Transoral Outlet Reduction (TORe)
in Toronto
A Minimally Invasive Revision Procedure After Gastric Bypass
What Is Transoral Outlet Reduction?
Transoral Outlet Reduction is an endoscopic revision procedure for patients who have previously undergone Roux-en-Y gastric bypass surgery.
During gastric bypass, a small stomach pouch is connected to the small intestine through an opening known as the gastrojejunal anastomosis or gastric outlet. In some patients, this opening can gradually stretch or enlarge.
When the outlet becomes wider, food may leave the stomach pouch more quickly. This can reduce fullness after eating and may contribute to larger portion sizes, increased hunger, or weight regain.
TORe reduces the diameter of the enlarged outlet using internal endoscopic sutures. The procedure is performed through the mouth and does not require abdominal incisions or the removal of additional stomach tissue.
Who Is a Candidate for TORe?
- Previously had Roux-en-Y gastric bypass
- Regained weight after your initial weight loss
- Have an enlarged opening between the stomach pouch and small intestine
- No longer feel as full or restricted after eating
- Have not had enough success with diet and lifestyle changes alone
- Want a less invasive alternative to surgical revision
- Are willing to follow the recommended diet and aftercare plan
- Are in good overall health for an endoscopic procedure
Benefits of TORe
No External Incisions
TORe is performed through the mouth using an endoscope, so it does not require abdominal incisions or external scars.
Less Invasive Than Surgical Revision
TORe does not require reopening or reconstructing the original gastric bypass. For appropriately selected patients, it may offer a less invasive revision option with a shorter recovery than surgical revision.
Restores Restriction
Reducing the size of the gastric outlet may help patients feel full sooner and remain satisfied for longer after eating.
Supports Renewed Weight Loss
TORe may help reduce ongoing weight regain and support additional weight loss when combined with nutrition, physical activity, behavioural support, and medical follow-up.
May Help with Dumping Syndrome
Because TORe slows the movement of food from the stomach pouch into the small intestine, it may also be considered for selected gastric bypass patients experiencing dumping syndrome. Whether this applies to you must be determined through a medical assessment.
What Results Can I Expect After TORe?
Results vary depending on the degree of outlet enlargement, previous weight regain, eating habits, activity level, medical factors, and participation in follow-up care.
In a published five-year study of patients who underwent TORe after gastric bypass average total body weight loss was approximately:
- 8.5% at one year
- 6.9% at three years
- 8.8% at five years
These figures represent study averages and should not be interpreted as guaranteed individual results. Some patients lose more or less weight.
The purpose of TORe is often to help stop further weight regain, restore restriction, and support a renewed weight-management plan. Patients who remain engaged with dietary guidance, regular activity, behavioural support, and follow-up care generally have the best opportunity for long-term success.
Results vary. No specific amount of weight loss can be guaranteed.
Recovery After TORe
- Temporary nausea, bloating, cramping, or abdominal discomfort
- A liquid diet immediately after the procedure
- Gradual progression to puréed, soft, and regular foods
- Light walking shortly after the procedure
- A return to light daily activities within a few days
- A return to work within approximately 3–7 days, depending on the type of work
- A gradual return to exercise as approved by the medical team
How Much Does TORe Cost?
The cost of Transoral Outlet Reduction surgery at 360 Sleeve Clinic in Toronto
$14,500.
Because TORe is performed in a private clinic setting, it is not covered by OHIP. Financing options may be available for qualified patients. During your consultation, our team will review the full cost, available payment and financing options, expected recovery, and whether TORe may be appropriate for you.Why Choose 360 Sleeve?
Canada’s Leader in Weight Loss Care
- Over 5,000 weight loss procedures performed
- Experienced bariatric surgeons and obesity specialists
- Comprehensive pre- and post-procedure support
- Personalized treatment plans
- Financing options available
- Long-term follow-up care
Whether you’re considering ESG, Gastric Sleeve Surgery, or SADI-S, our team is committed to helping you achieve lasting results safely and confidently.
Have Questions About TORe
Explore our FAQ to learn all about long-term weight loss.
We address your most pressing questions and provide you with the information you’ll need to make informed decisions about this weight loss procedure.
TORe is an endoscopic bariatric procedure rather than traditional abdominal surgery. It is performed through the mouth using an endoscope and does not require external incisions.
TORe is primarily intended for selected patients who previously underwent Roux-en-Y gastric bypass and have an enlarged gastric outlet. It is not normally used to revise a gastric sleeve or gastric band.
TORe primarily reduces the opening between the stomach pouch and small intestine. In some cases, additional sutures may be used to address the pouch, depending on the patient’s anatomy and the doctor’s treatment plan.
Weight loss varies. Published five-year data reported average total body weight loss of approximately 8.8% at five years, but individual outcomes differ.
TORe does not repeat or recreate the entire gastric bypass. It is intended to restore some of its restrictive effect by reducing the size of an enlarged gastric outlet.
The sutures are intended to create a lasting reduction in outlet size, but anatomy can change over time. Some patients may experience renewed enlargement or weight regain and may require further treatment.
In selected cases, another endoscopic treatment may be considered if the outlet enlarges again or additional treatment is needed. This depends on the patient’s anatomy, medical history, and previous response.
No external scars are created because the procedure is performed through the mouth.
TORe commonly takes approximately 45–90 minutes, although procedure time varies depending on the patient’s anatomy and the techniques required.
Most patients return home on the same day. An overnight stay may be recommended when medically necessary.
Many patients return to non-strenuous work within approximately 3–7 days. Your doctor will provide personalized instructions based on your recovery and occupation.
Patients begin with a liquid diet and gradually progress to puréed, soft, and regular foods. Your care team will provide a structured dietary plan.
TORe may help selected gastric bypass patients with dumping syndrome by slowing the movement of food into the small intestine. A medical evaluation is required to determine whether it is appropriate for your symptoms.
Your bariatric team may discuss other options, including nutritional treatment, anti-obesity medication, behavioural support, another endoscopic procedure, or surgical revision.
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