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Rediscovering the wheel in reporting on weight loss and other outcomes after BMS

Publications on outcomes of bariatric metabolic surgeries (BMS) are going through the phase of rediscovering the wheel. Obesity is a life long disease. From the later half of the 70s through the early nineties, the field of BMS was characterised by introduction of surgical procedures that were claimed to be effective and popularised because of observed initial significant weight loss in the first year only to be discarded a few years later because of poor weight loss maintenance and/or significant weight loss regain.

Examining the outcomes from primary and revision banded procedures

At the recent XXV IFSO World Congress, a series of presentations highlighted the benefits of banded gastric bypass and banded sleeve gastrectomy primary procedures and revisional gastric bypass in helping to prevent weight regain.

Large-scale ERP improves outcomes for bariatric surgery patients

A large-scale implementation of a protocol to improve recovery of patients after weight-loss operations was found to reduce rates of extended hospitalisation by almost half at 36 participating accredited bariatric surgery centres in the US. The study compared outcomes of 8,946 bariatric operations before with 9,102 operations that occurred after implementation of the protocol, known as an enhanced recovery program (ERP).

OABG-MGB is an effective option for patients with super-super obesity

One Anastomosis (Mini) Gastric Bypass (OAGB-MGB) is a safe and effective option for management of patients with super obesity (BMI>50kg/m2) and super-super obesity (BMI > 60kg/m2) patients and results in similar or higher %EWL (Excess weight loss) than with other procedures like sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB). Interestingly, they note that the role of tailoring the biliopancreatic limb (BPL) may result in more successful weight loss in the super-obese group, although this requires further research.

Five-year ESG outcomes reveal significant total body weight loss

Endoscopic sleeve gastroplasty (ESG), a relatively new, minimally invasive weight-loss procedure, resulted in significant total body weight loss in the first long-term study to follow patients' progress over five years, according to research - ‘Long-term follow up and outcomes after endoscopic sleeve gastroplasty for treatment of obesity (5-year data)’ (abstract 70) - were presented Digestive Disease Week (DDW) 2019.

Sleeve gastrectomy: A simple operation that is not that simple

Vertical resection of the stomach to reduce the gastric reservoir in the biliopancreatic diversion operation (BPD) was introduced by Hess in order to decrease the incidence of marginal ulcers in that operation and by maintaining the pylorus to also enhance the restrictive effects of the operation and also decrease the incidence of dumping. The volume of the gastric pouch created by Hess was 250-400cc akin to the size of the transverse fundal pouch in the Scopinaro procedure.

RYGB offers better weight loss but higher readmission rates vs LSG

One-year outcomes from over 47,000 Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy procedures has reported that RYGB resulted in a higher rate of patients with total weight loss (TWL) >20% (95.8% vs 84.6%, p<0.001). However, there were no significant differences between the two procedures in the rate of severe complications (2.6% vs 2.4%, p=0.382) and 30-day mortality (0.04% vs 0.03%, p=0.821), although readmission rates were higher post-RYGB (4.3% vs 3.4%, p<0.001).

Endoscopic sleeve gastroplasty well-tolerated, safe and effective in 1,000 patients

Endoscopic sleeve gastroplasty (ESG) appears to be well-tolerated, safe and effective, according to a report from researchers Saudi Arabia, which included 1,000 consecutive patients. The study found that the procedure resulted in significant weight loss occurs during the first 18 months without mortality or significant morbidity, although a minority of patients require revision or reversal during the first year.

Magnetic liver retraction incision-less technique is a safe

Levita Magnetic Surgical System facilitates a safe, reproducible, incision-less technique for port-less intra-abdominal liver retraction during bariatric surgery, according to researchers from Duke University Health System in Durham, NC. The study noted that the device successfully permitted optimal liver retraction during laparoscopic bariatric surgery, facilitating surgical exposure while decreasing the number of abdominal incisions.

Obalon outcomes show 9.9% reduction in total body weight

Clinical data from a large-scale commercial study assessing the safety and efficacy of the Obalon Balloon System, has reported that average weight loss data on patients receiving three balloons and six months of therapy was 21.7lbs, resulting in a 9.9% reduction in total body weight and a 3.5 point decrease in BMI compared to baseline values. The data was presented at the American Society for Metabolic and Bariatric Surgery (ASMBS) Annual Meeting at Obesity Week 2018, by Dr Rachel Moore, bariatric surgeon and weight loss specialist.

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