The Lap-Band The Facts

Why the fuss Obesity is increasing at an alarming rate Co – existing conditions including NIDDM are posing significant problems

Criteria for Surgery BMI > 35 with co-morbidity BMI >40 Exceptions

How does it work?

How is it done

FACTS Low morbidity operation Requires MDT input Adjunct to weight loss – NOT a guarantee Failures – 15-20% of people Average of 50% EWL Loss is slow and steady – 0.5 – 1kg/week Follow up is for life

Roux En Y Gastric Bypass Diabetes 70-80% EWL Higher morbidity

Sleeve gastrecomy

Case study Mrs X Type 2 diabetes and BMI of 46 Long history of diets The Yo-Yo dieter Insulin recently commenced ? Band ? More diets ? Drugs

What next Under went extensive pre-op counselling regarding the lap band Information session GP specialist – close liaison with LMO if abnormal results Dietition Psychologist Surgeon

What Happened Lap Banding Lost 28 kg over 12 months HbA1c – 7.8 pre op to 6.3 and insulin has now stopped Part of a banding support group and she is happy

Diabetes and Lap-Band Recent research (dixon et al.2002) has shown that 64% of people with type 2 diabetes have remission of diabetes after Lap-Band Remission defined as Normal fasting BSL/Insulin level and normal HbA1c Average HbA1c drop from over 12 months

MIOS Multidisciplinary clinic in Boronia Local service Achieving excellent results 85 Lap Bands No major complications Audit Offer alternatives to lap band if appropriate