News and Trends—May 2013

| May 15, 2013

Bariatric Times. 2013;10(5):16–18

Society of American Gastrointestinal and Endoscopic Surgeons Issues Statement on Benefits of Laparoscopic Obesity Surgery
Governor Chris Christie’s Decision to Undergo Procedure Provides Opportunity to Educate Patients
LOS ANGELES, California—Committed to enhancing overall patient well-being, the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) issued a statement on the benefits of laparoscopic obesity surgery. “We echo the NIH consensus that weight loss surgery is the only effective, long-term method for the treatment of obesity while diet management and other systems achieve temporary results,” said Dr. Scott Melvin, Professor and Chief of Gastrointestinal Surgery at Ohio State University and the immediate past President of SAGES. “For the right patients, surgery for obesity is life saving, improves quality of life, and may even reduce healthcare costs over the course of time. New Jersey Governor Chris Christie’s decision to share his experience has provided a valuable opportunity for patients to educate themselves and dialogue with their physicians on such minimally invasive surgical (MIS) procedures,” Dr. Melvin said.
SAGES has been at the forefront of best practices in laparoscopic obesity surgery by researching, developing, and disseminating the guidelines and training for standards of practice in surgical procedures. Both open and laparoscopic bariatric operations are effective therapies for morbid obesity and represent complementary state-of-the-art procedures; however, as is the case with a majority of MIS procedures, recovery is generally faster with MIS and there are less complications.
Patients are encouraged to review the SAGES Patient Information Guidelines for Laparoscopic Surgery for Severe (Morbid) Obesity at http://www.sages.org/publications/patient_information to learn about treatment options, the advantages of laparoscopic obesity surgery and if they would be considered as a candidate for this type of surgery.

American Association of Clinical Endocrinologists Releases New Comprehensive Diabetes Management Algorithm for Treatment of Diabetes and Prediabetes Patients
JACKSONVILLE, Florida—The American Association of Clinical Endocrinologists (AACE) announced the publication of its new comprehensive diabetes management algorithm created to guide primary care physicians, endocrinologists, and other healthcare professionals in the treatment of prediabetes and type 2 diabetes mellitus (T2DM) patients.
Recommendations in the algorithm, published online at https://www.aace.com/files/glycemic-control-algorithm.pdf and in the March/April 2013 issue of the association’s peer-reviewed scientific journal Endocrine Practice, consider the whole patient, the spectrum of risks and complications for the patient, and evidence-based approaches to treatment.
Specifically, the document provides suggestions for treatment prioritization and risk-reduction strategies while addressing the following circumstances and conditions that frequently are precursors to, or are concurrent with, a T2DM diagnosis:
•    Management of diabetes and co-existing diseases or disorders in the prediabetic phase of disease
•    A hierarchy of steps for the management of high blood sugar control using an approach that balances age and comorbidities while minimizing the adverse effects of hypoglycemia and weight gain
•    Complications-centric treatment of the patient with overweight or obesity, as opposed to a body mass index (BMI)-centric approach, including medical and surgical treatments for greater weight loss
•    Management of cardiovascular disease risk factors, hypertension, and hyperlipidemia (high lipid levels) in those patients with prediabetes or T2DM.

Among the algorithm’s key recommendations is that a comprehensive care plan for persons with diabetes must now consider obesity management as an integral part of the overall treatment plan to effectively reduce morbidity, mortality, and disability in the majority of patients with T2DM who are obese.
Also, while suggesting a blood sugar goal of <6.5% as optimal for most diabetes patients if it can be achieved in a safe manner, the algorithm recommends the target be individualized based on numerous factors, such as age, comorbid conditions, duration of diabetes, risk of hypoglycemia, patient motivation and adherence, and life expectancy. Higher targets may be appropriate for some individuals and may change for a given individual over time.
The algorithm includes every FDA-approved class of medications for diabetes and differentiates the choice of therapies based on the patient’s initial A1C.
“This algorithm is a definitive, point-of-care tool for clinicians engaged in the treatment of those who are at risk for or have developed diabetes,” said Alan Garber, MD, PhD, FACE, chair of the algorithm task force and President of AACE. “We have expanded on our previous efforts to address broad-reaching, critical factors that accompany the disease and its treatment.”
“With more than 100 million suffering from diabetes and prediabetes in the United States, there simply are not enough endocrinologists to care for all patients,” he added. “Thus, this algorithm is essential to assist and educate clinicians who are charged with these patients’ care.”
To learn more about the AACE, visit www.aace.com.

Loma Linda University Medical Center utilizes new, innovative system to treat Gastroesophageal Reflux Disease
LOMA LINDA, California—Loma Linda University Medical Center (LLUMC) is the first medical facility in the Inland Empire to utilize the LINX Reflux Management System to treat Gastroesophageal Reflux Disease (GERD). LLUMC is one out of six facilities that offer this specialized procedure in California.
Dr. Marcos Michelotti, a minimally invasive surgeon at Loma Linda University Medical Center, is excited to be able to offer such an innovative technique to those suffering from gastroesophageal reflux. “The LINX system will prove itself beneficial to our patients as it is supported through robust research and will provide economic benefits,” he said.
The LINX System is a small implant comprising interlinked titanium beads with magnetic cores. The magnetic attraction between the beads augments the existing esophageal sphincter’s barrier function to prevent reflux. The device is implanted with a standard, minimally invasive, laparoscopic procedure and is an alternative to the more anatomically disruptive fundoplication, commonly used in surgical anti-reflux procedures.
To read the full press release, visit http://www.prweb.com/releases/prweb2013/4/prweb10636709.htm
For additional information on the LINX system, including pictures and animation visit https://www.dropbox.com/s/112pitawprshvt0/LINX%20Center%20Media%20Kit2.zip
For more information about this procedure at LLUMC, please call 909-558-4000, ext. 43616.

Carefusion Launches New Drainage Products at Society of Interventional Radiology Annual Scientific Meeting
SAN DIEGO, California—–CareFusion Corp., a global medical technology company, introduced three new products to help physicians with the drainage of fluids for patients with ascites and pleural effusions.
The new products were on exhibit in at the 38th Annual Society of Interventional Radiology (SIR) Scientific Meeting being held in New Orleans, April 15 to 17, 2013. Highlighted products included the following:
•    Denver® shunt 15.5 Fr percutaneous access kit (PAK): Denver 15.5 Fr shunts are now available in a procedure tray containing updated components for percutaneous placement. The new procedure tray helps effectively manage refractory ascites patients.
•    New 5 Fr Thora-Para device: A smaller version of CareFusion’s existing 8 Fr Thora-Para device, features an echo-enhanced needle, which improves visualization under ultrasound. The device offers an optimized tip taper and a new surface treatment, shown to minimize insertion force. The catheter offers large, spirally oriented drainage holes that facilitate fast flow rates, which may lead to decreased procedure time.
•    PleurX® Catheter System: The PleurX catheter system is easy to use for managing recurrent pleural effusions and malignant ascites at home. A new supplemental catheter insertion kit will help reduce the amount of fluid leakage during catheter placement. The kit includes an orange stylet designed to occlude the openings in the catheter during placement, and a valved introducer that helps prevent air from entering and fluid from leaking.
More information may be found at www.carefusion.com.

Microline Surgical Launches Enhanced MiSeal Reposable Thermal Ligating System at SAGES 2013 Annual Meeting
BEVERLY, Massachusetts—Microline Surgical, Inc., a manufacturer of reposable instruments for minimally invasive surgery, launched an enhanced version of its MiSeal Reposable Thermal Ligating System at The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) 2013 Scientific Session and Postgraduate Course in Baltimore, Maryland. MiSeal comprises a reusable handle and disposable tips, combining the precision of a fully disposable instrument with the economic benefits and quality of a fully reusable handpiece. Leveraging feedback from surgeons, Microline has redesigned MiSeal to feature a more ergonomic handle that can be locked into position for continuous sealing to minimize fatigue and improve the surgeon’s experience when performing long, complex surgical procedures.
For more information on MiSeal, please visit www.microlinesurgical.com

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