APC (Argon Plasma Coagulation)

APC is another endoscopic procedure for the treatment of weight regain after gastric bypass specifically for patients with a dilated outlet. We currently have the largest experience performing this procedure, having performed over one thousand cases.

What is APC?

APC is a revision procedure, meaning it’s only appropriate for certain patients who’ve already had gastric bypass surgery.

APC is an endoscopic treatment for gastric bypass patients who are struggling with weight regain. Weight regain can happen if the gastric outlet and/or pouch stretches. The gastric outlet is the opening between your gastric pouch and your small intestine. Similar to a laser, APC ablates and scars the tissue around the outlet, making the opening smaller and helping you lose weight.

How is APC performed?

While under sedation without anesthesia, your doctor inserts an endoscope into your digestive tract through the mouth. A catheter is used to apply heat energy around the outlet to make it smaller. APC typically takes less than fifteen minutes and you go home on the same day. APC is a minimally invasive endoscopic procedure, so it doesn’t require any incisions (cuts) on the outside of your body.

How much weight can you expect to lose from APC?

Your expected weight loss can vary with APC, and it likely depends on how much weight was regained after your gastric bypass. Some patients may require more than one session to meet their goal weight.

What is recovery like after APC?

After APC, you are discharged home on the same day and may go back to work the next day. During recovery, you are first prescribed a special liquid meal plan. Over time, you transition to a soft food plan (including easy-to-eat foods, like oatmeal, bananas, and soft-cooked rice) and then return to normal eating.

Are there any additional health benefits to treatment, besides weight loss?

You might experience better health, like improvements in weight-related health conditions. These can include sleep apnea, high blood pressure, type 2 diabetes, fatty liver and dyslipidemia. Dyslipidemia is when you have abnormal amounts of lipids (fats) in your blood. In some cases, these conditions may even resolve completely.

Am I a candidate for APC?

You must have had a previous gastric bypass with a mildly dilated outlet to qualify for this procedure. There are no strict body mass index (BMI) criteria for this procedure.

How do I improve my health before the procedure and prepare for APC?

You can meet with your doctor to ask any questions you may have about APC. We know it can be depressing or discouraging for some patients to regain weight after a gastric bypass procedure. We offer psychological support to patients who are undergoing revision treatments by collaborating with mental health specialists. We also have dieticians who can work with you before and after the procedure to adopt and maintain a healthy lifestyle.

Do you offer long-term weight management support?

Yes. We take a collaborative approach to treatment that combines the expertise of many different specialists, including dietitians and mental health professionals. Our team-based approach helps us offer a very high quality of care.

Which doctors offer APC?

Christopher Thompson, MD, MSc, AGAF, FASGE, FACG
Co-director of Center for Weight Management and Wellness
Director of Endoscopy
Director of Bariatric Endoscopy

Pichamol Jirapinyo, MD, MPH, ABOM
Associate Director of Bariatric Endoscopy
Director of Bariatric Endoscopy Fellowship

How do I schedule an appointment to learn more about APC?

If you would like more information or would like to schedule an appointment with a Brigham doctor, you can call us at 617-525-3597 or fill out our appointment request form.

I’m a physician. How do I refer a patient for treatment?

Physicians who are looking to refer a patient can call 617-525-3597 or email us at brighamweightloss@bwh.harvard.edu.

APC illustration

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