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Predictors of weight loss following endoluminal gastric pouch reduction after failed gastric bypass Elliot R. Goodman, M.D.* ,  David Bodansky, B.Med.Sc., Chiranjiv S. Virk, M.D., Burton Surick, M.D., John L. Holup, D.O., Daniel Rosen, M.D.,  I. Michael Leitman, M.D.,  Julie Ellner, M.D. ,  Sol Silverman *Department of Surgery Beth Israel Medical Center New York, NY
Disclosures ,[object Object],[object Object],[object Object]
Background ,[object Object],[object Object],[object Object],Pories WJ, Swanson MS, MacDonald KG.  Who would have thought it?  An operation proves to be the most effective therapy for adult-onset diabetes mellitus.  Ann Surg  1995;222:339-350.
Background ,[object Object],[object Object],[object Object],Gagner M., et al.  Laparoscopic Reoperative Bariatric Surgery :  Experience from 27 consecutive patients.  Obes Surg, (12) 254-260, 2002.
Background ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Jones KB. Revisional bariatric Surgery-potentially safe and effective.  SOARDS 1 (2005) 599-603
Background ,[object Object],[object Object],[object Object],[object Object]
Complications of Revisional Surgery ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Endoluminal Gastric Pouch Reduction Using StomaphyX (EGPRSx) ,[object Object],[object Object],[object Object],[object Object]
EGPRSx Click to play animation
Objective ,[object Object]
Patients & Methods ,[object Object],[object Object],[object Object],[object Object],[object Object]
EGPRSx ,[object Object],[object Object],[object Object],[object Object],[object Object]
EGPRSx Procedure ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Baseline Characteristics   Means ± SD ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Characteristics Pre and Post GB Means ± SD ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Results Procedure ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Anastomosis Before and After EGPRSx Pre-EGPRSx Post-EGPRSx
Results at 1 Year   Means ± SD (n=109) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],60% achieved at least 15%EBL, 50% RWL, and BMI 35
BMI Trajectory Means ± SEM (n=109)
Three BMI Groups   Means ± SD (n=109) Significant ( P  = 0.01 ) increase of BMI < 35 and decrease of BMI >40
Results - Predictors ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Conclusions   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Weight Loss Comparison Mullady et al (2009) - - 8.8 17 3 Horgan et al (2010) 32.0 18.0 - 96 6 Borao et al (2010) 29.0 18.0 7.9 18 6 ROSE Goodman 32.0 24.0 8.0 109 12 Leitman et al (2010) - - 7.3 64 6 Mikami et al (2010) - 19.5 10.0 6 12 Mikami et al (2010) - 17.0 8.7 14 6 EGPRSx Reference %RWL %EWL WL (kg) n FU (mo)
Mechanism of Weight Loss After EGPRSx ,[object Object],[object Object],[object Object],[object Object]
Lessons Learned ,[object Object],[object Object],[object Object],[object Object],[object Object]

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Latest data on stomaphyx

  • 1. Predictors of weight loss following endoluminal gastric pouch reduction after failed gastric bypass Elliot R. Goodman, M.D.* , David Bodansky, B.Med.Sc., Chiranjiv S. Virk, M.D., Burton Surick, M.D., John L. Holup, D.O., Daniel Rosen, M.D., I. Michael Leitman, M.D., Julie Ellner, M.D. , Sol Silverman *Department of Surgery Beth Israel Medical Center New York, NY
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  • 9. EGPRSx Click to play animation
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  • 17. Anastomosis Before and After EGPRSx Pre-EGPRSx Post-EGPRSx
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  • 19. BMI Trajectory Means ± SEM (n=109)
  • 20. Three BMI Groups Means ± SD (n=109) Significant ( P = 0.01 ) increase of BMI < 35 and decrease of BMI >40
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  • 23. Weight Loss Comparison Mullady et al (2009) - - 8.8 17 3 Horgan et al (2010) 32.0 18.0 - 96 6 Borao et al (2010) 29.0 18.0 7.9 18 6 ROSE Goodman 32.0 24.0 8.0 109 12 Leitman et al (2010) - - 7.3 64 6 Mikami et al (2010) - 19.5 10.0 6 12 Mikami et al (2010) - 17.0 8.7 14 6 EGPRSx Reference %RWL %EWL WL (kg) n FU (mo)
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