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Exclusive interview

XIX IFSO World Congress: An interview with Michel Gagner

The IFSO 2014 Congress will be taking place at the Palais des Congrès de Montréal in Montréal, Québec, Canada from August 26-30, 2014. Bariatric News looks forward to the meeting with Professor Michel Gagner, Congress President of the XIX IFSO World Congress, who discusses the highlights of this year’s scientific programme from cutting-edge research and world-class plenary sessions to a record number of live surgery cases...

You must be very excited that the IFSO world congress is coming to Montréal?

We are having a great response from our colleagues around the world have had almost 1,000 abstracts, from which we have accepted nearly 20 percent and as a result we have some excellent high quality papers that will be presented in Montréal.

Interestingly, there are very few papers on gastric banding and there will be only one session that will focus on banding and this is certainly a change on previous years. There were also a smaller number of abstracts submitted on gastric plication than we were expecting. In comparison, we have had a higher number of papers on mini gastric bypass. One could conclude that perhaps IFSO is more of a forum for those procedures that are not yet officially accepted or available in the United States.

"We welcome delegates from all over the world to Montréal and to the IFSO’s 19th World Congress." - Michel Gagner

For example, we have more presentations of single anastomosis gastric bypass, sleeve gastrectomy with duodenal jejunal bypass and single-anastomosis duodenal switch. You will not see many of these presentations at the ASMBS meetings. IFSO is certainly a meeting which delegates can witness presentations on procedures that are a deviation from the norm and I think it is important to give these interesting procedures a forum in which they can be analysed and discuss by bariatric and metabolic experts from around the world, and let them just whether they are experimental or worthy of consideration.

This year’s meeting includes a comprehensive postgraduate programme?

There are several postgraduate courses to be held in Montréal, which we believe reflects what delegates want.

There will be a two-day ‘5th International Conference on Sleeve Gastrectomy’, this will include 23 live cases and delegates will see sleeve gastrectomies performed with different techniques, with different tubes and with different instruments. There will also be live revision sleeve cases, cases looking at stenosis, leak repair, hiatal hernia, one-stage band to sleeve, plication to sleeve, as well as ‘banded’ or ring sleeve gastrectomy. In addition, we will also show conversion from bands to sleeve, sleeve to single anastomosis gastric bypass, sleeve to single-anastomosis duodenal switch, as well are the classic procedures such as conversion to Roux-en-Y gastric bypass or duodenal switch.

Professor Michel Gagner, Congress President of the XIX IFSO World Congress

The first day consist of live surgery and lots of discussion, so if delegates are interested in sleeve gastrectomy this is the place to see and discuss the entire spectrum of sleeve gastrectomy in one day – it will be of great interest to all participants.

We will also host a ‘Single Anastomosis Gastric Bypass Course’ and has been organised by the same group who held the First and Second Mini Gastric Bypass Conference in Paris, France, in October 2012 and 2013. They have experts from around the world who will discuss variants of the technique, results, complications, issues comparing the mini- and Roux-en-Y gastric bypass. The course has been well organised and should be attended by those with an interest in the single anastomosis gastric bypass procedure.

We are delighted that Francesco Rubino, Ricardo Cohen and Marco Bueter will be hosting a course on ‘Metabolic Surgery’, designed for practicing bariatric surgeons, integrated health professionals (including basic scientists) and endocrinologists involved in the treatment of type 2 diabetes mellitus (T2DM). The course will examine the mechanisms behind control of T2DM after gastrointestinal operations and well as the rationale behind weight loss independent mechanisms of T2DM control/remission.

We will also have a course on ‘Robotic Bariatric Surgery’ that will include a liver case from Orlando. The concept of Robotic Bariatric Surgery is one that has not yet grabbed the attention of mainstream surgeons so I think the discussion from the course will be interesting.

There will also be a ‘Scientific And Medical Writing Course’, organised by Jane Buchwald, and should be attended by those, perhaps younger surgeons, who wish to learn how to write a medical paper and improve their chances of having their research published in a peer review journal.

The ‘Duodenal Switch: An Introduction to Metabolic Surgery’ course is an introduction to understand the anatomy and physiology of BPD-DS with a sleeve gastrectomy. In Quebec, duodenal-switch is a popular procedure and Canada is one of the few countries in which the procedure has much larger percentage of the total of bariatric procedures performed, and keeps increasing year after year. The team from Quebec will present their 25 year experience of the procedure, and experts from around the world will discuss the technical aspects of the procedure, and there will also be two live duodenal switch cases, a classic duodenal switch procedure and a revision.

"I believe that this year’s programme is the most comprehensive ever witnessed at an IFSO World Congress." - Michel Gagner

Christopher Thompson from Harvard and Manoel Neto from Brazil have designed the ‘Bariatric Endoscopy’ course and will include live broadcasts of bariatric endoscopic procedures , as well as didactic lessons presented by worldwide experts integrating the surgical procedure anatomy, surgical approach and therapeutic endoscopic options and will examine the ‘multi-dimensional’ aspects of these procedures. The course will include live cases including endoscopic sleeve gastroplasty from the Mayo Clinic, POSE procedure, endolumenal duodeno-jejunal bypass, intragastric balloon implant and explant, as well as endoscopic treatment of bariatric surgery complications such as gastric band and RYGB ring erosions, RYGB and sleeve gastrectomy leaks and stenosis.

Last, but not least, we have a course of the principles of obesity management hosted by Arya Sharma and will be an intensive educational experience with a strong emphasis on the practical aspects of obesity management and the role of inter-professional bariatric care.

Wednesday will include the 10th International Bariatric Club Symposium organised by Haris Khwaja, Mervyn Deitel, Manoel Galvão Neto, Ariel Ortiz Lagardele and Tomasz Rogula. They have a very interesting programme with keynote speakers and debates asking whether mini bypass will kill RYGB in ten years and if duodenal switch is the best revisional surgery for weight re-gain after sleeve gastrectomy. In addition, there will also be an experts forum asking when should RYGB be reversed.

There is also a Gore sponsored symposium discussing revisional bariatric surgery entitled ‘Complications and Considerations when Converting Bands to Sleeves and Sleeves to Duodenal Switches’.

At the end of the day, there will be a Welcome reception and we are delighted to have music and act from Montréal’s world famous circus, as well as culinary delights from across our country as we welcome delegates from all over the world to Montréal and to the IFSO’s 19th World Congress.

How you incorporated any new elements to the World Congress this year?

We have decide to have a ‘Meet the Experts Luncheon’ so everyday delegates can meet with experts from around the world and have a one-to-one conversation about difficult cases, ask advice and their opinion, it really is a unique opportunity for attendees to listen to the advice and recommendations of 10-20 experienced surgeons each lunch time.

The Congress will include comprehensive live surgeries with nearly 50 interventions, free WiFi with iPhone and Android applications that give users access to abstracts, programme, schedule, speakers, videos and CME Credits.

Delegates can look forward to more than 20 sessions, what are some of the sessions you are looking forward to?

There are so many sessions that I believe will be interest to delegates, the scientific programme is one of the most comprehensive I have seen and there is something for everyone at the meeting. From nearly 1,000 abstracts submitted, we had a team of over 80 reviewers who in teams of three or four assessed each abstract and marked it accordingly. Of course, the reviewers were blinded to the authors and centres, eliminating possible bias.

The papers with the highest score will be presented in the ‘Top Paper Session’ and will include some high quality randomised studies. We also have six additional video sessions - and for the first time each video was submitted online and reviewed instead of being reviewed via a paper abstract. So the quality, content, sound and appeal of the videos are all of a high quality this year.

On Thursday, we will have sessions on ‘Revisions’, Pre- and post-operative management’, as well as a very good session on ‘Long-term results’ that will witness the outcomes and assessment of a range of procedures from all over the world including Canada, Europe, Mexico and India. We are also delighted to welcome our colleagues from Latin-America who will host an all-day ‘IFSO Latin American Chapter Symposium’

The latest and emerging technologies will be presented and discussed in the ‘Emerging Technologies Session: The Future of Obesity Surgery Symposium’, hosted by Laurent Biertho and Jerome Dargent.

There is also a lot in this year’s programme on ‘Allied Health’ and will include presentations from psychologists, nutritionists and bariatric physicians, as well as sessions hosted by the Canadian Obesity Network.

Ethicon will also be hosting a ‘Metabolic Applied Research Surgery (MARS)’ symposium and will feature updates on what is new from the science of bariatric and metabolic research by Drs Kaplan and Seeley. We have a symposium on ‘Petersen’s and other mesenteric defects’ and this is still a controversial area and a lot of surgeons still do not close them. This session will also include a debate, videos and a Keynote Lecture by Dr Eric De Maria.

There are several sessions on surgery and diabetes and this is reflective on the fact that it is widely accepted that surgery now has a metabolic component. In addition, there is a ‘Roundtable on BPD and DS’ that will ask why one of the most effective procedures are only done in 2% of patients, I am sure we will see some fascinating discussions.  And sessions on 'Sleeve gastrectomy - outcome study, 'Comparative Trials', Management of Complications', Medical management' and 'Health and Economy' sessions.

Thursday will close with a Covidien symposium on ‘SIPS viability as a primary or revision procedure: debate on the efficacy of a single loop DS’, moderated by Ninh Nguyen.

On Friday, we have a session on ‘20 Years Follow-Up Post Bariatric Surgery’, in which Richard Welbourn will present the first report from the IFSO Bariatric Registry Pilot that has over 100,000 patients.

"I would encourage colleagues from around the world to come and visit Montréal, meet old friends and make new ones, join in the debates and discussions, and enjoy all this wonderful city has to offer!" - Michel Gagner

This will be followed by the ‘Mason Lecture: Severe Obesity Is A Congenital Disease – Epigenetic’ by Picard Marceau, and the ‘Scopinaro Lecture: Why Obesity Is A Disease?’ by Arya Sharma. In addition, we have several ‘Honorary Membership Awards’ and this year’s recipients are Shrihari Dhorepatil from India, Lloyd D MacLean from Canada and Lars V Sjostrom from Sweden. This session will be concluded with Luigi Angrisani’s ‘Presidential Address’.

There are many more sessions to follow from ‘Sleeve gastrectomy and GERD’ and ‘Disasters in the OR’ to ‘Genetics and Obesity’. Not forgetting an Apollo Endosurgery symposium on low BMIs, a symposium ‘On Enhanced Recovery After Bariatric Surgery’, a session on ‘Ileal Interposition As An Option: Physiology, Pathophysiology, Technique, Clinical Trends’, a session on the ‘Management Of Barrett’s In Patients Having Bariatric Surgery', as well as more video and poster sessions.

On the Friday evening, we will also have the Gala Dinner with a cocktail reception and a ‘Montréal Jazz Festival evening’ with live jazz band and singers, a 3-course plated dinner with wines, an award ceremony, ending with fabulous music and dancing. I hope many delegates will attend and enjoy a fantastic evening at the Arsenal, a contemporary art exposition gallery in Griffintown.

On Saturday, we will have more live surgery from Canadian centres that will show ‘Unusual Situations in Bariatric Surgery’ and ‘Revisional Surgery’.

I believe that this year’s programme is the most comprehensive ever witnessed at an IFSO World Congress. I would encourage colleagues from around the world to come and visit Montréal, meet old friends and make new ones, join in the debates and discussions, and enjoy all this wonderful city has to offer!

The final programme for IFSO 2014, can be viewed here