Lapband Seminar Port Lap Surgery

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Lapband Seminar Port Lap Surgery

  1. 1. Recent advances in surgical treatment for obesity<br />Managing Obesity in Adults“Laparoscopic gastric band surgery, a partnership in sustained weight loss”<br />69 Lake Rd, Port Macquarie NSW<br />Dr George Petrou BSc (Med) MBBS FRACS<br />
  2. 2. Obesity: Definition<br /><ul><li> Imbalance between calorie intake&expenditure
  3. 3. BMI (body mass index) = weight/height2</li></ul> BMI &gt; 25 = overweight (&gt;50% adults) <br /> BMI &gt; 30 = obese (20% adults)<br /> BMI &gt; 35 = severe obesity (8% adults)<br />The most common chronic illness in the Western world<br />
  4. 4. Obesity:Prevalence<br /><ul><li>3.25 million Australians * 2005
  5. 5. 15.1% males
  6. 6. 16.8% females
  7. 7. $3.767 billion </li></li></ul><li>The increase in severe obesity (USA)<br />Sturm R. Arch Intern Med 2003;163(18):2146-8.<br />
  8. 8. Prevalence : Australian trends<br />
  9. 9. The weight problem in Australia today <br /><ul><li>OVERWEIGHTBMI 25 –29.9
  10. 10. Class I BMI 30 –34.9
  11. 11. NORMAL BMI 18.5 –24.9
  12. 12. Class II BMI 35 –39.9
  13. 13. Class III
  14. 14. BMI  40
  15. 15. 4%
  16. 16. 45%
  17. 17. 6%
  18. 18. 33%
  19. 19. 12%
  20. 20. 1:10 of the Australian adult community may have a BMI >35
  21. 21. BEACH 2003-2004 the Australian adult population data consistent with AUSDIAB data</li></li></ul><li>Health Risks and Increased Risk of Mortality<br /><ul><li>Diabetes
  22. 22. Hypertension
  23. 23. Sleep apnea
  24. 24. Depression
  25. 25. Joint pain
  26. 26. Infertility
  27. 27. Cancer
  28. 28. Acid reflux
  29. 29. Asthma
  30. 30. 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.
  31. 31. 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.</li></li></ul><li>Diseases Attributable to Obesity<br /><ul><li>Relative Risk of Developing Certain Diseases Over the Next Decade For Men With BMI >351
  32. 32. 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.</li></li></ul><li>Medical Complications of Obesity1<br /><ul><li>Pulmonary Disease
  33. 33. Abnormal Function
  34. 34. Obstructive Sleep Apnea
  35. 35. Hypoventilation Syndrome
  36. 36. Idiopathic Intracranial Hypertension
  37. 37. Stroke
  38. 38. Cataracs
  39. 39. Nonalcoholic Fatty
  40. 40. Liver Disease
  41. 41. Steatosis
  42. 42. Steatohepatitis
  43. 43. Cirrhosis
  44. 44. Coronary Heart Disease
  45. 45. Diabetes
  46. 46. Dyslipidemia
  47. 47. Hypertension
  48. 48. Severe Pancreatitis
  49. 49. Gall Bladder Disease
  50. 50. Cancer
  51. 51. Breast, Uterus, Cervix,
  52. 52. Colon, Esophagus, Pancreas,
  53. 53. Kidney, Prostate
  54. 54. Gynecologic Abnormalities
  55. 55. Abnormal Menses
  56. 56. Infertility
  57. 57. Polycystic Ovarian Syndrome
  58. 58. Osteoarthritis
  59. 59. Phlebitis
  60. 60. Venous Stasis
  61. 61. Skin
  62. 62. Gout
  63. 63. 1. Obesity OnLine slide presentation. Accessed May 17, 2007. Accessible as slide #5 at http://www.obesityonline.org/slides/slide01.cfm?tk=33.</li></li></ul><li>BMI & death<br />
  64. 64. Does Weight Loss Make a Difference?<br />
  65. 65. Impact of Weight Loss on Risk Factors<br /><ul><li>1
  66. 66. 1
  67. 67. 2
  68. 68. 2
  69. 69. 3
  70. 70. 3
  71. 71. 3
  72. 72. 3
  73. 73. 4
  74. 74. 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.</li></li></ul><li>Short-term Obesity Therapy Does Not Result in Long-term Weight Loss<br /><ul><li>Diet alone
  75. 75. Behavior therapy
  76. 76. Combined therapy
  77. 77. Change in Weight (kg)
  78. 78. 5-YearFollow-up
  79. 79. End ofTreatment
  80. 80. Baseline
  81. 81. 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</li></li></ul><li><ul><li>0
  82. 82. -2
  83. 83. -4
  84. 84. -6
  85. 85. -8
  86. 86. -10
  87. 87. -12
  88. 88. -14
  89. 89. -16
  90. 90. 0
  91. 91. 1
  92. 92. 2
  93. 93. 3
  94. 94. 4
  95. 95. 5
  96. 96. 6
  97. 97. 7
  98. 98. 8
  99. 99. 9
  100. 100. 10
  101. 101. 11
  102. 102. 12
  103. 103. 13
  104. 104. 14
  105. 105. 15
  106. 106. 16
  107. 107. 17
  108. 108. -18
  109. 109. Time (mo)</li></ul>Long-term Weight Loss is Improved with Long-term Maintenance Therapy<br /><ul><li>No maintenance tx
  110. 110. Maintenance tx
  111. 111. Weight Loss (%)
  112. 112. Diet andbehaviormodificationtherapy
  113. 113. P<0.05
  114. 114. I
  115. 115. 18
  116. 116. Source: Perri MG, McAllister DA, Gange JJ, et al.Effects of four maintenance programs on the long-term management of obesity. J Consult Clin Psychol. 1988 Aug;56(4):529-34. </li></li></ul><li>Weight loss sustained with surgery!<br />weight loss<br />%<br />Year<br />
  117. 117. Resolution of Diabetes: Recent Data<br />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&apos;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.<br />
  118. 118.
  119. 119. Most Common Surgical Options <br /><ul><li>The LAP-BAND® System Adjustable Gastric Banding
  120. 120. Gastric Bypass (GBP)
  121. 121. Sleeve Gastrectomy (SG)</li></li></ul><li>The LAP-BAND® System<br />
  122. 122. Am I a candidate for Surgery? <br /><ul><li>OVERWEIGHTBMI 25 –29.9
  123. 123. Class I BMI 30 –34.9
  124. 124. NORMAL BMI 18.5 –24.9
  125. 125. Class II BMI 35 –39.9
  126. 126. Class III
  127. 127. BMI  40
  128. 128. 4%
  129. 129. 45%
  130. 130. 6%
  131. 131. 33%
  132. 132. 12%
  133. 133. 1:10 of the Australian adult community
  134. 134. Potential candidates for surgery
  135. 135. * BMI (Body Mass Index): A measurement of an individual’s weight in relation to height (kg/m2).
  136. 136. BEACH 2003-2004 the Australian adult population data consistent with AUSDIAB data</li></li></ul><li>How much weight will I lose?<br />Slow, gradual weight loss (0.5 kg per week)<br />60% excess weight loss in 2 years <br />Requires life-long commitment to change<br />Requires long-term follow-up<br />
  137. 137. The LAP-BAND® produces similar sustained weight loss as more invasive surgery<br /><ul><li>Weight loss is gradual!
  138. 138. %EWL
  139. 139. Years of Follow Up
  140. 140. O’Brien P, McPhail T, Chaston T, & Dixon J Obes Surg. 2006: 16; 1032-1040.</li></li></ul><li>But how does it work?<br />
  141. 141. The LAP-BAND® System Allows You toTame Your Hunger!<br />
  142. 142. <ul><li>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</li></li></ul><li>The LAP-BAND® System Is Affordable<br />Private health insurance<br />Reimburses cost of LAP-BAND device, theatre staff, time and equipment to do operation<br />Reimburses most of hospital stay<br />There are “out of pocket” specialist fees<br />Can I take out insurance now? YES<br />BAND adjustments- $15 “out of pocket” charge per adjustment<br />
  143. 143. Next Steps<br />If you would like to schedule a consultation to see if the LAP-BAND® System is appropriate for you:<br />Contact our reception (02) 6584 3268<br />69 Lake Rd, Port Macquarie 2444<br />Reception @portlapsurgery.com.au<br />

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