Outcomes of bariatric anastomotic reduction system clips in patients with refractory weight regain: a retrospective case series with 1-year follow-up

Background and Aims Roux-en-Y Gastric Bypass (RYGB) is an effective bariatric procedure; however, it may result in gastrojejunostomy dilation leading to dumping syndrome and refractory weight gain (RWG). The Bariatric Anastomotic Reduction System (BARS) is a novel endoscopic option for managing RWG. This study evaluated its feasibility and durability. Methods This retrospective case series included 9 patients with ≥10% RWG after RYGB who underwent endoscopic clipping system placement with 12-month follow-up. Results Nine patients (median age 45 years [33–48]; eight females) with enlarged gastrojejunostomies (median 23 mm [22–24]) were included; two had dumping syndrome. Median gastrojejunostomy size decreased to 8 mm (63.6% reduction, p=0.007). Median weight loss at one year was 11.3 kg (11.4% total weight loss; p=0.008), and dumping syndrome improved in both patients. Conclusions The clipping system showed feasibility and potential durability at one year, with weight loss and improvement in dumping syndrome in select patients.