Posts Tagged ‘ Lap-band ’

Dr. Fusco contributes to article on Intra-Gastric Balloon

April 19, 2012
By Mark Fusco MD

The following article appeared on the Doctors of Weight Loss blog. Intra-gastric balloon

 

The New York Times recently published an article about how obese people are going to Canada to receive the intragastric balloon weight loss device, which is not approved for use in the United States. The intragastric balloon is a small balloon-like device that is inserted in the stomach and is filled with liquid, providing a sense of satiety (fullness). It can be left in the stomach for up to six months. The balloon is appealing to people who have a significant amount of weight to lose but are not heavy enough to qualify for bariatric surgery, such as gastric bypass surgery or lap band surgery. It is a relatively non-invasive procedure: the balloon is inserted into the stomach endoscopically through the mouth, and then it is removed in another similar procedure after about six months.

While the intragastric balloon is not yet approved by the FDA, several small studies on its safety and effectiveness have been performed in the Unites States. Last year at the American Society for Metabolic and Bariatric Surgery (ASMBS) national meeting, we reported about a session on emerging medical technology, where talks on new concepts, investigational devices, and late-breaking research were presented. The session featured results of a randomized trial, evaluating the safety and efficacy on the intragastric dual balloon in obese patients. The device appeared to be safe and induce some weight loss. Additionally, results of a pilot study were presented, in which patients received an intragastric balloon by swallowing it. The patients in the small study did lose some weight at the very short-term follow up of 30 days.

There is also an on-going clinical trial that may lead to FDA approval, but many Americans are not willing to wait for the device. According to the article, Americans account for nearly a third of patients undergoing the procedures in Canadian clinics just across the border. However, while the procedure is not as invasive as surgical options, there are several potential complications–-ranging from nausea and vomiting, ulcers and infections, to life-threatening issues like obstruction and stomach perforation. Additionally, weight loss with the balloon has been found to be modest, at best. Research has shown weight loss results ranging from 13–34 pounds on average, with some people losing up to 50 pounds. Weight regain after the device is removed is also a concern. The combination of these potential risks and limited benefit is the primary reason that the intragastric balloon is not approved in the United States. Dr. Robin Blackstone, president of the ASMBS is involved in a clinical trial of the balloon and commented that people “who need to lose a modest amount of weight may do just as well with a more conventional approach, given the risk of complications”. People should understand that successful weight loss with the intragastric balloon requires lifestyle changes, including a better diet and increased physical activity. If these changes are not maintained after the balloon is removed, weight regain will likely occur.

Dr. Mark Fusco, Medical Director of Lifeshape Advanced Bariatics in Florida, bariatric surgeon and an investigator in the largest US study evaluating the intragastric balloon, echos Dr. Blackstone’s statements: “The intragastric balloon is unique among presently available weight loss procedures in that the device is meant to be implanted for only 6 months. This heightens the importance of incorporating very significant dietary, behavioral, and activity changes if patients hope to effect long term weight loss. Only certain patients optimally benefit from this procedure versus nonprocedural or more invasive procedures. It would be nice if US surgeons had this procedure in our armamentarium to offer to patients. In the mean time, I would caution patients to consult with a bariatric surgeon familiar with the procedure prior to undergoing intragastric balloon placement to see if this is a reasonable plan for their particular situation.”

Gut feelings about diabetes

March 30, 2012
By Mark Fusco MD

New research has discovered something surprising: a study in mice found that issues with controlling blood sugar–the hallmark of diabetes–may start in the intestines. It has long been theorized that diabetes begins in the liver or pancreas, but researchers at the Washington University School of Medicine in St. Louis found evidence that may upend long-held theories about the disease’s causes. Sugar is stored in the liver and insulin is produced in the pancreas, so scientists have previously looked to those organs for the underlying causes of diabetes. For the study, researchers studied mice that are unable to make fatty acid synthase (FAS) in the intestines, which is a critical enzyme in the production of lipids. FAS is regulated by insulin, and people with diabetes have defects in FAS.
The findings indicated that the mice without the enzyme in the intestines developed chronic inflammation in the gut, a strong predictor of diabetes. They had lost the protective lining of mucus in the intestines that keeps microbes from direct exposure to cells, allowing bacteria to enter cells in the gut. This made the mice sick, and they experienced weight loss and diarrhea. The lead study author, Xiaochao Wei, PhD, explained that in order to keep the mucus layer intact, fatty acid synthase is required. Bad bacteria will invade cells in the colon and the small intestine without this mucus, creating inflammation which contributes to insulin resistance and diabetes. These findings are in agreement with some of the early signs of diabetes, which are often reports of stomach pain and diarrhea. More research is needed; however, FAS, as well as an important component of the intestinal mucosa called Muc2, might be potential targets for diabetes therapy. The researchers will next study diabetic people to see whether FAS is altered in a way similar to the mice.
Weight loss surgery has been shown in most cases to improve or even resolves diabetes. You can learn more about LifeShape Advanced Bariatric Center of Florida’s comprehensive weight loss program here.

LifeShape Group Fitness Classes

March 19, 2012
By Mark Fusco MD

LifeShape trainer Jessica talks about the LifeShape Fitness “Beginners weight training” and the “H.A.B.I.T” group classes.

Remember Group classes are FREE to LifeShape Lap-Band patients (nominal fee for others).

Contact the fitness center or visit the fitness calendar page for more information.

LifeShape trainer Jessica talks about the LifeShape “Kickboxing” group class

December 29, 2011
By Mark Fusco MD

LifeShape trainer Jessica talks about the “Yogalates” group class

December 29, 2011
By Mark Fusco MD

LifeShape trainer Jessica talks about the “Tip Top Shape” group class

December 29, 2011
By Mark Fusco MD

LifeShape Fitness Video – Walking club

December 29, 2011
By Mark Fusco MD

LifeShape trainer Jessica talks about the LifeShape Fitness walking club.

Review of the new Allergan smartphone Lap-Band App

September 25, 2011
By Mark Fusco MD

Special guest post by LifeShape patient Sarah R.
Last week Allergan came out with a free app for your smartphone to augment patient support. I asked if any of our patients would like to write a review and Sarah has been nice enough to submit her review.

As an experienced bandster (my 2 year anniversary is 10/26) I know how valuable support has been in my weight loss journey and I’m always looking for new ways to keep me motivated and focused. When I saw Allergan was offering a Lap-Band application for your smart phone (iPhone or Android) I was really excited to check it out.
How to sign up:
The app is available on the website: http://www.lapband.com/en/learn_about_lapband/mobile_app/ or in the iPhone App Store / Android Market depending upon which type of smart phone you own. If you click on the link you can even watch a video about the app. The best part? It’s free! All I did was click the link for my phone type (Android), agree to the terms and the next thing I knew my phone made its little “alert” noise and said my download was complete. The whole process took less than 30 seconds. I was already had a lapband.com user account, if you don’t already have one you’ll need to take a couple of minutes to sign up.
Highlights:
1.) There’s a “My Surgeon” section with your surgeon’s photo and practice contact info. You can also track any upcoming LifeShape appointments by putting them in the calendar section of the app. BONUS: you can pull up Dr. Fusco’s picture anytime you’re feeling tempted and visualize he’s right there watching you as you think about putting that bag of chips in your grocery cart – highly effective!

2.) There’s a surgery checklist section with different categories – you can check off each task as you complete it. Some examples of categories are: “Initiate Lifestyle Changes”, “Grocery Shopping List” and “Prepare Mentally and Emotionally”.

3.) If you struggle with band-friendly healthy recipes you’ll love the “My Recipes” section which has sections for breakfast, lunch and dinner. Each time you click on a recipe you have the option to save it to your “recipe box” for future reference. NOTE: while this is a great feature, please be aware that some of these recipes are not necessarily low calorie. I estimated the calories in one of the protein shake recipes and it added up to about 400 calories!

4.) They have a FAQ section with pre-surgery, during surgery and post-surgery answers to many common questions.

5.) The Weight tracker is probably my favorite section! You can enter your starting weight, current weight and your goal. There’s also a graph option: you can track by 1, 3 or 6 months and see your progress. The only complaint I have is there’s no BMI calculator.
Summary:
After using this app for a few days I have to say I’m very pleased. There are plenty of great tools no matter what stage you are in: pre-op, newly post-op, or several years out from surgery. It’s very user-friendly and easy to download. If you don’t have a smart phone this is a great opportunity to convince your spouse that a new phone really IS necessary for your health :)

New App for smart-phones from Allergan

September 20, 2011
By Mark Fusco MD

Allergan has come out with  a new app for Lap-Band patients to help track there progress. We also reviewed the Lose-it app for the iPhone a while back. (http://www.facebook.com/loseitapp) Of course your weight goal page has some of this same functionality. (www.Wt-Goal.com)

If anyone would like to use the app and review it for us, feel free to post it under the notes section of the facebook page.


LAP-BRAND AP
My Lap-Band Mobile app is here!
Dear greg grimm,
Exciting news! Allergan has launched our first mobile app designed exclusively for our LAP-BAND® weight-loss candidates.
The app, a complementary piece to the My LAP-BAND® Journey website, is simple to navigate and provides an array of motivational tools to keep patients moving toward their LAP-BAND® surgery date.
THIS EXCITING APP FEATURES:
Motivational photo-slimming technology
Answers to questions about the LAP-BAND® System
Complete pre-surgery checklist
Convenient weight tracker
Healthy recipes for any meal
Encouraging patient stories
Instant registration to seminars
Questions to ask the surgeon
Click to watch a video abut the mobile app Providing a mobile app is yet another way we’re demonstrating our commitment to helping patients achieve their weight-loss goals and enhance their lives. Click here to see a video of the LAP-BAND® mobile app in action.To download, search for “My LAP-BAND” in the App StoreSMor Android Market. You can also download it directly fromwww.lapband.com! 

Regards,
The LAP-BAND® Team
DOWNLOAD FOR FREE AT:
lapband App Store Android Market
© 2011 Allergan, Inc., Irvine CA 92612, U.S.A. ® and™ Marks Owned by Allergan, Inc. All rights reserved. 

Important LAP-BAND® System Safety Information

Indications: The LAP-BAND® System is indicated for weight reduction for patients with obesity, with a Body Mass Index (BMI) of at least 40 kg/m2 or a BMI of at least 30 kg/m2 with one or more obesity related comorbid conditions.Contraindications: The LAP-BAND® System is not recommended for non-adult patients, patients with conditions that may make them poor surgical candidates or increase the risk of poor results (e.g., inflammatory or cardiopulmonary diseases,GI conditions, symptoms or family history of autoimmune disease, cirrhosis), who are unwilling or unable to comply with the required dietary restrictions, who have alcohol or drug addictions, or who currently are or may be pregnant.

Warnings: The LAP-BAND® System is a long-term implant. Explant and replacement surgery may be required.
Patients who become pregnant or severely ill, or who require more extensive nutrition may require deflation of their bands.
Anti-inflammatory agents, such as aspirin, should be used with caution and may contribute to an increased risk of band erosion.

Adverse Events: Placement of the LAP-BAND® System is major surgery and, as with any surgery, death can occur. Possible complications include the risks associated with the medications and methods used during surgery, the risks associated with any surgical procedure, and the patient’s ability to tolerate a foreign object implanted in the body. Band slippage, erosion and deflation, reflux, obstruction of the stomach, dilation of the esophagus, infection, or nausea and vomiting may occur. Reoperation may be required.

Rapid weight loss may result in complications that may require additional surgery. Deflation of the band may alleviate excessively rapid weight loss or esophageal dilation.

Important: For full safety information please visit www.lapband.com, talk with your doctor, or call Allergan Product Support at
1-800-624-4261.

CAUTION: Rx only.

Not all contraindications, warnings, or adverse events are included in this brief description.
More detailed Risk Information is available on www.lapband.com or at 1-800-LAPBAND.

App Store is a service mark of Apple Inc. Android is a trademark of Google Inc.

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APC73AN11

 

Dr. Fusco and LifeShape among the first in Florida to offer a new surgical weight loss procedure called Gastric Plication.

June 20, 2011
By Ashley

As many LifeShape patients know, Dr. Mark A. Fusco and the LifeShape team are committed to Laparoscopic Adjustable Gastric band as it remains the safest, least invasive weight loss solution for patients that choose to undergo weight loss surgery. With hundreds of thousands procedures performed worldwide, hundreds of scientific studies confirming its efficacy and safety, the Lap-Band is firmly established as an excellent option to help patients improve their health. Dr. Fusco began LifeShape over eight years ago. Over the years, Dr. Fusco and his team have made numerous improvements to the LifeShape program in an attempt to perfectly tailor the program to meet the needs of Lap-Band patient’s in order to maximize their success. Dr. Fusco and LifeShape will continue to have a strong focus on Lap-Band patients.

Occasionally, for various anatomic reasons, patients are not able to have a band. Or occasionally a band must be removed.  In the past, for this unfortunate minority of patients, subsequent surgical options include gastric bypass, or gastric sleeve resection. Both these operations involve cutting into the stomach, which in a small percentage of patients leads to life threatening intestinal leaks.  In an attempt to decrease the risk of these serious leaks a new procedure has been developed called gastric plication. Gastric plication, also called the gastric pleat, involves folding the stomach into itself to reduce the size of the stomach.

The idea of this procedure is that by decreasing the size of the stomach, patients feel full earlier and have less hunger making it easier to loose weight. Like the band, the procedure is done as an outpatient using minimally invasive techniques. Because of the newness of the procedure there is very limited long-term weight loss data.  The short-term two year weight loss is comparable to gastric sleeve.  Unlike the band, the gastric plication procedure and the sleeve are NOT adjustable.

If you would like to learn about the gastric plication or Lap-band, please contact our office to schedule a consultation appointment or attend one of our free patient information seminars. For upcoming seminar dates and times, please click here.