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ROSE Procedure

The ROSE (Restorative, Obesity Surgery, Endolumenal) procedure is a revision weight loss surgery (WLS) for patients who have had gastric bypass surgery (also known as Roux-en-Y surgery) previously (at least 2 years ago) and lost 50% of excess weight but regained at least 15% of it back. Most people lose their excess weight to a great extent following a gastric bypass surgery which makes the size of the stomach and stoma very small. Smaller stomach means that it can now hold much less food and the feeling of fullness is achieved after consuming only a small amount of food. However, the stomach pouch and the stoma may expand/stretch over time causing the capacity of the stomach to increase. The stomach can now hold more food and the feeling of satiety is achieved after consumption of a larger amount of food than before. This results in weight regain.

An open or laparoscopic gastric bypass revision carries a large amount of risks and complications with it and therefore is avoided by most patients and even surgeons. The ROSE procedure is an alternative to revision gastric bypass surgery which is done endoscopically without the need for any incisions into the body.

How is the ROSE procedure performed?

The purpose of the ROSE procedure is to reduce the size of the stomach (to about the size at the time of the original gastric bypass surgery) by pleating/folding the stomach with sutures and also to reduce the size of the stoma. The actual procedure is carried out in the following way:
The patient is put under general anesthesia. An endoscope (a long narrow tube carrying a camera and surgical instruments) is then inserted into the patient`s stomach pouch through his mouth and down the esophagus. The surgical tools in the endoscope are then used to gather together sections of stomach tissue to create a pleat which is then sutured together. With this process, the stomach volume and stoma diameter can be reduced to increase restriction and help weight loss. The procedure takes about an hour to complete.

How does the ROSE procedure work?

The goal of the ROSE procedure is to recreate the restriction of the initial gastric bypass surgery. The reduction in the stomach capacity helps limit food intake. By reducing the diameter of the stoma, the passage of food from the stomach pouch into the small intestine is slowed giving a feeling of fullness for a prolonged time after a meal and lessen hunger sensations between meals. Together these cause the patient to eat less and thereby achieve weight loss.

Candidacy for the ROSE procedure

To be eligible for the ROSE procedure you must have had the gastric bypass procedure at least 2 years ago, lost 50% of your excess body weight following the surgery and regained 15% of it back. In some cases, patients may also be a candidate if they underwent gastric bypass surgery but failed to lose weight.

After an initial interview with your bariatric surgeon to determine if you qualify for the ROSE surgery, you will undergo a series of tests including nutritional and dietary counseling, a full medical exam and endoscopy to establish your candidacy.

Advantages of the ROSE procedure

  • No external incisions or cuts (incisionless) therefore lower risk of infection and associated complications, and also no scarring
  • Quick procedure (takes about an hour)
  • Causes little or no discomfort to the patient
  • Minimal post operative pain/symptoms (mild sore throat, hoarseness, swollen lip, and lip pain due to the endoscopic instruments that were inserted into the mouth)
  • Fast recovery time
  • Done mostly on an outpatient basis
  • Quick recovery time, patient requires minimal time off work and can resume normal activities within a few days

How much does the ROSE procedure cost?

Request for a FREE and customized pricing estimate for the ROSE procedure.

Find a bariatric surgeon that offers affordable high quality ROSE procedure in the US as well as abroad.

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