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Recap

IFSO 2011: the highlights

Record-breaking number of delegates and exhibitors turn out for international obesity federation's meeting
784 presentations, videos and posters presented over three days
Focus on new techniques, particularly surgical approaches to T2DM

The XVI World Congress of the International Federation for the Surgery of Obesity and metabolicdisorders (IFSO) was held in Hamburg (August 30 – 3 September), under the auspices of the German Society for the Surgery of Obesity of the German Society for Visceral- and General Surgery.

The Congress was officially opened in an opening ceremony by the Congress President, Professor Rudolf A Weiner and IFSO President, Professor Karl Miller. Overall, there were ten plenary sessions, ten symposia, one keynote lecture, six integrated health sessions and consensus conferences and 23 scientific sessions including video sessions allowing participants to focus on key topics including: implications of severe obesity; new technologies; metabolic surgery; controversies with interactive debate; lap revisional surgery; bariatric surgery and the law; and several multidisciplinary symposia.

From 922 submitted abstracts a total of 589 abstracts were presented, this included including 85 videos and 323 posters. The total number of oral presentations, videos and posters) was a record 784.

The IFSO 2011 World Congress reflected the importance of metabolic surgery and began with the postgraduate course. As well as to behavioural and medical approaches, various types of surgery on the gastrointestinal tract and new endoscopic techniques were highlighted. Many of the discussions concerned the ability of these new techniques to resolve diabetes not only in patients with severe obesity, but in patients considered of normal weight.

In addition, there were several presentations focusing on the surgical approaches to type 2 diabetes mellitus (T2DM) that reported how surgery can help in normalise blood glucose levels, thereby reducing or avoiding the need for medications, and providing a potentially cost-effective approach to treating the disease. An interdisciplinary plenary session with endocrinologists focused on research into surgery for the resolution of diabetes as well as looking at the non-weight-loss effects on glucose tolerance.
Awards

Several awards and scholarships were also presented, including: The best posters awards: 1st Poster prize Kirstin Carswell (UK), 2nd Poster prize: James Rink(UK) and 3rd Poster prize (shared by two surgeons with the same ranking in the blind peer review):Conor Magee (UK), Susanne Richter (Germany). Three scholarships were also awarded to the following young surgeons: Maria Dolores Frutos (Spain), Jayashree Todkar (India) and Marco Bueter (Switzerland).

A new concept for the Hamburg meeting was the electronic voting system in all Plenary sessions. The questions were established by the Scientific Committee together with the Chairman and voted on by the audience.

Gastric Plication

A special session focused on Gastric Plication Session and included experts from around the world, Chaired by Dr Phil Schauer. The session began with Dr Talebpour (Iran) presenting a multi-centre experience of over 800 procedures. Additional presentations included Dr Ramos (Brasil) who described plication as a ‘rescue technique’ following the failure of other. There was relative agreement in the session that plication does have its merits, and has a place in the armamentarium of the surgeon, but surgeons performing the procedure should have formal training before attempting this technique.

Dr Henry Buchwald gave several presentations that encompassed several topical subjects including the ‘Guidelines for metabolic and bariatric surgery and the Center of Excellence concept - data on the efficacy of Center of Excellence in enhancing outcomes and decreasing complications. In addition, he looked into the future as he assessed micro-orifice surgery.

Tantalus

There were also several updates from device-related clinical studies. Professor Arthur Bohdjalian, Medical University of Vienna, presented favourable benefit-risk profile of the Diamond (Tantalus) System. This is a minimally-invasive gastric stimulator for treatment of Type 2 Diabetes and its metabolic comorbidities. Bohdjalian stated that the system brings significant glycaemic and metabolic improvement with mostly mild to moderate adverse events.

In the meta-analysis of 80 obese T2DM patients treated with the Diamond system for at least six months after failing on oral anti-diabetics, the results showed a mean reduction of 0.9% in HbA1c accompanied by significant weight loss, waist circumference reduction, lowering of blood pressure (systolic and diastolic) and improvement in blood lipid profiles. In addition, the majority of adverse events reported were not related to the device and resolved within four weeks of implantation without sequelae.

“Diamond’s safety and efficacy are due to the fact that it acts physiologically, enhancing the normal metabolic processes and not causing any metabolic dysfunction.” said Bohdjalian. “Therefore it is an attractive alternative treatment for managing Type 2 Diabetics who have exhausted oral medications.”

Maestro

Separately, EnteroMedics presented data their VBLOC-DM2 ENABLE (DM2) trial evaluating the second generation Maestro RC System in the treatment of obesity, diabetes and hypertension. In an ooral presentation entitled ‘Treatment of Obesity-Related Co-Morbidities with VBLOC Therapy,’ Dr Miguel Herrera Hernández, Instituto Nacional de la Nutrición, Mexico, said the results reflect a statistically significant and sustained improvement in glycaemic control and blood pressure, as well as clinically meaningful weight loss in obese, diabetic patients using the Maestro RC System.

The 18-month data showed that excess weight loss (EWL) of approximately 24.6% (n=22), a mean reduction in HbA1c of 1.2 percentage points from a baseline of 8.1% (n=13), a change in fasting plasma glucose of -38.4 mg/dl from a baseline of 151.4mg/dl (n=12). In hypertensive patients (n=10), there was a reduction in mean arterial pressure of 13.0mmHg from a baseline of 99.5mmHg and a reduction in diastolic blood pressure of 15.9mmHg from a baseline of 87.2mmHg (n=10). Through 18 months, no change in mean arterial pressure was observed in patients that did not present with hypertension (n=10).

abiliti launch

Also at IFSO, IntraPace, the developer of the innovative abiliti implantable obesity management system, launched its lifestyle management portal and support network. A unique online resource, my.abiliti allows its users to track personal eating and exercise performance, set and achieve goals, receive individual coaching, access educational resources and benefit from a valuable support network. They can also share personal experiences and achievements at their discretion with peers, friends and family, and experienced healthcare professionals.

The abiliti system is an implantable device that uses proprietary eating event sensors to initiate gastric stimulation that helps patients feel full sooner than they otherwise would. Additionally, the device automatically records information on those eating and drinking events, as well as frequency and duration of exercise. The my.abiliti portal is the only online destination and community that can utilise objective behavioural data, collected and stored by the abiliti device and wirelessly retrieved with the connect.abiliti Wand. This accurate information enables intelligent weight loss management based on routine self monitoring.

IFSO 2011 was attended by 2,230 participants from 74 countries and as well as 425 exhibitors, the highest number in the history of the IFSO World Congress.

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