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ROSE Procedure

The ROSE procedure, which stands for Restorative Obesity Surgery, Endoluminal, is a minimally invasive bariatric surgery, which restores the size of the stomach in patients whose gastric bypass failed, whether because complications arose or because they regained weight.

The small pouch created by the bariatric surgeon during a gastric bypass may stretch out over time, which increases appetite and no longer prevents the individual from ingesting large amounts of food at once.

Alternatively, the patient might not have followed the diet plan their bariatric doctor compiled for them, which inevitably led to weight gain.

No matter why the ROSE procedure is necessary, it is a very safe, incisionless revision weight loss surgery, which can quickly and safely reduce the volume of your stomach.

The most outstanding advantage of the ROSE procedure is that it does not involve making any incisions on the body, as the surgery is performed entirely through the mouth.

While it is a very simple and low-risk surgery, you are still required to undergo a series of tests before having the ROSE procedure so that the bariatric surgeon will know with certainty that it is safe for you.

These tests may include some of the following:

• upper endoscopy
• blood tests such as basic serum electrolytes
• physical examination
• a chest X-ray
• pH monitoring studies
• EKG
• pulmonary function tests
• urine work

Once you are deemed a good candidate, the date of your surgery will be set up and you will receive instructions from your bariatric surgeon with regard to your preoperative diet. It is of utmost importance that you follow your diet plan to a T, as the surgery might otherwise be compromised. At least 12 hours before the ROSE procedure, you should begin fasting, as it must be performed on an empty stomach.

The surgery is carried out endoscopically, which means a thin, flexible tube (the endoscope) equipped with a fiberoptic camera will be inserted through your mouth to reach your stomach. You will be put under general anesthesia and a bariatric nurse will constantly monitor your vital signs while the procedure is taking place. The procedure consists of the surgeon creating folds in the wall of your stomach, which are stitched together with the purpose of reducing the size of the organ. The duration of the ROSE procedure is approximately one hour and most patients are allowed to leave the hospital the same day. Nevertheless, some may be required to stay overnight for close monitoring.

The benefits of the ROSE procedure are multiple, including:

• no scarring
• minimal postoperative discomfort
• short recovery time
• low risk of infection
• decreases your appetite and promotes satiety
• can be carried out on an outpatient basis
• slows down the digestion process
• reduced risk of complications

After the ROSE procedure, the majority of people can return home within 24 hours and resume their usual activities within a few days. You may experience the following symptoms when the effects of the anesthesia wear off:

• hoarseness
• a sore throat
• swollen lips
• lip pain

These symptoms will gradually alleviate within several days and their occurrence is perfectly normal due to the endoscopic instruments which were inserted through your mouth during the surgery. The postoperative diet you will have to follow is similar to that entailed by a gastric bypass, namely 2 weeks of high-protein liquids and 2 subsequent weeks of soft food. You are allowed to introduce solid foods in your diet only 4 weeks after the ROSE procedure and will have to follow a strict diet plan for the next 2 or 3 years to lose the excess weight.

As for the risks and complications of the ROSE procedure, they are minimal, since no incision is made in your abdomen. Nevertheless, if you notice any of the symptoms below, you should seek medical attention immediately:

• difficulty swallowing
• nausea
• fever
• vomiting
• persisting or intensifying pain