Lapband Seminar Port Lapsurgery

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  • 1. Recent advances in surgical treatment for obesity
    Managing Obesity in Adults“Laparoscopic gastric band surgery, a partnership in sustained weight loss”
    69 Lake Rd, Port Macquarie NSW
    Dr George PetrouBSc (Med) MBBS FRACS
    www.portlapsurgery.com.au
  • 2. Obesity: Definition
    • Imbalance between calorie intake&expenditure
    • 3. BMI (body mass index) = weight/height2
    BMI > 25 = overweight (>50% adults)
    BMI > 30 = obese (20% adults)
    BMI > 35 = severe obesity (8% adults)
    The most common chronic illness in the Western world
  • 4. The increase in severe obesity (USA)
    Sturm R. Arch Intern Med 2003;163(18):2146-8.
  • 5. Prevalence : Australian trends
  • 6. The weight problem in Australia today
    • OVERWEIGHTBMI 25 –29.9
    • 7. Class I BMI 30 –34.9
    • 8. NORMAL BMI 18.5 –24.9
    • 9. Class II BMI 35 –39.9
    • 10. Class III
    • 11. BMI  40
    • 12. 4%
    • 13. 45%
    • 14. 6%
    • 15. 33%
    • 16. 12%
    • 17. 1:10 of the Australian adult community may have a BMI >35
    • 18. BEACH 2003-2004 the Australian adult population data consistent with AUSDIAB data
  • Health Risks and Increased Risk of Mortality
    • Diabetes
    • 19. Hypertension
    • 20. Sleep apnea
    • 21. Depression
    • 22. Joint pain
    • 23. Infertility
    • 24. Cancer
    • 25. Acid reflux
    • 26. Asthma
    • 27. Calle EE, Michael MJ, Petrelli JM, et al. Body-mass index and mortality in a prospective cohort of US adults. N Eng J Med. 1999;341(15):1097-105.
    • 28. Flegal KM, Graubard, B. I., Williamson, D.F., Gail, M.H. Excess deaths associated with underweight, overweight and obesity. JAMA. April 20, 2005 2005;293(15):1861-1867.
  • Diseases Attributable to Obesity
    • Relative Risk of Developing Certain Diseases Over the Next Decade For Men With BMI >351
    • 29. 1. Lopes HF, Egan BM. Autonomic dysregulation and the metabolic syndrome: Pathologic partners in an emerging global pandemic. Arq Bras Cardiol. 2006;87:489-498.
  • BMI & death
  • 30. Does Weight Loss Make a Difference?
  • 31. Impact of Weight Loss on Risk Factors
    • 1
    • 32. 1
    • 33. 2
    • 34. 2
    • 35. 3
    • 36. 3
    • 37. 3
    • 38. 3
    • 39. 4
    • 40. 1. Wing RR, Koeske R, Epstein LH, et al. Long-term effects of modest weight loss in type II diabetic patients. Arch Intern Med. 1987;147(10):1749-53. 2. Mertens IL, Van Gaal LF. Overweight, obesity, and blood pressure: the effects of modest weight reduction. Obes Res. 2000;8(3):270-8. 3. Blackburn G. Effect of degree of weight loss on health benefits. Obes Res. 1995;3 Suppl 2:211s-216s. 4. Ditschuneit HH, Frier HI, Flechtner-Mors M. Lipoprotein responses to weight loss and weight maintenance in high-risk obese subjects. Eur J Clin Nutr. 2002;56(3):264-70.
  • Short-term Obesity Therapy Does Not Result in Long-term Weight Loss
    • Diet alone
    • 41. Behavior therapy
    • 42. Combined therapy
    • 43. Change in Weight (kg)
    • 44. 5-YearFollow-up
    • 45. End ofTreatment
    • 46. Baseline
    • 47. Source: Wadden TA, Sternberg JA, Letizia KA, et al. Treatment of obesity by very low calorie diet, behavior therapy, and their combination: a five-year perspective. Int J Obes. 1989;13 Suppl 2:39-46
  • Weight loss sustained with surgery!
    weight loss
    %
    Year
  • 48. Resolution of Diabetes: Recent Data
    Pontiroli AE et al. Diabetes Care. 2005;28:2703-2709. Ahroni JH et al. Obes Surg. 2005;15:641-647. Spivak H et al. Am J Surg. 2005;189:27-32. Ponce J et al. Obes Surg. 2004;14:1335-1342. Dixon JB, O'Brien PE. Diabetes Care. 2002;25:358-363. Torquati A et al. J Gastrointest Surg. 2005;9:1112-1118. Skroubis G et al. Obes Surg. 2006;16:488-495. Pories WJ. Presented at: NAASO-The Obesity Society Annual Scientific Meeting; October 20-24, 2006; Boston, Mass. White MA et al. Obes Res. 2004;12:949-955.
  • 49.
  • 50. Most Common Surgical Options
    • The LAP-BAND® System Adjustable Gastric Banding
    • 51. Gastric Bypass (GBP)
    • 52. Sleeve Gastrectomy (SG)
  • The LAP-BAND® System
  • 53. Am I a candidate for Surgery?
    • OVERWEIGHTBMI 25 –29.9
    • 54. Class I BMI 30 –34.9
    • 55. NORMAL BMI 18.5 –24.9
    • 56. Class II BMI 35 –39.9
    • 57. Class III
    • 58. BMI  40
    • 59. 4%
    • 60. 45%
    • 61. 6%
    • 62. 33%
    • 63. 12%
    • 64. 1:10 of the Australian adult community
    • 65. Potential candidates for surgery
    • 66. * BMI (Body Mass Index): A measurement of an individual’s weight in relation to height (kg/m2).
    • 67. BEACH 2003-2004 the Australian adult population data consistent with AUSDIAB data
  • How much weight will I lose?
    Slow, gradual weight loss (0.5 kg per week)
    60% excess weight loss in 2 years
    Requires life-long commitment to change
    Requires long-term follow-up
  • 68. The LAP-BAND® produces similar sustained weight loss as more invasive surgery
    • Weight loss is gradual!
    • 69. %EWL
    • 70. Years of Follow Up
    • 71. O’Brien P, McPhail T, Chaston T, & Dixon J Obes Surg. 2006: 16; 1032-1040.
  • But how does it work?
  • 72. The LAP-BAND® System Allows You toTame Your Hunger!
  • 73.
    • The LAB-BAND® System acts by allowing small meals to satisfy for a long period – You can choose to eat less without becoming hungry. It “Tames Hunger” providing a tool you can work with to allow significant weight loss
  • The LAP-BAND® System Is Affordable
    Private health insurance
    Reimburses cost of LAP-BAND device, theatre staff, time and equipment to do operation
    Reimburses most of hospital stay
    There are “out of pocket” specialist fees
    Can I take out insurance now? YES
    BAND adjustments- $15 “out of pocket” charge per adjustment
  • 74. Next Steps
    If you would like to schedule a consultation to see if the LAP-BAND® System is appropriate for you:
    Contact our reception (02) 6584 3268
    69 Lake Rd, Port Macquarie 2444
    Reception @portlapsurgery.com.au
    www.portlapsurgery.com.au