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a-00101                  Dr. Robert RUTLEDGETitle of Paper: RESOLUTION OF DIABETES MELLITUS INLOWER WEIGHT PATIENTS WITH M...
RESOLUTION OF DIABETESMELLITUS IN LOWER WEIGHTPATIENTS WITH MINI-GASTRIC         BYPASS            Robert RUTLEDGE11Direct...
Introduction• Bariatric procedures have been shown to  improve the outcome of Diabetes Mellitus  (DM).
Introduction•   The Mini-Gastric Bypass (MGB)•   includes both a•   Gastric component &•   Bypass component•   Which has b...
Introduction• Studies have shown that the MGB leads to  resolution of Type II DM in up to 95% of  morbidly obese patients•...
Methods:• 6,234 patients underwent MGB  including• 303 DM patients with BMI 21-35.• The MGB operations were  tailored for ...
Tailored MGB?• Think as a General Surgeon  NOT as a Bariatric Surgeon• Antrectomy and Billroth II  Large pouch and 20-50 c...
Tailored MGB• Antrectomy and Billroth II  Large pouch and 20-50 cm bypass• MGB  Small Pouch and Long (200 cm) Bypass
Tailored MGB         For THIN Diabetic• Antrectomy and Billroth II  Large pouch and 20-50 cm bypass• MGB  Small Pouch and ...
Tailored MGB           For THIN Diabetic• Antrectomy and Billroth II  Minimal Weight Loss• MGB  Maximal Weight Loss• Tailo...
Results• 68.9% of patients were female.• Average age 48 + 11.• Follow up 6 to 48 months.• Mean preop weight  97 kg and pos...
Results• DM resolved in 98% and improved in  the remaining patients.• 98% of patients were off all oral  medications.• 15....
Conclusions:• The TAILORERD MGB  particularly well suited for Rx of DM in low  weight patients  Gastric pouch = Larger &  ...
Conclusions• The Mini-Gastric Bypass improves DM  in 95% of obese patients and also leads  to resolution or improvement of...
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Apc a-00101-resolution of diabetes low weight

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Apc a-00101-resolution of diabetes low weight

  1. 1. a-00101 Dr. Robert RUTLEDGETitle of Paper: RESOLUTION OF DIABETES MELLITUS INLOWER WEIGHT PATIENTS WITH MINI-GASTRIC BYPASS Nationality: United States of America Position: Director Department: Surgery Organization: Center For Laparoscopic Obesity Surgery Tel: +1-702 714 0011 E-mail: drr@clos.net
  2. 2. RESOLUTION OF DIABETESMELLITUS IN LOWER WEIGHTPATIENTS WITH MINI-GASTRIC BYPASS Robert RUTLEDGE11Director, Surgery, Center For Laparoscopic Obesity Surgery, United States of America
  3. 3. Introduction• Bariatric procedures have been shown to improve the outcome of Diabetes Mellitus (DM).
  4. 4. Introduction• The Mini-Gastric Bypass (MGB)• includes both a• Gastric component &• Bypass component• Which has been shown to be more effective than either alone.
  5. 5. Introduction• Studies have shown that the MGB leads to resolution of Type II DM in up to 95% of morbidly obese patients• Because of the risks and danger of DM and the success of the MGB in obese diabetic the MGB was offered to lower weight patients.
  6. 6. Methods:• 6,234 patients underwent MGB including• 303 DM patients with BMI 21-35.• The MGB operations were tailored for lower weight patients• Shorter bypass length and Larger gastric pouch
  7. 7. Tailored MGB?• Think as a General Surgeon NOT as a Bariatric Surgeon• Antrectomy and Billroth II Large pouch and 20-50 cm bypass
  8. 8. Tailored MGB• Antrectomy and Billroth II Large pouch and 20-50 cm bypass• MGB Small Pouch and Long (200 cm) Bypass
  9. 9. Tailored MGB For THIN Diabetic• Antrectomy and Billroth II Large pouch and 20-50 cm bypass• MGB Small Pouch and Long (200 cm) Bypass• Tailored MGB: For THIN Diabetic Pouch << than Antrectomy Pouch >> than “Bariatric” MGB Bypass >> than Antrectomy Bypass << than MGB
  10. 10. Tailored MGB For THIN Diabetic• Antrectomy and Billroth II Minimal Weight Loss• MGB Maximal Weight Loss• Tailored MGB Selected for - Min Weight Loss + Foregut Effect
  11. 11. Results• 68.9% of patients were female.• Average age 48 + 11.• Follow up 6 to 48 months.• Mean preop weight 97 kg and post op was 69 kg• Mean weight loss of 27 kg.
  12. 12. Results• DM resolved in 98% and improved in the remaining patients.• 98% of patients were off all oral medications.• 15.2% were taking insulin and all were taken off the insulin by their physicians.
  13. 13. Conclusions:• The TAILORERD MGB particularly well suited for Rx of DM in low weight patients Gastric pouch = Larger & Bypass length = Shorter Weight loss can be customized• Laparoscopic MGB has a beneficial effect on glucose metabolism and serum lipid composition in obese DM patients.
  14. 14. Conclusions• The Mini-Gastric Bypass improves DM in 95% of obese patients and also leads to resolution or improvement of DM in lower weight patients.

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