New Horizons in Gastric Surgery
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Webinar on endoluminal revisional bariatric surgery
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New Horizons in Gastric Surgery
- 1. New Horizons in Bariatric Surgery – endoluminal treatments for weight regain after gastric bypass: Elliot R Goodman MD Bariatric Surgery Service Beth Israel Medical Center New York, NY
- 4. Weight loss trajectory after gastric bypass:
- 7. Endoluminal Gastric Pouch Reduction (EGPR) StomaphyX TM
- 10. Diagram for fasteners H H H H H H
- 11. Endoluminal Gastric Pouch Reduction
- 12. Endoluminal Gastric Pouch Reduction Pre anastomosis Post anastomosis
- 13. Endoluminal Gastric Pouch Reduction Gastro-esophageal Junction
- 14. Fluoroscopic evidence of stomal narrowing after EGPR with Stomaphyx: GJ stoma before EGPR Stoma after EGPR
- 15. Serosa-to-serosa Fusion Full thickness tissue plication and serosa-to-serosa fusion seen in several animal models
- 16. Beth Israel Medical Center results 2008-9 (N=64) 5 (2-10) Median time(years) after Gastric bypass surgery 31.3 Median BMI Post-GB(nadir) 31.3 Median BMI Post-Gastric Bypass (nadir) 48.7 Median BMI Pre-Gastric Bypass 65 Height (inches) 92% female / 8% male Female / Male 47.5 (24-66) Age (years)
- 17. 7(12%) No follow up weight available 14(21%) No. Patients no weight loss 43(67%) No. Patients Weight loss 6(1-13) Median follow up(months) 37.75(25.1-55.2) Median BMI post Stomaphyx 39.85 (25.9-54.9) Median BMI before StomaphyX
- 18. 23(10-40) Median # of fasteners 33%(0-67) Median reduction in gastric pouch length 50 (35-130) Median OR time 15.5(3.3-67) Median weight loss (lbs.) post StomaphyX
- 25. The ROSE Procedure (by USGI):
- 26. Stomal reduction with ROSE: Diameter 2.6cm Diameter 0.5cm
- 27. Stoma/Pouch Reduction Achieved Cases Completed N=112/116 (97%) Mean Final Stomal Diameter 11.5 mm Mean % Stomal Reduction 50% Mean Final Pouch Length 3.3 cm Mean % Pouch Reduction per Case 44% Mean # Total Anchors per Case 5.9 Mean O.R. Time 87 min
- 28. Results-6 Month Weight Loss *based on target BMI 25kg/m 2 6 Month Endpoint (N=96) Mean for Total Registry Max for Individual Subject Weight Loss (kg) 6.5kg 30kg %EWL* 18% 84% % Regained Weight Lost (RWL) 32% 300%
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