International Federation for the Surgery of Obesity and metabolic disorders XIV World Congress – Paris, France – 2009 HELIOGAST : Anneau gastrique ajustable ORAL PRESENTATION -
O-033 RESULTS FROM A FRENCH PROSPECTIVE MULTICENTRIC STUDY HELIOGAST ADJUSTABLE GASTRIC BAND S. MSIKA
OF
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P-190 ENDOSCOPIC REMOVAL OF ADJUSTABLE GASTRIC BAND (AGB) EROSION. LESSONS LEARNED AFTER 5 YEARS AND 78 CASES GALVAO NETO
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P-221 PRELIMINARY RESULTS WITH THE NEW-HAGA (HELIOGAST SYSTEM) LAGB: STUDY WITH FOUR DIFFERENT SURGICAL TECHNIQUES P. PIZZI
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P-237 TREATMENT OF SEVERE OBESITY WITH ADJUSTABLE GASTRIC BAND. ANALYSIS OF 1350 CASES – 5 YEAR RESULTS N. SIKAS
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P-283 GASTRIC BAND: A MULTICENTRE, INTERNATIONAL EXPERIENCE HELIOGAST® SYSTEM - THE FIRST 7,205 PATIENTS F. BELLINI
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P-287 ARE THE COMPLICATIONS OF THE GASTRIC BAND RELATED TO THE SURGEON? THE ITALIAN EXPERIENCE WITH THE HELIOGAST SYSTEM. OUTCOMES AFTER 3492 BANDS F. BELLINI
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P-290 NON-FIXED LAPAROSCOPICALLY PLACED GASTRIC BAND: MY EXPERIENCE WITH THE NEW HELIOGAST HAGA BAND J. P. VOREUX
WITH THE
Published in : Obesity Surgery, 2009, Volume 19, Number 8, Pages 953-1076
HELIOSCOPIE
Gastric Banding
O-033 Results From a French Prospective Multicentric Study of Heliogast Adjustable Gastric Band Presenter: S. Msika (Hôpital Louis MOURIER , Colombes, France) Co-authors: B. Castel 1, G. Aulagnier 2, S. Benchetrit 3, S. Kolmer 4, R. Portet 5, A. Marrie 6, T. Dugre 7, J. Berger 8, K. Aouad 9 1 Hôpital Louis MOURIER Colombes France; 2 Hôpital Lucien Hussel Vienne France; 3 Hôpital Privé Lyon Mermoz Lyon France; 4 Clinique Saint Sauveur Mulhouse France; 5 Clinique de l’Occitanie Muret France; 6 Clinique du Diaconat Mulhouse France; 7 Centre Hospitalier Camille Guerin Chatellerault France; 8 Centre Hospitalo-universitaire de St Etienne Saint Etienne France; 9 Centre hospitalier de Lagny Lagny sur Marne France Background : Gastric banding is a common surgical technique for obesity treatment. However, few results are available on prospective evaluation of the Heliogast Band. Furthermore Quality of life and comorbidity evaluation are rarely described for this technique. Methods : A prospective study has being performed in 25 french centers to evaluate the effectiveness and the safety of the Heliogast band. 250 morbidly obese patients have been included for 24 months extensive follow-up. The main criteria analysed is excess weight loss (EWL, %). Secondary criteria recorded were comorbidities, tolerance, complications and quality of life data. Result : Preoperative clinical data are 87% women, 13% men: Average weight = 116.9 kg, Average BMI = 43.7, medically treated comorbidities : HTA (16.7%), pain (5.2%), SAS (3.8%). After 12 month follow up, Excess weight loss was (46%), BMI loss (8.3 kg/m). After 24 month follow up, Excess weight loss was (56%), BMI loss (10.1 kg/ m), band related complications: 9.4% (slippage). A per-protocol analysis shows resolution of 50% of HTA and more than 80% of pain and Type 2 diabetes. Thus, self measured articular pain drop off more than 50% after 12 month and 74% after 24 month. Conclusion : The population studied was representative of the usual treated patients. After 24 months Heliogast bands showed a good efficiency, low complication rate with only three band removals. The self-measured QOL and comorbidities were significantly improved.
HELIOSCOPIE
Gastric Banding
P-190 Endoscopic Removal of Adjustable Gastric Band (AGB) Erosion. Lessons Learned After 5 Years and 78 Cases Presenter: M. Galvao Neto (Gastro Obeso Center, Sao Paulo, Brazil) Co-authors: A. Ramos 1, M. Galvao 1, Y. Souza 1, A. Murakami 1, A. Carlo 1, E. Canseco 1, J. Campos 2, A. Escalona 3, M. Falcao 1 1 Gastro Obeso Center Sao Paulo Brazil; 2 Federal University of Pernambuco Recife Brazil; 3 Pontific Catholic University Santiago Chile Background : AGB is one of options on bariatric surgery. One of its complications is the migration into the stomach leading to a revisional procedure in order to remove it. Endoscopic removal is less invasive and seems more logical. Authors present the results of 5y multicentric experience Methods : Between August 2003 and June 2008, 78 AGB between 6 brands (Helioscopie – 13/ Midband - 12/ Lapband - 17/ SAGB – 33 / Maximizer - 1 / AMI – 1) were endoscopically removed from 82 patients (95,1%). 50 (64%) were female, age 25-55y (M=36y). pre-op BMI from 34-50 Kg/m2 (M= 43,2 Kg/m2). BMI at the procedure from 24-41 Kg/m2 (M=31,8 Kg/m2). Maximum weight loss in pos-op varied from 10-65Kg (M=33,8Kg). Migrations occurred in a range of 6-36 m (M=16,3 m). All migrations were discovered by endoscopy and the symptoms leading to diagnostic were pain in 25p(31%), porth infection in 21p(27%), weight regain in 20p(25%) and 12p(15%) patients had their AGB migration discovered in routine endoscopies Result : 63 AGB (85%) were removed in one session. The Lapband was the harder to remove representing more than 80% of the band that needed more than one session to be removed. 4 AGB (5%) were just divided and not able to be removed The procedure time were between 25 and 150 min (M= 55 min). 5 patients (6,4%) had pneumo-peritoneum (3 clinical treat, 1 Verres needle puncture and 1 conversion to laparoscopy) with no mortality Conclusion : Endoscopic AGB removal is a safe and effective procedure granting first choice status
HELIOSCOPIE
Gastric Banding
P-221 Preliminary Results with the New-Haga (Heliogast System) LAGB: Study with Four Different Surgical Techniques Presenter: P. Pizzi (Policlinico Di Monza, Monza, Italy) Co-authors: G. De Lorenzis, A. Alberti, M. Pizzi, G. Mari Policlinico Di Monza, Monza, Italy Background : LAGB is a safe and effective procedure for the menagement of morbid obesity. A different surgical technique could help the surgeons to not increase the complications. Methods : Between September 2008 and Mars 2009, we studied case series of 154 consecutive patients operated with the new-HAGA(Heliogast System) LAGB. We performed four surgical techniques: 1-"pars flacida technique" with anterior fixation; 2-"pars flacida technique" without fixation; 3-"two-step perigastric technique" with anterior fixation; 4-"two-step perigastric technique" without fixation. We consider the intraoperative, early and medium-term complications, BMI and EWL trand. Results : We operated154 patients (27 M and 127 F) with mean age of 38.7 M and 40.3 F (International HAGA results: 39.3 M and 41.2 F). The age range is 18- 53 M and 16-66 F (International results: 16-68 M and 16-71 F). Mean BMI is 44.6 M and 42.1 F (international results: 43.8 M and 41.6 F). Mean BMI evaluation at 3 months (107 pts) is 39.1 M and 36.7 F (International results: 40.2 M and 38.3 F). Mean BMI evaluation at 6 months (39 pts) is 39.1 M and 36.6 F (International results: 37.9 M and 36.8 F). Mean EWL evaluation at 3 months (107 pts) is 17.3 M and 18.1 F (International results: 17.1 M and 17.8 F). Mean EWL evaluation at 6 months (39 pts) is 27.7 M and 31.3 F (International results:27 M and 29 F). No intraoperative, early and medium-term complications. Conclusion : This preliminary study affirms that also the new-HAGA (Heliogast System) LAGB is safe and effective for the treatment of morbid obesity:in particular the BMI and EWL trand at 3 and 6 months is better than old- HAGA LAGB.Subsequent studies are necessary for the results and long-term complications confirmation.
HELIOSCOPIE
Gastric Banding
P-237 Treatment of Severe Obesity with Adjustable Gastric Band. Analysis of 1350 Cases – 5 Year Results Presenter: N. Sikas (Interbalkan Medical Center, Thessaloniki, Greece) Co-authors: I. Goulimaris, G. Kavvadias Interbalkan Medical Center, Thessaloniki, Greece Background: The aim of this study was to determine the long-term results of LAGB in a series of 1350 obese patients. Methods : Between April 2004 and March 2009, 1350 patients have undergone LAGB, all operated by one surgeon in a single center using the Helioscopie band (Heliogast® HAGE). The pars-flaccida technique was used and close follow-up was achieved in 98.5% of patients. Complication rate and weight loss have been prospectively recorded. Result: The mean age of patients was 37 years(range 15-70), mean weight 129 kgs(range 87-265) and mean BMI 45(range 31-75). A family-relationship among patients was observed in 16% of them. The mean hospital stay was 24 hrs, 3% of patients were discharged home the same day. In 6 patients (0.4%) a small stromal tumour was found incidentally. There was 1 mortality (0.07%) from massive pulmonary embolism 22 days postoperatively. Early complications were found in 4 patients (2 cases of bleeding, 2 cases of stoma obstruction). All 4 cases required reoperation. Late complications comprised slippage in 42 patients (3%), erosion 13(1%) and band infection in 3 patients (0.2%). Mean excess weight loss was 49%, 60%, 65% and 67% at 1, 2, 3 and 4 years respectively. Better results were found in patients who visited the clinic regularly and in the group of patients with BMI 31-39. Resolution of comorbidities was seen in the majority of patients. In patients with a complete 2-year follow-up, failure(
