2nd International MGB
Consensus Conference
Preliminary Data
35 Surgeons, 200 cases/yr
Experience with 7,000 cases/yr
MGB Technique
Opinion of MGB Surgeons
Fear that MGB patients can have
an increased risk of gastric cancer
MGB Surgeons
Non-MGB Surgeons
Non-MGB Surgeons Not
Knowledgeable, Not Well Informed
Non-MGB Surgeons 1 in 4
WRONG
Cognitive Bias: Refuses to Admit Data
that opposes their belief system
• Confirmation bias (also called confirmatory bias
...
Cognitive Bias: Refuses to Admit Data
that opposes their belief system
• Research on “confirmation bias” shows that
people...
Cognitive Bias: Refuses to Admit Data
that opposes their belief system
• Most of us are biased to think of ourselves as
sm...
Fear of the Hot
Dog vs Billroth II
Hot Dog vs Billroth II
Lack of Knowledge
Knowledge of H. Pylori and
Gastric Cancer MGB Surgeons:
Non-MGB Surgeons
25% Error Rate:
Gastic
Band
Sleeve RNY MGB
Number
Cases (#)
29.3 91.7 75.3 272.0
Avg BMI 36.3 44.2 44.6 46.9
Avg Op
Time
(Min.)
35.2 57.4 ...
Gastic
Band
Sleeve RNY MGB
Hosp Stay 1.4 4.5 5.4 4.8
1y DM
Resolve
24.3 72.4 73.7 87.5
PreOp GE
Reflux (%)
13.0 10.9 27.7 ...
Gastic
Band
Sleeve RNY MGB
PreOp
GERD (%)
13.0 10.9 27.7 23.1
PostOp
GE Reflux
20.9 21.2 4.3 7.6
Excess
Weight
Loss (%)
46...
Gastic
Band
Sleeve RNY MGB
EWL (%) 46.1 66.3 68.2 75.2
5yr Wt.
Loss Fail
36.6 24.9 31.1 8.9
Lost >
50% EBW
32.4 61.6 65.5 ...
Fear of Cancer after Bariatric
Surgery
• Esophageal Cancer
–Rising rapidly around the world
–Directly related to ACID Refl...
Sleeve/Band Esophageal
Cancer
Gastic
Band
Sleeve RNY MGB
N/V,
Dyspepsia
25.5 20.7 10.1 6.8
Ulcers % 1.2 0.7 2.7 2.0
SBO (%...
Marginal Ulcer
Gastic
Band
Sleeve RNY MGB
N/V,
Dyspepsia
25.5 20.7 10.1 6.8
Ulcers % 1.2 0.7 2.7 2.0
SBO (%) 0.2 0.1 3.3 0...
Small Bowel Obstruction
Gastic
Band
Sleeve RNY MGB
N/V,
Dyspepsia
25.5 20.7 10.1 6.8
Ulcers % 1.2 0.7 2.7 2.0
SBO (%) 0.2 ...
2nd International MGB Consensus Conference  Preliminary Data
2nd International MGB Consensus Conference  Preliminary Data
2nd International MGB Consensus Conference  Preliminary Data
2nd International MGB Consensus Conference  Preliminary Data
2nd International MGB Consensus Conference  Preliminary Data
2nd International MGB Consensus Conference  Preliminary Data
2nd International MGB Consensus Conference  Preliminary Data
2nd International MGB Consensus Conference  Preliminary Data
2nd International MGB Consensus Conference  Preliminary Data
2nd International MGB Consensus Conference  Preliminary Data
2nd International MGB Consensus Conference  Preliminary Data
2nd International MGB Consensus Conference  Preliminary Data
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2nd International MGB Consensus Conference Preliminary Data

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2nd International MGB Consensus Conference Preliminary Data

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2nd International MGB Consensus Conference Preliminary Data

  1. 1. 2nd International MGB Consensus Conference Preliminary Data
  2. 2. 35 Surgeons, 200 cases/yr Experience with 7,000 cases/yr
  3. 3. MGB Technique
  4. 4. Opinion of MGB Surgeons
  5. 5. Fear that MGB patients can have an increased risk of gastric cancer
  6. 6. MGB Surgeons
  7. 7. Non-MGB Surgeons
  8. 8. Non-MGB Surgeons Not Knowledgeable, Not Well Informed
  9. 9. Non-MGB Surgeons 1 in 4 WRONG
  10. 10. Cognitive Bias: Refuses to Admit Data that opposes their belief system • Confirmation bias (also called confirmatory bias or myside bias) is a tendency of people to favor information that confirms their belief • Confirmation biases contribute to overconfidence in personal beliefs and can maintain or strengthen beliefs in the face of contrary evidence. Poor decisions due to these biases have been found in political and organizational contexts.
  11. 11. Cognitive Bias: Refuses to Admit Data that opposes their belief system • Research on “confirmation bias” shows that people actively avoid evidence or simply shut their ears to anything that opposes their views • When we make mistakes, we must calm the cognitive dissonance that jars our slef view. • People refuse to admit mistakes because it harms their view of them selves as “good” people.
  12. 12. Cognitive Bias: Refuses to Admit Data that opposes their belief system • Most of us are biased to think of ourselves as smart and, therefore, not subject to such biases. This bias (self-deception) prevents us from realizing the confirmation bias. • - so deeply that they transform their own brains? ... Their discussion of confirmation bias, one of the worst breeders of bad ... to information that confirms our beliefs while discounting contrary data)
  13. 13. Fear of the Hot Dog vs Billroth II
  14. 14. Hot Dog vs Billroth II
  15. 15. Lack of Knowledge
  16. 16. Knowledge of H. Pylori and Gastric Cancer MGB Surgeons:
  17. 17. Non-MGB Surgeons 25% Error Rate:
  18. 18. Gastic Band Sleeve RNY MGB Number Cases (#) 29.3 91.7 75.3 272.0 Avg BMI 36.3 44.2 44.6 46.9 Avg Op Time (Min.) 35.2 57.4 109.8 81.3
  19. 19. Gastic Band Sleeve RNY MGB Hosp Stay 1.4 4.5 5.4 4.8 1y DM Resolve 24.3 72.4 73.7 87.5 PreOp GE Reflux (%) 13.0 10.9 27.7 23.1
  20. 20. Gastic Band Sleeve RNY MGB PreOp GERD (%) 13.0 10.9 27.7 23.1 PostOp GE Reflux 20.9 21.2 4.3 7.6 Excess Weight Loss (%) 46.1 66.3 68.2 75.2
  21. 21. Gastic Band Sleeve RNY MGB EWL (%) 46.1 66.3 68.2 75.2 5yr Wt. Loss Fail 36.6 24.9 31.1 8.9 Lost > 50% EBW 32.4 61.6 65.5 71.6
  22. 22. Fear of Cancer after Bariatric Surgery • Esophageal Cancer –Rising rapidly around the world –Directly related to ACID Reflux • Stomach Cancer –Declining rapidly arouoond the world –Almost entirely prevetable
  23. 23. Sleeve/Band Esophageal Cancer Gastic Band Sleeve RNY MGB N/V, Dyspepsia 25.5 20.7 10.1 6.8 Ulcers % 1.2 0.7 2.7 2.0 SBO (%) 0.2 0.1 3.3 0.2
  24. 24. Marginal Ulcer Gastic Band Sleeve RNY MGB N/V, Dyspepsia 25.5 20.7 10.1 6.8 Ulcers % 1.2 0.7 2.7 2.0 SBO (%) 0.2 0.1 3.3 0.2
  25. 25. Small Bowel Obstruction Gastic Band Sleeve RNY MGB N/V, Dyspepsia 25.5 20.7 10.1 6.8 Ulcers % 1.2 0.7 2.7 2.0 SBO (%) 0.2 0.1 3.3 0.2

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