Highlights From the North American Society for the Study of Obesity Annual Meeting: A Physician's View

Raymond A. Plodkowski, MD


December 01, 2003

In This Article

Surgical Interventions and Medical Devices for Weight Loss

For patients who have failed lifestyle modification and medication, the next step usually has been bariatric surgery. However, a study introduced the first efficacy data on a new technology, the Implantable Gastric Stimulator (IGS) (Transneuronix Inc, Mt. Arlington, New Jersey).The IGS does not alter the gastrointestinal anatomy as is seen with bariatric surgery. Shikora and colleagues[32] studied 30 subjects who had laparoscopic implantation of 2 bipolar leads along the lesser curvature of the stomach. Generally, 4 trocars (5-12 mm) were used during the laparoscopic IGS implantation procedure: 1 for the camera, 2 operating ports, and 1 for a liver retractor. After the leads were implanted into the stomach, a pocket (the manufacturer recommends a left lateral suprafascial position) was made for the pulse-generator device. The leads were connected to an electrical generator that was placed under the abdominal skin. The generator was activated 2 weeks after implantation. The amount of electrical stimulation was adjusted for each patient. Settings were chosen so that the amount of stimulation was just lower than the level that caused symptoms. All 30 subjects had successful implantation, and there were no operative complications. The baseline BMI of the subjects was 42 kg/m2. The mean follow-up was 8.7 months, and 80% of patients lost weight. Sixty percent of patients lost over 10% of their excess weight with a mean weight loss of 18.8% of excess.


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