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OverStitch™ System Full-Thickness Suturing Provides Bariatric Solution

Thursday, July 10, 2014 9:28 am CDT

The OverStitch™ Endoscopic Suturing System continues to gain recognition as a viable tool in addressing patient weight regain following bariatric surgery. Recent studies have presented the Overstitch System as a strong choice for Roux-en-Y Gastric Bypass (RYGB) revisions over other endoscopic revision options including sclerotherapy and other superficial suturing devices.

Roux-en-Y Gastric Bypass (RYGB) is one of the most common bariatric procedures in the U.S. and as the number of surgeries increases, post-operative weight regain has become a growing concern.2 The majority of patients undergoing RYGB regain 30% of the weight they have lost and almost one-third of patients regain most of the weight they have lost.2,3,4

Surgical revisions are problematic and carry high risk of major complications so professionals are turning to less invasive endoscopic techniques and devices to address weight regain.2, 3

How the OverStitch System May Help

While weight regain after RYGB can be the result of multiple factors, several recent studies indicate that weight regain is correlated with a dilated or larger gastrojejunal (GJ) stoma diameter as well as an enlarged gastric pouch.1-4 Data in one study showed that five years after RYGB, each 10mm increase in the GJ stoma diameter was associated with an 8% increase in weight regain.3

Many research studies suggest that endoscopically reducing the patient’s GJ stoma diameter, in a procedure known as transoral outlet reduction (TORe), is effective in treating or preventing weight regain.1-5 In addition, other current studies indicate that OverStitch with full-thickness sutures offers significant advantages over other endoscopic suturing methods.2, 4, 5

Recent research comparing OverStitch with several traditional techniques and devices for bariatric revision suggests that Overstitch is a promising alternative.

Sclerotherapy versus OverStitch. Sclerotherapyuses repeated injections of sodium morrhate around the gastrojejunal anastomosis aperture (GJA) to induce scarring to create a smaller, less compliant GJA.5 A recent study showed that while both this technique and full-thickness sutures were effective in halting weight regain, a significantly higher percentage of patients achieved cessation of weight regain and subsequent excess weight loss using Overstitch (94.9% versus 58.6% in the sclerotherapy group).5

Suction-based Superficial Suturing devices versus OverStitch. Previous endoscopic suturing devices have been limited in their capability to place full thickness stitches. Full-thickness suturing (with OverStitch) is proving to be more effective and providing more durable results, according to a comparison study by Drs. Kumar and Thompson.2,4 Their study showed that patients with full-thickness suturing had a higher percentage of weight loss at 6 months than patients with superficial suction-based suturing.4

For more information about the advantages of the OverStitch System, click here.

1Kroh, Matthew and Bipan Chand. Influence of pouch and stoma size on weight loss after gastric bypass. Surgery for Obesity and Related Diseases 8 (2012) 408-415.

2Kumar, Nitin and Christopher C. Thompson. Comparison of a superficial suturing device with a full-thickness suturing device for transoral outlet reduction (with videos). Gastrointestinal Endoscopy, 2014 Jun; 79(6):984-9

3Barham K. Abu Dayyeh, David B. Lautz, and Christopher C. Thompson. Stoma Diameter Predicts Weight Regain After Roux-en-Y Gastric Bypass. Clinical Gastroenterology and Hepatology 2011;9:228–233.

4Kumar, Nitin, David B. Lautz, and Christopher C. Thompson. Comparison of a suction-based superficial suturing device with a full-thickness suturing device for transoral outlet reduction: a matched cohort study. Developmental Endoscopy Lab. DDW 2013.

5Kumar, Nitin and Christopher C. Thompson. Comparison of a full-thickness sutured transoral outlet reduction and endoscopic sclerotherapy for weight regain after Roux-En-Y Gastric Bypass. Developmental Endoscopy Lab. DDW 2013.

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