FIGURE 5. Endoscopic revision of RYGB: A) the transoral reduction of the gastrojejunal anastomose after RYGB (transoral outlet reduction/TORE) is performed endoscopically, using a special full-thickness suture device (Apollo Overstich(r), Austin, TX, USA); B) a special overtube is inserted to prevent esophageal damage; C) the enlarged gastrojejunal anastomosis (around 5 cm) is prepared for sutures using Argon beamer; D) the dilated outlet anastomosis is effectively reduced to less than 9 mm through Overstich(r) sutures.