ROSE Procedure Frequently Asked Questions

• What is the ROSE PROCEDURE?

  New surgical tools now allow surgeons to reduce the size of the pouch and stoma through the patient’s mouth without making external cuts into the body.  Your doctor may refer to this as the “ROSE” procedure, which stands for Restorative Obesity Surgery, Endoscopic.

  Before the ROSE incisionless procedure, patients who regained weight after gastric bypass generally had few treatment options.  Scarring and adhesions related to the initial bypass procedure make open or laparoscopic revision surgery very challenging.  Revision surgery procedure time is typically longer than the original bypass procedure and patients can be up to three times more likely to develop a complication following revision surgery.  Therefore, most patients who regain weight after gastric bypass opt not to undergo open or laparoscopic surgical revision after weighing the risks and benefits. 
  
  

• Why would I gain weight after gastric bypass?

  A number of studies suggest that patients regain weight due to the gradual enlargement of the surgically altered small stomach pouch and stoma, (connection between the stomach and small intestine).  When the Roux-en-Y procedure is performed, the stomach and stoma are made very small, which slows the passage of food and creates a feeling of fullness after just a small volume of food is eaten.  It is believed that when the stomach pouch and stoma gradually enlarge, the feeling of fullness is no longer present, patients can eat larger meals, and weight regain occurs.  
  
  
  

• How do I find out if I’m eligible for this new incisionless, restorative ROSE procedure?

  Patients who had a Roux-en-Y gastric bypass more than 2 years ago, lost over 50% of their excess weight and have now regained 15% or more of this weight are ideal candidates for this procedure. 

  After an initial screening, you will undergo a series of evaluations including nutritional and dietary counseling, a full medical exam and endoscopy to determine if you are a good candidate.
  
  

• How long will I need to stay in the hospital?

  Typically, patients stay less than 23 hours.  You may be discharged the same day if the procedure was done early in the morning, or you may stay overnight.  Your surgeon will make the determination following your procedure.
  
  

• What type of side effects can I expect?

  It is anticipated that patients will feel little or no discomfort from the procedure.  To date, the only noted side effects have been short-term sore throat, swollen tongue and lip pain from the insertion of the instruments into the mouth. 
  
  

• What is the success rate?

  It is too soon to estimate the likely procedure success rate.  However, to date, the procedure has been well tolerated and the first few patients have experienced weight loss within the first 4 weeks and a reduction in food volume capacity.
  

• What is the recovery process?

  Typically patients return to normal activity within a few days of their procedure.  Your doctor will give you specific instructions.  In addition, patients are asked to follow a post bariatric surgery diet and exercise plan, similar to the regimen prescribed following the initial bypass surgery.  In addition, follow-up appointments with your doctor and regular visits with bariatric support staff will be required. 
  
  

• Will it be covered by insurance?

  As with gastric bypass surgery, coverage will vary depending upon the insurance provider.  A specialist in your physician’s office will discuss your plan with you.  In the event insurance will not cover the procedure, financing options may be available.  Check with your surgeon’s office for information on possible financing programs as well as potential tax advantages for any expenses you may incur.  
  
  

• What will the procedure cost?

  The cost for the procedure will vary depending upon where the procedure is performed, how long you stay in the facility and other factors.  Your doctor or the program coordinator will be able to give you an estimate of the total cost.  
  
  

• Is incisionless surgery just for gastric bypass restorations?

  This procedure is one of the first of many potential applications for Incisionless Surgery.  Incisionless Surgery is considered the next wave in minimally invasive procedures and, in addition to obesity, it has generated interest among physicians in areas such as GERD, GI cancer and NOTES (Natural Orifice Translumenal Endoscopic Surgery).