★★★★★ 4.9 from 850+ reviews
Transoral outlet reduction · Tijuana and Cancún
TORe (transoral outlet reduction) tightens the stretched connection between your gastric pouch and small intestine through the mouth, with no external incisions. It takes about 60 minutes under general anesthesia.
For people who have had a Roux-en-Y gastric bypass. HSA and FSA accepted.
Free, no-obligation review
A coordinator will contact you about your options and quote, with no commitment.
Prefer to talk? Call (844) 736-3963, available 24/7.
Prefer to talk? Call 24/7 (844) 736-3963
If you’re here, you’ve already done the hard part
You followed the plan and lost the weight. Then, years later, portions got bigger and hunger came back sooner. Over time, the opening between your pouch and small intestine can stretch. When it widens, food empties faster and fullness fades earlier. TORe tightens that opening from the inside, without another operation.
Portions have crept back up.
The full feeling fades quickly.
The scale is moving the wrong way.
Dumping-type symptoms after eating.
These signs can point to a stretched outlet, but only an evaluation that includes an endoscopy can confirm it.
The procedure
| TORe | |
|---|---|
| Approach | Endoscopic, through the mouth |
| External incisions | None |
| Procedure time | About 60 minutes |
| Anesthesia | General |
| Hospital stay | Same-day discharge or one monitored night |
| Anatomy removed | None. Your bypass stays intact |
| Can it be repeated? | Sometimes, after assessment |
Am I a candidate?
TORe is only for people who already have a gastric bypass. It is not used after a gastric sleeve.
People who regain weight after bypass may be candidates when their BMI reaches 30 or more (Johns Hopkins Medicine).
A diagnostic endoscopy confirms the outlet size and rules out ulcers before TORe is done.
Not sure TORe is the right fit? See all gastric bypass revision options.
Results
TORe weight loss is more modest than a first bariatric surgery, and results depend on your diet, activity and follow-up. The outlet can stretch again over time, and some people need a repeat procedure. A 2026 review found more weight loss in people who were further out from their bypass, and its authors say TORe works best as part of long-term weight care.
All-inclusive pricing
One package, one price, with no surprise hospital bills. A deposit reserves your date, and your deposit is valid for two years. Credit cards, HSA and FSA cards, and financing are accepted.
Your team and trip
Every TORe at Renew is performed by Dr. Héctor Pérez, a double board-certified bariatric surgeon, with the Renew endoscopy team. Fly into San Diego for SER Hospital in Tijuana, with pickup and border-crossing help, or fly direct to Hospital Joya Cancún.
Itineraries vary. Your coordinator confirms your schedule before you book flights.
Recovery and safety
Clear liquids sipped slowly. Some nausea and cramping is common.
Full liquids with protein and fluid targets. No heavy lifting.
Pureed, then soft foods as tolerated. Most people are back at desk work within days.
Protein first, controlled portions, bypass vitamins and regular follow-up.
What are the risks of TORe? TORe avoids incisions, but it is still done under general anesthesia. Mild stomach discomfort and nausea are common for a few days. Rarely, bleeding, perforation, infection or narrowing of the outlet can happen. The outlet can also stretch again over time. Risk information from Johns Hopkins Medicine.
Choosing a path after regain
| TORe | Surgical revision | GLP-1 medication | |
|---|---|---|---|
| External incisions | None | Yes | None |
| Requires a prior gastric bypass | Yes | Yes | No |
| Procedure time | About 60 minutes | Longer operating-room surgery | Not applicable |
| Adverse events | 6.5% in a matched study (Dolan et al.) | 29% in the same study | Mostly digestive side effects |
| Ongoing medication | No | No | Usually, to keep the effect |
| At Renew | $8,599 all-inclusive | Not currently offered | GLP-1 program |
Send your bypass history and our team will review it. Virtual consultations are available.
5-star reviews from Google and Facebook. Want to talk with a past patient? Ask your coordinator.
“My bariatric surgeon was amazing; they know what they are doing. They walked me through the whole process and made sure I was prepared. The place where they do the surgery is all modern and clean. I felt safe and well taken care of.”
“This was the best medical health decision we ever made. All of the doctors, nurses and medical staff were so accommodating and really work hard to ensure the patient’s comfort and safety at the hospital.”
“Could not be happier with the treatment and success of the service from Renew. Everything went smoothly and I am 100% satisfied with the results. Zero complications and every member of the staff was pleasant and professional.”
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TORe stands for transoral outlet reduction. A flexible endoscope is passed through your mouth and stitches are placed around the stretched opening between your pouch and small intestine, tightening it to about 8 to 10 mm. There are no external incisions and nothing is removed.
People who have had a Roux-en-Y gastric bypass and are regaining weight, typically with a stretched outlet confirmed on endoscopy. Johns Hopkins notes candidates may qualify when their BMI reaches 30 or more.
TORe at Renew Bariatrics is $8,599 all-inclusive, covering the endoscopy team, anesthesia, the suturing device, a diagnostic endoscopy, labs, your room, hotel, transportation and aftercare. Airfare is not included.
Results are more modest than a first bariatric surgery. A 2026 review of 25 studies found average total weight loss of 8.0% at 1 year and 7.7% at 2 years, falling to 4% at 3 years. The authors say TORe works best as part of long-term weight care.
It is done under general anesthesia, so you feel nothing during it. Afterward, mild stomach discomfort and nausea are common for a few days, and your team can give you medication for them.
Most patients are home on day 3 or 4. Some are discharged the same day as the procedure, and others stay one monitored night.
Every TORe at Renew is performed by Dr. Héctor Pérez, at SER Hospital in Tijuana or Hospital Joya Cancún. You choose the location that travels best from your city.
Sometimes. The outlet can stretch again over time, and some people need a repeat procedure after assessment.
Free surgeon review
Tell us when you had your bypass and what has changed, and our team will follow up with your options and quote. No commitment.
Double board-certified surgeons with 9,000+ surgeries.
Prefer to talk? Call 24/7 (844) 736-3963
Free, no-obligation review
Form loading. Prefer to talk? Call (844) 736-3963, available 24/7.
No commitment. A coordinator will contact you.
