UPDATED Preliminary Program: MGB-OA Consensus Conference

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UPDATED Preliminary Program:  
MGB-OA Consensus Conference
*** Optional ***  Added Saturday LIVE Surgery
UPDATED Preliminary Program (Shortened link = http://wp.me/s2Dmx-mccp2 )

** Oct 18: Thursday morning : PUBLISHED DATA ON MGB

–      ***Hand out Voting Questionnaire for Consensus Voting***

–      Pr. JM Chevallier Charge to the Meeting; Listen, Learn, Discuss, Vote, Plan
Time: 8 min
Objectives:
1. Why Are We Here: MGB Excellent Therapy – Not Widely Recognized
2. Report of MGB Series: Is MGB Excellent/Best Practice Treatment for Obesity/Metabolic Disease
3. Technical Details of Best Performance of MGB
4. Plan for Adoption and Improvement of MGB around the World

Questions and Answers and Votes from Floor
Time: 8 min
1. Why is MGB not used by everyone
2. What are the Results of MGB
3. What are the Technical Details (Critical Success Factors of the MGB)
4. What Should Be the Next Steps in Adoption of MGB

–      Intro Safwan A Taha; Bariatric Surgery, Where are We Now and Where are We Going
Time: 8 Min
1. 2 min JIB, VBG, RNY, Band, Sleeve, Plication
2. 2 min History of Failure
3. 2 Min Rise of the MGB
4. 2 Min The Future

–      Kamal Mahawar & Dr P Lointer, MGB: Review of Literature on MGB
Time: 8 min
Objectives:
1. Literature Results Non-MGB
2. Review of MGB Series
3. Conclusion of Literature Review
4. Recommendations Based Upon Literature Review

Questions and Answers and Votes from Floor
Time: 8 min
1. Results of Non-MGB Bariatric Surgery is Not Ideal
2. Ideal Bariatric Surgery
3. Results of MGB
4. Recommendations based upon Literature review of MGB

–      Special Guest Presentations:
Dr. Narwaria  Former President Obesity Surg Soc India
My Journey to the MGB / MGB-In India
Time 8 min
1. Who Am I: Successful International leader in Bariatric Surgery
2. Initial Skepticism of MGB
3. Initial Results with MGB
4. Insights into the Mind of an MGB Skeptic

–      Pr. JM Chevallier President Obesity Surg Soc France:
What I know about MGB: 7 years experience
Time 8 min
1. Who Am I: Successful International leader in Bariatric Surgery
2. Initial Skepticism of MGB
3. Initial Results with MGB
4. Insights into the Mind of an MGB Skeptic

Questions and Answers and Votes from Floor
Time: 8 min
1. Why Should Presently Successful Bariatric Surgeons Choose MGB
2. Skepticism of MGB
3. Results of MGB
4. Response to MGB Skeptics

–     Michal Cierny          The Czech Experience (Ulcer & MGB)
Time: 8 min
1. Ulcer after MGB vs RNY
2. PreOp and Post Op Management Prevention
3. Treatment of Gastritis / Ulcer
4. No NSAIDs, Rx H.Pylori, Anti-Acids (PPI’s, H2 Blockers), Bismuth subsalicylate, Yogurt, No Smoking!!, Soda, Coffee, Etoh, Green Tea, Meat, Hand washing, Careful food prep, Safe water source

–     R Weiner :       MGB Results in Germany
Time 8 min
1. Bile Reflux Ulcer after MGB vs RNY
2. PreOp and Post Op Management / Prevention
3. Treatment of Gastritis / Ulcer
4. No NSAIDs, Rx H.Pylori, Anti-Acids (PPI’s, H2 Blockers), Bismuth subsalicylate, Yogurt, No Smoking!!, Soda, Coffee, Etoh, Green Tea, Meat, Hand washing, Careful food prep, Safe water source, *** Endoscopy ***, *** Surgery Revision ***

–      R Rutledge : Rational Choices in Bariatrics, Fear of Gastric Cancer/Marginal Ulcer
Time: 8 min
1. Performance Assessment Tool (What are the criteria of ideal weight loss / metabolic surgery, MGB Nearest to Ideal
2. Confused Surgeons; It is not the Bile that is feared but the Consequences (Cancer, Gastritis, Ulcer)
3. Fear Gastric Cancer
I. Unfounded
II. Fear Held by those with the LEAST Knowledge
4 Ulcer MGB = RNY

Questions and Answers and Votes from Floor
Time: 8 min
1. Ulcers / Gastritis in MGB
2. Ulcers / Gastritis Prevention
3. Ulcers / Gastritis Treatment
4. Surgery for Ulcers / Gastritis

–     Manuel Garcia Caballero:    One Anastomosis Gastric Bypass, Critical Advantages
Time 8 min
1. Bile Reflux After Billroth II
2. Caballero/Carbajo Anti-Reflux Stitch
3. 11 yr Results with OAB
4. Fear Bile Reflux => Do OAB

Questions and Answers and Votes from Floor
Time: 8 min
1. Bile Reflux After MGB
2. Anti-Reflux Stitch (OAB)
Sometimes / Always / Never
3. Rate of bile reflux After MGB
4. Management of Bile Reflux After MGB

–      Mario Musella          The Italian Experience; Technical Details of MGB Best Practice
Time: 8 min
1. Caliber & Length of sleeve
2. Length of Bypass
3. Anastomosis (hand-sewn, mechanical, side to side, end to side,linear stapler, circular stapler, Reinforcement of the staple gastric sleeve line, Reinforcement of the gastric remnant staple line, (seam-guard, peri-strip, fibrin glue, other sealant…) Closure of the stapler access (single layer, double layer, mechanical continuous suture, manual continuous suture, mechanical interrupted stitches, manual interrupted stitches…)
4. Only ONE WAY or Multiple Equally Good Ways to Perform MGB

–     C Peraglie
Time: 8 min
1. Caliber & Length of sleeve
2. Length of Bypass
3. Anastomosis (hand-sewn, mechanical, side to side, end to side,linear stapler, circular stapler, Reinforcement of the staple gastric sleeve line, Reinforcement of the gastric remnant staple line, (seam-guard, peri-strip, fibrin glue, other sealant…) Closure of the stapler access (single layer, double layer, mechanical continuous suture, manual continuous suture, mechanical interrupted stitches, manual interrupted stitches…)
4. Only ONE WAY or Multiple Equally Good Ways to Perform MGB

Questions and Answers and Votes from Floor
Time: 8 min
1. MGB; Technical Details; Critical Success Factors
2. MGB-Sleeve
3. MGB Bypass
4. MGB-Gastro-Jejunostomy

–      Rui Ribeiro              Portugal Experience: Technical Details II: MGB Part 1: Gastric Pouch
Time 8 min

1. Surgeon/Patient Position, Ports Position/Placement,

2. Location of pouch initiation, Skeletonization of lesser curve,

3. Creation of the pouch:

Use of the staple gun, Covidien/Ethicon: Pros & Cons,

Location and angle of first staple cartridge

Cartridge selection: White/Blue/Gold/Green,

Delays: Before and During Staple Gun Firing

4. Wisdom of Old Men:

Fear “Thickness”,

Fear The Tube/Bougie/NC tube

Fear the angle of His

–     Jan Apers                Dutch experience with MGB
Time 8 min
1. Dutch Experience with MGB
2. Running the Bowel, Distance of the bypass, Tailoring the length bypass
3. Leaks after MGB
4. Managing Leaks

Directed Discussion:  Agreements and Controversies
–     Panel: Chevalier, Caballero, Tacchino, Kular, Peraglie, Nawaria, Weiner
–     Moderator/Floor Person: Rutledge
–     Recorders: Musella, Van Den Bossche,

** Thursday afternoon : LONG TERM STUDIES AND OTHER TOPICS

–      Sandeep Aggarwal   Role of MGB vs Other Surgery
Time 8 min
1. Band vs MGB
2. BPD vs MGB
3. RNY vs MGB
4. Sleeve vs MGB

– Dr Jean Cady   : MGB as Rescue for Failed Band
Time 8 min
1. Band is Good choice?
2. Failure Rate (Weight Regain, Reflux) and Leak Rate
3. FU Band and MGB, complications and Weight Loss
4. Band vs MGB;  50% vs 90% Success

–      K S Kular:                 MGB vs Sleeve; A comparison and Prediction of the Future
Time 8 min
1. Sleeve is Good choice for Many
2. Failure Rate (Weight Regain, Reflux) and Leak Rate
3. 3 yr FU Sleeve and MGB, Pouch Dilation and Weight Loss
4. Lee; Sleeve vs MGB,  50% vs 90% Success

–     R Tacchino : MGB and BPD; compare and contrast
Time 8 min
1. BPD is Good choice for Many
2. Failure Rate (Weight Regain, Reflux) and Leak Rate
3. 3 yr FU BPD and MGB, Pouch Dilation and Weight Loss
4. BPD, Band, Sleeve, MGB My Advice and Perspective

–     Dr. Atul N.C Peters   MGB compared to RYGB
Time 8 min
1. RNY is Good choice for Many
2. Failure Rate (Weight Regain, Reflux) and Leak Rate
3. FU RNY and MGB, Bowel Obstruction and Weight Regain
4. RNY, BPD, Band, Sleeve, MGB My Advice and Perspective

– Questions and Answers and Votes from Floor
Time: 8 min
1. Long Term Expectations and Predictions of Band, Sleeve, RNY, BPD Outcomes
2. Long Term MGB Outcomes
3. Band, Sleeve, RNY, BPD vs. MGB Recommendations
Always Choose MGB (Rutledge Doctrine)
Always Choose Band, Sleeve, RNY, BPD
Tailored Approach
When to choose Band, Sleeve, RNY, BPD
When to choose MGB
4. BPD vs. MGB Need for Further Study

–      Emilio Manno,     Long term experience, Complications and Management
1. Italian Experience of MGB
2. Anemia
3. Ulcer
4. Inadequate / Excess Weight Loss / Other Complications

–    Michael Van den Bossche; UK experience with MGB; Complications and Management

Time 8 min

1. UK Experience of MGB
2. Anemia
3. Ulcer
4. Inadequate / Excess Weight Loss / Other Complications

** Friday morning : TIPS and Tricks , COMPLICATIONS and risks

–     K S Kular: How I Came to the MGB; My Path Cannot Be Your Path
Time 8 min
1. Background Leading to Consideration of MGB
2. Data Supporting My Decision to Choose MGB 5 years Ago
3. Struggle to Offer MGB
4. Advice from My Experience

–     Karl-Peter.Rheinwalt Germany Starting/Integrating New MGB Program
Time 8 min
1. Background Leading to Consideration of MGB
2. Data Supporting My Decision to Choose MGB 5 years Ago
3. Struggle to Offer MGB
4. Advice from My Experience

–     Maurizio De Luca   Complication of mini-gastric bypass
Time 8 min
1. My Consideration of MGB
2. My Results of MGB
3. Complications and Outcomes
4. Advice from My Experience

Voting CONSENSUS : QUESTIONS AND ANSWERS
Questionnaire and the answers of the floor
Plans for Future
— IFSO European Chapter
— IFSO 2013 1 day MGB Interest Group
— Paris Oct 2013?
— Excess Funds from Meeting? Use
— International Collaboration and Assistance / Organization and Founding Members and Officers

Bold Database Interface

Optional ADDED Saturday LIVE Surgery
4 Select Surgeons Invited to View Live Surgery in Paris with Dr Jean Cady/DrRutledge
Surgeons and 20 Other Slots Added to Watch Live Streaming Surgery
Meet Following Surgery for Group Discussion
Possible Dinner Meeting to Follow

Gluten Sensitivity and Psoriasis

Think of gluten sensitivity in cases of psoriasis.

Amplify’d from www.ncbi.nlm.nih.gov

Digestion. 2003;68(1):9-12. Epub 2003 Aug 29.

Rapid regression of psoriasis in a coeliac patient after gluten-free diet. A case report and review of the literature.

Addolorato G, Parente A, de Lorenzi G, D’angelo Di Paola ME, Abenavoli L, Leggio L, Capristo E, De Simone C, Rotoli M, Rapaccini GL, Gasbarrini G.

Institute of Internal Medicine, Università Cattolica del Sacro Cuore, Rome, Italy. g.addolorato@tin.it

Abstract

BACKGROUND: Several skin disorders are present in patients affected by coeliac disease (CD) – among them, psoriasis has been described. However, at present the relationship between CD and psoriasis remains controversial since there are few and contrasting data on this topic.

METHOD: Here we describe a case of psoriasis in a CD patient not responding to specific therapies for psoriasis.

RESULT: The regression of skin lesions after gluten-free diet (GFD) was evident in a short time.

CONCLUSION: The present case supports the association between CD and psoriasis and the concept that psoriasis in CD patients can be improved by GFD. Future studies are needed to clarify the possible mechanisms involved in this association.

Read more at www.ncbi.nlm.nih.gov

 

Study by Independent CPA Firm Shows Excellence of MGB

Independent Certified Public Accounting firm assessed the outcomes of over 1,000 MGB patients that were more than 6 months post op.

This independently performed study confirm the excellent results and high levels of patient satisfaction of the Mini-Gastric Bypass.

Amplify’d from clos.net

INDEPENDENT CONFIRMATION OF EXCELLENT RESULTS IN THE MINI-GASTRIC BYPASS 

Background: The initial reported results of the
Mini-Gastric Bypass (MGB) have been remarkably good. 
The purpose of this study was to perform an independent unbiased analysis of the
outcomes.   

Methods: An impartial certified public accounting
(CPA) firm was engaged to independently assess the outcomes of a sample of  MGB
patients. The review consisted of a structured telephone interview performed
between June 4-8 and 11-15, 2001. Of 1,082 MGB patients who were more than six
months after survey, 180 patients  (17%) were randomly selected by the CPA firm
for study.  One patient declined to participate in the study (0.6%.)
The data collection tool used for the survey was created
and the patient selection were performed independently by the CPA firm.

Results: The patients were found to be highly
satisfied. Both preoperative patient desires for
health status improvement and weight loss were consistently satisfied. The
overall satisfaction score was reported by 100% of the patients at a level 5
(range 1-5) the highest level possible.  If the one patient that declined
participation was judged as dissatisfied the overall patient satisfaction rate
would be99.4%. 
All of the patients said they would recommend this surgery to
a friend or a family member and would have the surgery again
.


Patient reported health status before and after
Mini-Gastric Bypass


 


PreOp


PostOp


Diabetes (includes gestational)


23%


 0


Elevated blood sugar


12%


0


Hypertension


87%


12%


Sleep Apnea


30%


0


SOB


26%


7%


Fatigue (ADL)


9%


0


Edema


7%


0


Depression


35%


0

Conclusions: The Mini-Gastric Bypass has been
reported to have a number of very attractive features and excellent outcomes. 
The present independently performed study confirms
previously reported excellent outcomes of patient satisfaction, resolution of
medical illness and weight loss.

The Mini-Gastric Bypass appears to be a straight forward,
safe and highly efficacious method of treating clinically severe obesity.

Read more at clos.net