international federation for the surgery of obesity and metabolic … · 2014. 2. 20. ·...

HELIOSCOPIE Gastric Banding

International Federation for the Surgery of Obesity and metabolic disorders

XII World Congress – Porto, Portugal – 2007

HELIOGAST : Anneau gastrique ajustable

ORAL PRESENTATION

- O32. LAPAROSCOPIC ADJUSTABLE GASTRIC BANDING LOWERS BLOOD PRESSURE

MONTHS AFTER SURGERY H QUACH

- O55. HELIOGAST BAND®: MID- TO LONG-TERM RESULTS IN 2,307 PATIENTS F BELLINI

- O58. LAPAROSCOPIC ADJUSTABLE GASTRIC BANDING: DEALING INTRA-OPERATIVELY

WITH A TIGHT BAND AFTER BAND CLOSURE H QUACH

POSTER

- P64. OUTCOME OF OBESITY-RELATED CO-MORBIDITIES FOLLOWING LAPAROSCOPIC

ADJUSTABLE GASTRIC BANDING: A TWO-YEAR PROSPECTIVE STUDY N SIKAS

- P65. LAPAROSCOPIC ADJUSTABLE GASTRIC BANDING COMBINED WITH OTHER

SURGICAL PROCEDURES N SIKAS

- P77. FIRST RESULTS FROM THE FRENCH MULTICENTRIC STUDY ON HELIOGAST®

GASTRIC BAND S MSIKA

- P86. LAPAROSCOPIC ADJUSTABLE GASTRIC BANDING: PREDICTORS OF LAPAROSCOPIC

OPERATING TIME H QUACH; P DUMBRELL

- P89. NATURAL HISTORY OF CHOLELITHIASIS FOLLOWING LAPAROSCOPIC ADJUSTABLE

GASTRIC BANDING C KARAINDROS

- P91. HELIOSCOPIE (HAGA & HAGE) GASTRIC BAND: OUTCOME AND WEIGHT LOSS

RESULTS 12 MONTHS POST-OPERATIVELY H QUACH; P DUMBRELL


- P96. LAPAROSCOPIC ADJUSTABLE GASTRIC BANDING: SLIPPAGE RATES OF

HELIOSCOPIE HAGA™ VS HAGE™ BANDS H QUACH; P DUMBRELL

- P122. SAFETY OF SHORT-TERM HOSPITALIZATION IN PATIENTS UNDERGOING

LAPAROSCOPIC ADJUSTABLE GASTRIC BANDING C KARAINDROS

Published in : Obesity Surgery, 2007, Volume 17, pages 1023-1068


O32. LAPAROSCOPIC ADJUSTABLE GASTRIC BANDING LOWERS BLOOD PRESSURE MONTHS AFTER SURGERY H. Quach, P. Dumbrell. Victorian & Sydney Obesity Surgery Centre, Australia Background: To study the effect of gastric banding surgery on systolic blood pressure readings. Methods: Data were prospectively collected on 75 patients undergoing laparoscopic gastric banding using the HELIOSCOPIE HAGA™ band between Jan 2005 to Feb 2006. Blood pressure readings (mmHg) were taken preoperatively and between 4-10 months after surgery. Results: *75% of patients experienced a drop in systolic BP (statistically significant), 15% had no change, 10% had a rise. 15% of preoperative patients had high BP (ie. systolic BP >140 mmHg). After surgery only 5% had high BP (not statistically significant). Of the patients with high systolic BP before surgery, 91% had normalized their blood pressure. 83% of patients were reviewed 4-7 months after surgery. 17% were reviewed at 8-10 months. 29% of the population had reported a known history of hypertension. The number of hypertensive patients on medication fell from 64% down to 45% after surgery. This was not found to be statistically significant. Improvements in BP postoperatively were best predicted by preoperative BP(coefficient = -0.583), preoperative age (coefficient=0.269) and %EWL (coefficient= -0.218). Conclusion: Gastric banding lowers systolic blood pressure postoperatively in 75% of all patients at as early as 4 months.


O55. HELIOGAST BAND®: MID- TO LONG-TERM RESULTS IN 2,307 PATIENTS F. Bellini Ospedale Desenzano Del Garda Background: Gastric banding is the most popular restrictive operation for the treatment of morbid obesity in Europe, Australia and South America. We present the outcomes of 2307 Heliogast Band® from experienced centers. Methods: From January 2001 to December 2006 we performed 2,307 Laparoscopic Adjustable Gastric Bands (LAGB). Perigastric “two step” technique, was used in 92% of the patients, while pars flaccida in 8%. Results: Mean age was 41 for female and 40 for male with the range from 16 to 72 years. Preoperative mean BMI was 42.8 for male and 42.5 for female. No intraoperative or postoperative deaths. Conversion rate: 2 (0.08%). Short-term complications: port site infection 14 (0.52%). Long-term complications: slippage: 66 (2,8%), intragastric migration 7 (0.3%), trocar hernias 9 (0.39%), port disconnections 5 (0.21%), port rotation 20 (0.86%), failure to lose weight 14 (0.52%), voluntary band removal 11 (0.47%), leak of the ring 10 (0.43). All major complications were treated laparoscopically. Mean excess weight loss at 48 months was 59.2% for female, 50.3% for male. Conclusion: The study shows that Heliogast Band® in the mid/long term, can achieve EWL >55%, with no mortality, and no major complications. All the complications were treated laparoscopically. Global acceptable short/medium/long term results occurred with 95% of reducing >55% of the EWL and the possibility of conversion to another procedure.


O58. LAPAROSCOPIC ADJUSTABLE GASTRIC BANDING: DEALING INTRA-OPERATIVELY WITH A TIGHT BAND AFTER BAND CLOSURE. H. Quach, P. Dumbrell. Victorian & Sydney Obesity Surgery Centre, Australia Background: The situation of an overly tight band can become apparent during LAGB after the band is closed.We sought to see if unbuckling the band was advantageous in these situations and how easily it could be performed laparoscopically. Methods: Laparoscopic gastric banding was performed on 267 patients using the HELIOSCOPIE HAGA™ band between the period Jan 2005 to Mar 2006. Intra-operative tight bands were identified. In these cases, the band was unlocked (a feature of the HAGA band). Further dissection of the fat pad using the ultrasonic dissector was performed before the band was relocked and routine anterior fixation of the band carried out. Results: 22 patients (8%) with tight bands were identified during surgery. All of them had high Waist-to-Hip ratios and 86% were male patients. All the tight bands encountered were due to a large volume of fat in the perigastric pad on the medial side of the gastro- esophageal junction preventing proximal stomach from being pulled up through the band for placement of gastro-gastric sutures into seromuscular tissue. The HAGA band was able to be easily unlocked laparoscopically. In all cases, an ultrasonic dissector was used for fat pad dissection before the band was relocked and the routine remainder of the operation was carried out. No problems with postoperative obstruction were encountered. Conclusion: A band that can be unbuckled easily laparoscopically is advantageous in this situation.

FIRST RESULTS FROM THE FRENCH MULTICENTRIC STUDY ON HELIOGAST® GASTRIC BAND

S. MSIKA • LOUIS MOURIER HOSPITAL (COLOMBES, France) and the French Multicentric Group [AOUAD, ATROUS, AULAGNIER, BANTI, BENCHETRIT, BERGER, CHABERT, CLARET, DESCOTTES, DUGRE, FAURE, FAYSSE, FELIX,

GELEZ, KOLMER, LETESSIER, MAGNE, MANUCEAU, MARRIE, MARTIN SAINT LEON, MSIKA, PORTET, ROSSI, VOREUX, YAKOUN]

> Introduction:Gastric banding is a known surgical technique for obesity treatment. However, Quality of Life and Comorbidity evaluation are rarely described for this technique. Furthermore, few results are available on prospective evaluation of the Heliogast® Band. This poster shows the preliminary results at 12 months from a french multicentric follow-up study.

> Methods:A prospective study is currently being performed in 25 centres in France to evaluate the effectiveness and the safety of the Heliogast® HAGA and HAGE bands. 250 morbidly obese patients have been included for a 24 months extensive follow up. The main criteria analysed is excess weight loss (EWL, %). Secondary criteria record tolerance, complications and quality of life data.

> Patients:250 patients (86% female, 14% male): Mean age: 36.2 years ± 1.3 • Mean BMI: 43.5 kg/m² ± 0.6 • Mean Excess weight: 49.9 kg ± 1.8Medically treated comorbidities: Hypertension (18.8%), Type II diabetes (6.4%), Pain (3.6%)

> Results:Surgery: There was no perioperative complication, no conversion in open surgery and no post-operative deaths during the 250 band placements.Tolerance:Band complications: no erosion, no band migration, 12 pouch dilatations or slippages (3 band removals). Access port site complications: 8Efficacy:

12th World Congress of the International Federation for the Surgery of Obesity Porto (Portugal), 5-8 September 2007

QOL-Comorbidities: The mean number of comorbidities per patient at 12 months was 0.17 versus 0.27 before operation (p<0.005).

> ConClusIon:The population studied was representative of the usual treated patients. After 12 months, Heliogast® bands showed a good efficiency, low complication rate with three band removals. Best efficiency was recorded for patient with BMI comprised between 35 and 45 kg/m2. The self-measured QOL and pain were significantly improved.

TAP-

004

. 09/

08/2

007

-10

0

10

20

30

40

50

60

70

80

90

100

EWL

(%)

Preoperative

Month 1

Month 3

Month 6

Month 12

Month 18

Visit

Oneway Analysis of EWL (%) by Visit: Mean EWL Oneway Analysis of BMI (kg/m2) by Visit: mean BMI

20

30

40

50

BMI (

kg/m

2)

Preoperative

Month 1

Month 3

Month 6

Month 12

Month 18

Visit

-8.5kg/m2± 3.8

47.8%± 3.6

Excess Weight Loss: the e�ect of Initial BMI

-10

0

10

20

30

40

50

60

70

80

90

100

EWL

(%)

Preoperative

Month 1

Month 3

Month 6

Month 12

Month 18

Visit

35-45>45

41.1%± 6.0

51.3%± 4.4

18,8%

12,5%

6,4%4,6% 3,6%

0,0%

0,0%

2,0%

4,0%

6,0%

8,0%

10,0%

12,0%

14,0%

16,0%

18,0%

20,0%

Perc

enta

ge o

f pat

ient

s

Hypertension Type II Diabetes Pain

Evolution of treated Comorbidities

0,34

1,6

4,04

2,02

0

0,5

1

1,5

2

2,5

3

3,5

4

4,5

Mea

ns o

f QO

L or

Pai

n sc

ores

BAROS QOL Score (-3 to 3) Self-measured pain (0-10)

Evolution of Quality of Life

At 1 year, discontinuation of medical treatment for at least1/3 and 1/5 of the patients treated for hypertension or diabetes.

QOL BAROS score was four times better at 1 year than before operation (p<0.0001) as the self measured pain was divided by two (p<0.0001).

Preoperative12 months follow-up

Preoperative12 months follow-up

ADJUSTABLE GASTRIC BAND IN THE MANAGEMENT OF MORBID OBESITY:

OUR EXPERIENCEA.Giovanelli, R.Sacco, L.Bertolani, R.Bonfanti, A.Centurelli

Department of surgery - Bariatric surgery Section,

Humanitas Gavazzeni Hospital

www.gavazzeni.it

210 Intragastric baloon BIB-BAG

12 VLS Gastric bypass

100 VLS Bilio-intestinal bypass

3 VLS Biliopancreatic diversion

1192 VLS ADJUSTABLE GASTRIC BAND

163 the superobese (average BMI 55,2 – range 50-84,6).

78,8%F and 22,2%M (in favour of male in superobesity)

BMI 43,4 (range 31-84,6)

PEW 82,4% (range 28%-232%)

0

10

20

30

40

50

60

PEWL 47,2 56,3 59,5 58,1 56,6 57

1 year 2 years 3 years 4 years 5 years 6 years

Results:BMI from 43,4 to 30,2 (6 years).PEWL: 47,2 (1 year), 56,3 (2 years), 59,5 (3 years),58,1 (4 years), 56,6 (5 years), 57,0 (6 years).Resolution of comorbiditis(OSAS, methabolic syndrome, diabetes,cardiovascular moridity), even if associated to othertherapies.

Midband

(Médical Innovation Développement)

Lap-Band® system (Allergan) Heliogast® HAGA

(Hélioscopie)

Swedish Adjustable Band

(Ethicon Endo-Surgery, Inc.)

Complications: • Death (30 days after) 0,10% (acute heart stroke);

• Pouch dilatation 6,0%, • Erosion/intragastric migration 2,7%;

• Slippage 0,17%; • Port injuries 1,3%;

• Gerd and oesophagitis 4,5% (2 years later); • Leakage 2%

5,7% of band removed (2,7% erosion/migration, 1,1% pouch dilatation, 1,9% personal problems).

Conclusions: BGR is the surgical choice in morbid obese patients with good compliance for dietological and life-

style changement. A careful monitoring by a multidisciplinary team of surgeons, dieticians and psychologists is necessary for the best results. Our experience in using BGR applied to superobese,

procedure-acknowledged and psychologically controlled patients, shown good results and may be a step in the treatment. Mininvasive surgery like BGR, associated with pharmacological treatment in control

of comorbidities should be considered a good choice in methabolic syndrome

HUMANITAS

GAVAZZENI

0

10

20

30

40

50

60

total BMI 43,4 34,7 33 32,2 32,4 32,5 30,2

BMI > 50 54,6 43,4 36,5 34,2 33,5 31,5 31

BMI < 50 41,7 32,8 31,3 27 25 23,2 23

BMI 1 year 2 years 3 years 4 years 5 years 6 years

Bergamo - Italy

guyon

Zone de texte

IFSO 2007 - Porto

THE GASTRIC BAND: TRICKS AND TIPS TO

ACHIEVE SATISFACTORY EWL% AND LOW

PERCENTAGE OF COMPLICATIONS -

F BELLINI (2010)

XV WORLD CONGRESS OF IFSO - Los

Angeles, USA

SIX YEARS EXPERIENCE WITH

ADJUSTABLE GASTRIC BAND. ANALYSIS

OF 1582 CASES – 41 TONNES WEIGHT LOSS

-

N SIKAS (2010)


Angeles, USA

GASTRIC BAND: THE PERIGASTRIC “TWO-

STEP” TECHNIQUE TO PREVENT

POSTERIOR SLIPPAGE. RESULTS AFTER

3492 PATIENTS -

F BELLINI (2010)


Angeles, USA

RESULTS FROM A FRENCH PROSPECTIVE

MULTICENTRIC STUDY OF HELIOGAST

ADJUSTABLE GASTRIC BAND

S. MSIKA (2009)

XIV WORLD CONGRESS OF IFSO - Paris,

France

PRELIMINARY RESULTS WITH THE NEW-

HAGA (HELIOGAST SYSTEM) LAGB: STUDY

WITH FOUR DIFFERENT SURGICAL

TECHNIQUES

P. PIZZI (2009)


France

TREATMENT OF SEVERE OBESITY WITH

ADJUSTABLE GASTRIC BAND. ANALYSIS

OF 1350 CASES – 5 YEAR RESULTS

N. SIKAS (2009)


France

GASTRIC BAND: A MULTICENTRE,

INTERNATIONAL EXPERIENCE WITH THE

HELIOGAST® SYSTEM - THE FIRST 7,205

PATIENTS

F. BELLINI (2009)


France

ARE THE COMPLICATIONS OF THE

GASTRIC BAND RELATED TO THE

SURGEON? THE ITALIAN EXPERIENCE

WITH THE HELIOGAST SYSTEM.

OUTCOMES AFTER 3492 BANDS

F. BELLINI (2009)


France

NON-FIXED LAPAROSCOPICALLY PLACED

GASTRIC BAND: MY EXPERIENCE WITH

THE NEW HELIOGAST HAGA BAND

J. P. VOREUX (2009)


France

Patients2834

in 2 centers1582

3492

in 4 centers

250

in 25 centers154 1350 7205 3492 30

Follow up 87% at 5 years96,6% at

37 months ± 135 years 2 years 6 months 5 years 5 years 5 years 6 months

Mean Age ND 37 ± 11 ND NDMen : 38,7

Women : 40,337 42,2 ND ND

Initial BMI

(kg/m²)

Men : 42,6

Women : 41,945 ± 7

Men : 43,9

Women : 41,943,7

Men : 44,6

Women : 42,145 42,6 42,9 44,3 ± 2

BMI Loss

(kg/m²)ND ND ND

1 year : 8,3

2 year : 10,1ND ND ND ND ND

Final BMI

(kg/m²)ND ND

Men : 30,6

Women : 30,1ND

6 months

Men : 39,1

Women : 36,6

ND

1 year : 34,7

2 years : 32,2

4 years : 29,7

5 years : 29

1 year : 34,4

5 years : 30,8ND

Weight Loss

(kg)ND ND ND ND ND ND ND ND ND

Excess WL

(%)

Men : 53,6

Women : 55,1

1 year : 49%

2 years : 60%

3 & 4 years : 65%

5 & 6 years : 68%

54,51 year : 46%

2 years : 56%

6 months

Men : 27,7

Women : 31,3

1 year : 49%

2 years : 60%

3 years : 65%

4 years : 67%

5 years : 58,61 year : 48,6%

5 years : 56%36,3 ± 9

Other 6,77% poor weight loss

9,5% rate failure at 2 years

(explanted band, lost of follow

up...)

7,08% failure to lose weight

(<25%EWL)

7% failure to lose weight

(<25%EWL)7% failure to lose weight

Total Band

complications (%)5,5 5,5 5,6 ND 0 4,2 3 4,35 0

Slippage /

dilatation (%)4,5 4,3 4,5 9,4 0 3 2,7 3,9 0

Migration

erosion (%)0,5 1 0,5 0 0 1 0,3 0,45 0

Band Removal (%)0,5

(psychological intolerance)ND

0,6

(psychological intolerance)ND 0 ND ND 0,6 0

Band default (%) ND 0,2% band infection ND ND 0 0,2% band infection ND ND 0

Non specific

complications (%)

0,91 % trocar hernia

0,07% conversion

0,13% bleeding

0,13% stroma obstruction

0,11% trocar bleeding

0,1% conversion

1,1% trocar hernias

ND 00,15% bleeding

0,15% stroma obstructionND

1,3% trocar hernia0

Complication site

(%)1,3 ND 1,3 ND 0 ND 2,1 1,28 0

Other1 death due to massive

pulmonary embolism (22days

postoperativly)

1 year : 50% HTA resolved and

80% type 2 diabetes to

1 death (0,07%) due to massive

pulmonary embolism (22days

postoperativly)

4 reoperations

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XV WORLD CONGRESS OF IFSO

Los Angeles, USA

XIV WORLD CONGRESS OF IFSO

Paris, France

HELIOSCOPIE July 2010

Patients

Follow up

Mean Age

Initial BMI

(kg/m²)

BMI Loss

(kg/m²)

Final BMI

(kg/m²)

Weight Loss

(kg)

Excess WL

(%)

Other

Total Band

complications (%)

Slippage /

dilatation (%)

Migration

erosion (%)

Band Removal (%)

Band default (%)

Non specific

complications (%)

Complication site

(%)

Other

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GASTRIC BAND: THE INTERNATIONAL

EXPERIENCE WITH THE HELIOGAST\

SYSTEM -

F. BELLINI (2008)

XIII WORLD CONGRESS OF IFSO - Buenos

Aires, Argentina

PARS FLACCIDA TO PERIGASTRIC “TWO

STEP TECHNIQUE”. NOT A RETURN TO THE

PAST BUT AN EVOLUTION. THE ITALIAN

EXPERIENCE WITH THE HELIOGAST\ BAND

IN 3104 PATIENTS -

F. BELLINI (2008)


Aires, Argentina

ADJUSTABLE GASTRIC BANDING, OUR

EXPERINCE ON 200 PACIENTES, 4 YEAR

AFTER THE SURGERY - J.A.V. CARIM (2008)


Aires, Argentina

LAPAROSCOPIC AND ENDOSCOPIC

SOLUTION IN LAGB COMPLICATIONS

P. PIZZI (2008)


Aires, Argentina

HELIOSCOPIE (HAGA & HAGE) GASTRIC

BAND: OUTCOME AND WEIGHT LOSS

RESULTS 12 MONTHS POST-OPERATIVELY

H. Quach (2007)

12TH WORLD CONGRESS OF IFSO - Porto,

Portugal

OUTCOME OF OBESITY-RELATED CO-

MORBIDITIES FOLLOWING LAPAROSCOPIC

ADJUSTABLE GASTRIC BANDING: A TWO-

YEAR PROSPECTIVE STUDY

N. Sikas (2007)


Portugal

HELIOGAST BAND®: MID- TO LONG-TERM

RESULTS IN 2,307 PATIENTS

F. Bellini (2007)


Portugal

FIRST RESULTS FROM THE FRENCH

MULTICENTRIC STUDY ON HELIOGAST®

GASTRIC BAND

S. Msika (2007)


Portugal

6360 3104

200

168 Allergan

32 Heliogast

(147 analyzed)

1980

1905 HAGA Heliogast

75 SAGB Obtech444 200 2307

250

(121 at 12 months)

5 years 5 years 4 years ND 1 year 2 years 4 years 1 year

ND ND ND ND 42 3541 Women

39,9 Men36,2 +/- 1,3

42,2Men : 43,9

Women : 41,945,5 ND ND 44

42,5 Women

42,8 Men43,5 +/-0,6

ND ND ND ND 11,3 ND ND 8,62 +/- 0,34

1 years : 34,4

5 years : 33,4

2 years : Men : 32

Women : 30,2

5 years : Men : 30,6

Women : 30,1

31,6 ND ND ND ND 35,06 +/- 0,5

ND ND ND ND 30 ND ND 23,51 +/- 1,02

1 years : 47,6

5 years : 56

2 years : 55

5 years : 5965,3 ND 60 65

59,2 Women

50,3 Men47,8 +/- 3,6

6,8% failure to lose weight 3,2% failure to lose weight

26,5% lost of follow up at 4

years

8,5% failure to lose weight and

Bypass procedure

3,1 3,7 12,9Heliogast : 2,1 %

Obtech : 21,3%3,4 4 4 ND

2,3 2,7 9,5Heliogast : 2 %

Obtech : 0 %ND 3 2,8 4,8

0,2 0,3 3,4Heliogast : 0,1 %

Obtech : 21,3 %ND ND 0,3 0

0,60,7

(psychological intolerance)12,2

Heliogast : nd

Obtech : 21,3 %ND ND 0,5 1,2

0 ND ND Obtech : 10,6 % infection ND 1 0,4 ND

0,4 % trocar hernia 0,6% trocar hernia ND ND ND ND ND ND

0,6 0,7 NDHeliogast : 1 %

Obtech : 0 %3,4 ND 1,6 3,2

0,07% conversion

0,07% trocar site bleeding

12TH WORLD CONGRESS OF IFSO

Porto, Portugal

XIII WORLD CONGRESS OF IFSO

Buenos Aires, Argentina


Patients

Follow up

Mean Age

Initial BMI

(kg/m²)

BMI Loss

(kg/m²)

Final BMI

(kg/m²)

Weight Loss

(kg)

Excess WL

(%)

Other

Total Band

complications (%)

Slippage /

dilatation (%)

Migration

erosion (%)

Band Removal (%)

Band default (%)

Non specific

complications (%)

Complication site

(%)

Other

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HELIOGAST® BAND: OUR EXPERIENCE

AFTER 1,756 POSITIONINGS.

F Bellini (2006)

11TH WORLD CONGRESS OF IFSO - Sydney,

Australia

SYSTEMATIC FOLLOW-UP RESULTS IN

SUPERIOR WEIGHT LOSS FOLLOWING

LAPAROSCOPIC ADJUSTABLE GASTRIC

BANDING

N Sikas (2006)


Australia

OUTCOMES AFTER LAPAROSCOPIC

ADJUSTABLE GASTRIC BAND, USING SAGB

OBTECH® AND HELIOGAST BAND®

F. Bellini (2006)


Australia


BANDING : LONG-TERM FOLLOW-UP IN A

LARGE SERIES

C. Karaindros (2006)


Australia

“PERIGASTRIC”VERSUS “PARS FLACCIDA”

LAPAROSCOPIC TECHNIQUE: A

COMPARATIVE STUDY USING A NEW

ADJUSTABLE GASTRIC BAND

(HELIOGAST®) AS TREATMENT OF MORBID

OBESITY

G SILECCHIA (2006)


Australia

SAFETY AND EFFECTIVENESS OF


BANDING IN OBESE PATIENTS WITH “LOW”

BODY MASS INDEX.

N SIKAS (2006)


Australia

HELIOSCOPIE (HAGA) GASTRIC BAND :

WEIGHT LOSS RESULTS AND EXPERIENCE

AT ONE YEAR

H.Quach (2006)


Australia

ERMS

EVALUATION DE L’EFFICACITE ET DE LA

SECURITE D’UN ANNEAU GASTRIQUE

AJUSTABLE.

Y. Claret

Le journal de ceoliochirurgie, 2005 ; 55, 68-73

1756

200

Group A : "free" follow up

Group B : regular follow up

75 SAGB Obtech

758 HELIOGAST

2948

100

Group 1 : 50 Perigastric

technique

Group 2 : 50 Pars Flaccida

technique

41 264 497

3 years 1 year ND 4 years 1 year 18 months 3 months 18 months

Men : 39

Women : 41ND ND 43,4

G 1 : 43,4

G 2 : 4339 41 38,4 +/- 11,4

Men : 43,8

Women : 41,6ND ND 43,2

G 1 : 43,3

G 2 : 42,532,5 +/- 1,6 43kg/m² 42,88 +/- 3,7

ND ND ND 13,8 ND ND 11,5 -9,86

ND ND ND ND ND ND ND

6 months : 37

12 months : 34,4

18 months : 33

ND ND ND ND ND ND ND ND

Men : 53

Women : 55

6 months: Group A : 29,2

Group B : 50

1 year: Group A : 36,4

Group B : 68

ND 56 nd1 year : 77 +/- 23

1,5 years : 878 +/- 1161 55,75

1,53% failure to lose weight Weight loss insuffisant in 12.5%

3 ND ND 1,6G 1 : 4

G 2 : 22,4 3,7 10,5

2,80% ND1,33

1,270,7

G 1 : 4

G 2 : 0ND ND 6,1

0,2 ND30,7

0,130,2

G 1 : 0

G 2 : 2ND ND 0

0,62 ND ND NDG 1 : 0

G 2 : 2ND ND 0

0,17% leak ND ND0,2 leak

0,7ND 2,4% leak ND 4,4

0,4% trocar hernia ND1,3

ND

0,54% gastric perforation

0,3% bleedingND ND 4,2 ND

1,88 ND10,7

1,9ND ND ND 2,6 0,8

0,06% conversion

11TH WORLD CONGRESS OF IFSO

Sydney, Australia


HELIOSCOPIE Intragastric Balloon

International Federation for the Surgery of Obesity and metabolic disorders

XII World Congress – Porto, Portugal – 2007

HELIOSPHERE : Ballon intragastrique

POSTER

- P114. AIR FILLED INTRAGASTRIC BALLON (BAG): ITALIAN MULTICENTRIC RESULTS. A. GIOVANELLI

VIDEO - V10. AIR-FILLED INTRAGASTRIC BALLOON FOR OBESITY TREATMENT

MP. GALVAO NETO Published in : Obesity Surgery, 2007, Volume 17, pages 1023-1068

AIR FILLED INTRAGASTRIC BALLON (BAG)

ITALIAN MULTICENTRIC RESULTS *

Humanitas Gavazzeni, BERGAMO

Spedali Civili, BRESCIA

Ospedale DESENZANO DEL GARDA

Ospedale, SESTO S. GIOVANNI

Istituto Clinico Villa Aprica, COMO

Ospedale di CANTU’

Ospedale di MORTARA

C.C. Città di PARMA

Ospedale di MANTOVA

Ospedale S. Agostino, MODENA

Ospedale di PISTOIA

Clinica Ruschi, NAPOLI

Asl, NAPOLI

Azienda Ospedaliera Federico II, NAPOLI

A.Giovanelli, R.Sacco, L.Bertolani, A.CenturelliDepartment of surgery - Bariatric surgery Section, Humanitas Gavazzeni Hospital, Bergamo – Italy - www.gavazzeni.it

67%F 33%M.

Age 37,7 (range 15-67).

BMI: 43,5 (range 29-76),

EW: 43,1 Kg (range 14-161)

35% of comorbidity.

37% balloons placement without anaesthesia,

all patients with a multidisciplinary approach,

Removal after 6 months

with endotraqueal intubation.

Italian multicentric* experience with air filled

intragastric balloon (EliosphereBAG) in

350 patients since 2005is reported in a similar

clinical and demographic features group even

before bariatric surgery (IB test) than as unique

bariatric option.

Results

BMI 39,6 (range 25-72)

PEWL 33% (range 2,2-96%)

after 6 months.

Complications1,2% early removal for psychological or physical intolerance23% nausea 4,3% severe vomiting4,3% epigastric pain 6,4% gastric failures0,6% intestinal migration and spontaneous evacuation no death

Results show the same effectiveness on weight loss with a better psychologicaland physical tolerance of air filled BAG confronted with other balloons.

Low incidence of gastric and systemic problems is performed in all our series.

Follow-up role is remarked: carefully monitored by a multidisciplinar team of endoscopists, surgeons, dieticians and psychologists.

Intragastric balloon (air or liquid filled) may not be considered a resolution for morbid obesity in long term but a possible step. In severe overweight bag is a good therapeutic option.

ConclusionsBAG may be a choose in body-weight control.

In morbid obesity the indication are: no-operable patients, gastrorestrictive-test, pre-surgery (especially in superobese).

In severe overweight may be usedas unique treatment. Selection criteria tend to a study a good compliance to a new dietetic life-style.

Policlinico, MONZA

Clinica S. Ambrogio, MILANO

* Sacco R. Giovanelli A. Humanitas Gavazzeni BERGAMO - Mittempergher F. Spedali civili di BRESCIA - Bellini F. Ospedale di DESENZANO DEL GARDA - Faillace G.Iollo P. Ospedale SESTO SAN GIOVANNI - Pizzi P. Lochis D. Policlinico di MONZA - Bottani G. Gerosa E. Ospedale di MORTARA - Brenna A. Scarpis M. Istituto Clinico Villa Aprica COMO – Azzola M.

Rovelli Ospedale di CANTU’- Micheletto G. Di Prisco F. Clinica S. Ambrogio MILANO – Palandri P. Torelli Ospedale di PISTOIA – Mechery F. Olivetti G.P. Ospedale S. Agostino di MODENA – Francia L. Ospedale di MANTOVA – Nicolì F. USSL 8 Montebelluna – De Lorenzi GF. Casa di Cura PARMA – Forestieri P. AO universitaria Federico II NAPOLI – Del Genio Cl.

Ruschi NAPOLI – Porcini ASL NAPOLI 1

FROM OVERWEIGHT TO SUPER-

OBESITY: THE EFFICACY OF AIR

FILLED BALLOON

A Giovanelli (2009)

14TH WORLD CONGRESS OF

IFSO, Paris, France

GASTRIC BALLOON

EFFICIENCY ON WEIGHT

LOSS (WL) WITH A

MULTIDISCIPLINARY

MEDICAL FOLLOWS UP

V Costil (2009)


IFSO, Paris, France

CARIBBEAN PROSPECTIVE

MULTIDISCIPLINARY STUDY

OF MANAGEMENT OF

OBESITY WITH THE AIR-

FILLED INTRAGASTRIC

BALLOON

R Romney (2009)


IFSO, Paris, France

AIR FILLED BALLOON -

BRAZILIAN MULTICENTRIC

STUDY

M Falcao (2009)


IFSO, Paris, France

AIR-FILLED INTRAGASTRIC

BALOON: A PRE-SURGICAL

DEVICE TO REDUCE BMI AND

MORTALITY BEFORE

GASTRIC BYPASS

A. Giovanelli (2008)


IFSO, Buenos Aires, Argentina

AIR FILLED INTRAGASTRIC

BALLON (BAG) ITALIAN

MULTICENTRIC RESULTS



IFSO, PORTO, Portugal


BALLON (BAG) ITALIAN

MULTICENTRIC RESULTS



IFSO, SYDNEY, AUSTRALIA

HELIOSPHERE

INTRAGASTRIC AIR

BALLOON: OUR INITIAL

EXPERIENCE IN THE

DOMINICAN REPUBLIC

DK Ramirez (2006)



INTRAGASTRIC BALLOON

FOR OBESITY:

COMPARATIVE STUDY WITH

420 PATIENTS: NEW

GENERATION AIRFILLED VS

LIQUID-FILLED.

C Hermida (2006)



TOLERANCE AND EFFICACY

OF AN AIR-FILLED BALLOON

IN NON-MORBIDLY OBESE

PATIENTS: RESULTS OF A

PROSPECTIVE

MULTICENTER STUDY

F. Mion

Obesity Surgery, 2007; 17, 764-

769

PRIMARY EXPERIENCE WITH


BALLOON CONFRONTED TO

LIQUID INTRAGASTRIC

BALLOON LITERATURE

DATA

H. Claudez (2005)

13TH UNITED EUROPEAN

GASTROENTEROLOGY

WEEK, COPENHAGEN,

DENMARK

Patients

583

167with BMI < 35

353 with 35 ≥ BMI > 49

63 with BMI ≥50

137 75 236 882 350 195 64

420

192 Heliosphere

228 BIB

32 32

Follow-up 6 months 6 months 6 months 6 months 6 months 6 months 6 months 8 months 6 months 6 months 6 months

Removal 6 months 6 months 6 months 6 months 6 months 6 months 6 months 8 months 6 months 4 months 6 months

Average age ND ND 37 ± 2 ND 38 (15-67) 38 (15 - 67) 38 ± 10 36 37 (18 - 56) 47 (24 - 60) 35 (18 - 57)

Initial BMI

(kg/m²)ND 33.9 39.4 ± 1.48 34.8 (34-52) ND 43.5 (29 - 76) 41.1 (29 - 72) 38.9 37.7 +/- 4.5 36.8 (30 - 44) 35 (30.1 - 40)

BMI Loss

(kg/m²)

ND

ND

5.88

4.1 5.4 ± 0.7 ND ND ND ND NDND

5 (2 - 9) 3.3 (1.1 - 7.7)

Final BMI

(kg/m²)ND ND ND ND ND 39.6 (25 - 72) 36.6 ± 3.8 32.4 ND 34.6 (25.8 - 50.8) 31.8 (24.6 - 38.1)

Weight Loss

(kg)

12.2 ± 1.1

19.8 ± 1.2

15.9 ± 2.6

10.5 ± 1.5 15.18 ± 1.9 ND ND ND ND 17.2

H: 24.7 +/- 10.9

B :24.3 +/- 9.9

13.1 (6 - 27) 9 (3 - 20)

EWL

(%)

62

51.3

ND

54.7 ± 1.0 42.5 ± 5.4 42 (15-72) ND 33 (2.2 - 96) ND 51 ND 31 (0 - 86.7) 38.6 (10.7 - 114)

Vomitting &

Nausea

(%)

ND> with BIB than with

Héliosphère (p<0.05)ND 35.1 ND

Vomiting : 4.3

Nausea : 23

Vomiting : 4.3

Nausea : 16

H : 12

B : 40

84

Mean time : 3.1 days (1 to

8)

10

Epigastric Pains

(%)ND

> with BIB than with

Héliosphère (NS)7 25 ND 4.3 4.3

H : 8

B : 46

31

80

Epigastric pains (1st

week)

Early removal

(%)<3 ND 0 0.42 ND ND ND ND

H : 0.7

B : 8.1

ND ND

Migration (%) ND ND1

removal > 6 months0 ND 0.6 0 0 ND 0

No migration

No gastrique perforation

Deflation (%) ND ND6.7

removal > 6 months0.85 ND ND ND 0 ND 0

1 spontaneus deflation

(4th month) without

migration

Most related Adverse

events :

nausea. vomiting and

abdominal pains

Mean time : 2.7 days

EF

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