Lapband Seminar Port Lap Surgery
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Lapband Seminar Port Lap Surgery

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    Lapband Seminar Port Lap Surgery Lapband Seminar Port Lap Surgery Presentation Transcript

    • 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 Petrou BSc (Med) MBBS FRACS
    • Obesity: Definition
      • Imbalance between calorie intake&expenditure
      • 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
    • Obesity:Prevalence
      • 3.25 million Australians * 2005
      • 15.1% males
      • 16.8% females
      • $3.767 billion
    • The increase in severe obesity (USA)
      Sturm R. Arch Intern Med 2003;163(18):2146-8.
    • Prevalence : Australian trends
    • The weight problem in Australia today
      • OVERWEIGHTBMI 25 –29.9
      • Class I BMI 30 –34.9
      • NORMAL BMI 18.5 –24.9
      • Class II BMI 35 –39.9
      • Class III
      • BMI  40
      • 4%
      • 45%
      • 6%
      • 33%
      • 12%
      • 1:10 of the Australian adult community may have a BMI >35
      • BEACH 2003-2004 the Australian adult population data consistent with AUSDIAB data
    • Health Risks and Increased Risk of Mortality
      • Diabetes
      • Hypertension
      • Sleep apnea
      • Depression
      • Joint pain
      • Infertility
      • Cancer
      • Acid reflux
      • Asthma
      • 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.
      • 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
      • 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.
    • Medical Complications of Obesity1
      • Pulmonary Disease
      • Abnormal Function
      • Obstructive Sleep Apnea
      • Hypoventilation Syndrome
      • Idiopathic Intracranial Hypertension
      • Stroke
      • Cataracs
      • Nonalcoholic Fatty
      • Liver Disease
      • Steatosis
      • Steatohepatitis
      • Cirrhosis
      • Coronary Heart Disease
      • Diabetes
      • Dyslipidemia
      • Hypertension
      • Severe Pancreatitis
      • Gall Bladder Disease
      • Cancer
      • Breast, Uterus, Cervix,
      • Colon, Esophagus, Pancreas,
      • Kidney, Prostate
      • Gynecologic Abnormalities
      • Abnormal Menses
      • Infertility
      • Polycystic Ovarian Syndrome
      • Osteoarthritis
      • Phlebitis
      • Venous Stasis
      • Skin
      • Gout
      • 1. Obesity OnLine slide presentation. Accessed May 17, 2007. Accessible as slide #5 at http://www.obesityonline.org/slides/slide01.cfm?tk=33.
    • BMI & death
    • Does Weight Loss Make a Difference?
    • Impact of Weight Loss on Risk Factors
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      • 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
      • Behavior therapy
      • Combined therapy
      • Change in Weight (kg)
      • 5-YearFollow-up
      • End ofTreatment
      • Baseline
      • 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
      • 0
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      • -18
      • Time (mo)
      Long-term Weight Loss is Improved with Long-term Maintenance Therapy
      • No maintenance tx
      • Maintenance tx
      • Weight Loss (%)
      • Diet andbehaviormodificationtherapy
      • P<0.05
      • I
      • 18
      • 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.
    • Weight loss sustained with surgery!
      weight loss
      %
      Year
    • 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&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.
    • Most Common Surgical Options
      • The LAP-BAND® System Adjustable Gastric Banding
      • Gastric Bypass (GBP)
      • Sleeve Gastrectomy (SG)
    • The LAP-BAND® System
    • Am I a candidate for Surgery?
      • OVERWEIGHTBMI 25 –29.9
      • Class I BMI 30 –34.9
      • NORMAL BMI 18.5 –24.9
      • Class II BMI 35 –39.9
      • Class III
      • BMI  40
      • 4%
      • 45%
      • 6%
      • 33%
      • 12%
      • 1:10 of the Australian adult community
      • Potential candidates for surgery
      • * BMI (Body Mass Index): A measurement of an individual’s weight in relation to height (kg/m2).
      • 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
    • The LAP-BAND® produces similar sustained weight loss as more invasive surgery
      • Weight loss is gradual!
      • %EWL
      • Years of Follow Up
      • O’Brien P, McPhail T, Chaston T, & Dixon J Obes Surg. 2006: 16; 1032-1040.
    • But how does it work?
    • The LAP-BAND® System Allows You toTame Your Hunger!
      • 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
    • 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