, some patients may stay in hospital or return to hospital for assistance with symptoms associated with acclimating to the sleeve. Symptoms are most often treated with IV fluids or medication, but medical intervention may be required.

Call your doctor if you have any concerns about your health or well-being following a TORe.

Some patients may not lose weight following a procedure with the OverStitch Endoscopic Suturing System. Talk to your doctors about your options. You may be a candidate to have another type of weight loss procedure.

If you have additional questions, talk with your doctor. For full safety information, visit IFU-BSCI.com.

CAUTION: Rx only.Individual Weight Loss May Vary