He said that the long-term results from LABG had been achieved without any significant technological innovation of the device in the last 20 years
"Low BMI patients are a target population that as metabolic surgeons we need to take care of to prevent future morbid obese patients"
Thursday, September 15, 2016 - 09:21
Owen Haskins - Editor in chief, Bariatric News
Patients who have a BMI30.0-34.0 (class 1) and who are suffering from a significant obesity-related health burden should be offered bariatric surgery, according to Luigi Angrisani, S Giovanni Bosco Hospital, Naples, Italy. In his presentation, ‘Low BMI patients: a target population to take care of to prevent future morbid obese patients, he cited a 2014 a Position Statement from the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) (Obesity Surgery. Bariatric Surgery in Class I Obesity – A Position Statement from the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) 2014), which states:“A clinical decision should be based on a more comprehensive evaluation of the patient’s current global health and on a more reliable prediction of future morbidity and mortality.”
Angrisani added that such a decision should take into account “more than just a patient’s BMI.”
He said that there an array of intragastric balloons (eg.Heliosphere Bag, Reshape Dual-balloon, Orbera, Spatz Adjustable Balloon System) and endoluminal procedures (eg. Apollo Overstitch, POSE and Endobarrier) that have shown weight loss in the short-term however, these devices/procedures have not yet proved long-term efficacy.
In comparison, the LAGB procedure has demonstrated long-term efficacy. Angrisani explained that in his own centre, between January 1996 and December 2015 they have carried out 107 bariatric procedures on obese patients with BMI≤35, and 32 patients received a LAGB. The ten year outcomes from these patients revealed on average patients lost 14kgs and the BMI was reduced from 33.78 to 29.6, with 40.2 average %EWL. Moreover, only three patients (9.3%) had their band removed.
He said that the long-term results from LABG had been achieved without any significant technological innovation of the device in the last 20 years (design, profile, material) or with little evolution of our knowledge in the last 15 years, such as the ability to calculate the ‘neo-pylorus’ diameter at time of band adjustment.
“Despite this lack of knowledge, the LAGB still remains an effective procedure and has demonstrated a high efficacy in low BMI and adolescents patients,” he concluded. “The LAGB has several advantages compared to more invasive procedures such as the absence of mortality and malnutrition, with no need for vitamin supplementation. Low BMI patients are a target population that as metabolic surgeons we need to take care of to prevent future morbid obese patients.”
NDR-UK has launched two innovative new resources, developed by specialist dietetic colleagues at NHS Ayrshire and Arran, Scotland. The comprehensive, 80 page book is designed to support patients before and after gastric sleeve and gastric bypass surgery (not gastric band surgery - for information on this, please see resource 9014).
According to NDR-UK, the recipes have all been tried and tested and are easy to prepare and cook. They are high in protein and low in fat and calories. The ingredients are all easily sourced and the recipes are suitable for all the family. They are divided into breakfasts, soups, lunches, main meals and desserts. There are at least seven recipes in each section (for a week’s meals). All recipes are coded for different consistencies, whether able to be frozen and if vegetarian. The recipes have handy hints and are nutritionally analysed for a small, bariatric sized portion.
"In NHS Ayrshire and Arran we use the recipe books to support our pre-operative practical cooking session. The groups really enjoy these sessions, we find it encourages them to do more home cooking and to increase their awareness of portion sizes and optimal consistencies at different stages post-surgery. They are also really good fun!" said Pam Lindsay, Bariatric Dietitian, University Hospital Ayr, and co-author of 'Recipes for Life'
The book will soon be available to be purchased by the public, advising that is should be used in conjunction with the information given by a Specialist Bariatric Dietitian.
For further information, to view a sample or to order 'Recipies for Life' (9016), please click here
This 16 page booklet is for people preparing for bariatric surgery who need to follow a diet high in protein and low in calories (kcal), carbohydrate and fat for two weeks before their surgery. Three options of the 800kcal diet (often called the 'Liver Shrinkage Diet'): using normal consistency foods, soft/liquid meals or meal replacement drinks.
For further information, to view a sample or to order 'Pre-operative 800kcal diet' (9015), please click here
Irish clients who are assured with Glohealth get their weightloss surgery with Belgium Surgery Services and Dr Chris Debruyne fully reimbursed. Due to our exellent reputation, low(est) rate of complications and Irish back-up network Glohealth and Laya Healtcare both reimburse weightloss surgery with Belgium Surgery Services.
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For more information visit us at our consultation clinics in Dublin, Belfast or Killarney.