Transoral outlet reduction: Outcomes of endoscopic Roux-en-Y gastric bypass revision in 284 patients at a community practice

Figure 1 Steps of transoral outlet reduction. A: Examination of the pouch, outlet, and jejunal limbs. Gastrojejunal anastomosis (GJA) appears dilated; B: Circumferential mucosal ablation with argon plasma coagulation of the gastric tissue of GJA; C: Purse-string suturing of the outlet using the Overstitch endoscopic suturing system; D: Cinching of the suture over a through-the-scope fluid-filled balloon positioned through the outlet into the efferent jejunal limb; E: Final view of GJA after transoral outlet reduction; F: Healed appearance of GJA 12 wk after transoral outlet reduction.