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Weight Loss Surgery with No Incisions or Scars

By Michael Hovey, MD, FACS February 06, 2024 Posted in: Weight Management

If you’ve been on the fence about weight loss surgery, a newer approach with no incisions, no scars and a shorter recovery may be an option for achieving lasting weight loss. 

CHI Health Immanuel Weight Management is the first and currently only program in the Omaha area to offer two new weight loss procedures in addition to laparoscopic minimally invasive surgeries. 

The Endoscopic Sleeve Gastroplasty (ESG) and Transoral Outlet Reduction (TORe) are outpatient procedures which are performed under general anesthesiology. Each uses an endoscopic device about the size of your finger to go through your mouth and into your stomach to either sew your stomach smaller (ESG) or retighten the stomach to a smaller size (TORe).

  • ESG is for people who haven’t had previous weight loss surgery. 

  • TORe is for people who have regained weight after gastric bypass due to the pouch stretching. 

Not only are there no incisions or scars, there’s also a shorter recovery and patients are generally back to work in two to three days. These benefits make this approach appealing, especially for the many people who struggle with weight loss but haven’t considered weight loss surgery. Consider these statistics:

  • 95% of people who use diet and exercise alone fail to achieve lasting weight loss. 

  • 1% of overweight/obese people have weight loss surgery. 

While endoscopic bariatric procedures aren’t major surgery, they are a significant life decision. 

FAQs about ESG and TORe

How new are these procedures?

Surgeons have been doing these endoscopic procedures for around 10 years, and the specific suturing device has been used in different surgeries for many years. What’s different is that ESG and TORe are now FDA-approved treatments for obesity. 

What results can I expect? 

Studies show anywhere from 14-23% weight loss after ESG. The majority of the patients we’re seeing have 17-23% weight loss. Sustained weight loss also offers overall health benefits, such as improved diabetes, high blood pressure and other obesity-related health issues, including lower rates of certain cancers.

Who is a good candidate for ESG and TORe?

People who are overweight/obese and have a BMI of 30 to 50 are candidates for ESG. Because BMI is a height-to-weight ratio, this can include shorter individuals who are 30 pounds overweight and taller individuals who are 120 pounds overweight. You must also be committed to making lifelong lifestyle changes and meet other requirements. Patients who have regained some weight after having a gastric bypass surgery may be candidates for TORe.

What are the risks?

The major risks of undergoing ESG or TORe are similar to any endoscopic procedure and include internal bleeding, perforation and damage to surrounding structures, though these risks are rare. The more common risks include minor bleeding and nausea.

How can I improve my odds of success?

Weight loss surgery is not an easy road. It takes significant changes to your lifestyle and daily habits that require work on your part. Things that improve your success include:

  • Education on diet, exercise and how to retrain your brain to make better choices. 

  • Consistently logging what you’re eating to help recognize your food intake volume. 

  • Exercising regularly. Even walking 30 minutes five times a week will greatly improve your results. 

  • Joining and participating in support groups led by our weight loss team. 

If you’re interested in weight loss surgery, reach out the CHI Health Weight Management Department at (402) 572-3684. It’s a worthwhile journey that can deliver long-lasting health benefits. 

Michael Hovey, MD, FACS
Michael Hovey, MD, FACS

Dr. Michael Hovey is a bariatric and general surgeon for CHI Health. He also serves at the Medical Director for the Weight Management Department.

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