1 B-Band Gastric Bypass Band enforcing the restrictive effect of gastric bypass surgery

2 Gastric Bypass Surgery >Surgical weight loss procedure for high-BMI patients -several variations exist, most common: Roux-en-Y >Reduction of stomach size by more than 90% >EWL approx. 65% >Complications include: -anastomotic leakage -pouch dilatation

3 EWL Gastric Bypass (approx. 65%) EWL (%) timeapprox months approx. 65% On average, results of gastric bypass surgery are good

4 The Average... derived from many individuals time EWL (%) approx months approx. 65% average above below approximately 10-15% of gastric bypass patients have insufficient long-term EWL

5 Improvements to Gastric Bypass Surgery are Possible “Stomal dilation has been long recognized as one of the causes of weight regain after... gastric bypass” Fobi, 2001 A band placed around the gastric pouch to control stoma dilation: - promotes more weight loss - in more patients - over a longer period of time. The B-Band is particularly effective for these types of patients.

6 B-Band Position 2 cm B-Band is placed approximately 2 cm above the anastomosis.

7 New B-Band – the Product

8 B-Band – the Product Soft and Pre-Shaped >Pre-curved shape facilitates placement >Soft silicone material -rounded edges -softness prevents band erosion >Three ears are used to secure the B-Band to the stomach -implant can’t move during the first few weeks

9 B-Band – the Product Closing Mechanism >Pre marked dimensions ( 5,5, 6,5 and, 7,5) with adjustment's steps 2 mm >Closing mechanism is patent-pending ???

10 Summary B-Band >Improves outcome of gastric bypass surgery in terms of -average EWL (thereby improving clinic’s results) -EWL over a longer period of time >Patients with secondary weight regain have a second chance. >B-Band -pre-curved -soft -closing mechanism variable diameter adjustment -widest adjustment range: 5.5, 6.5, 7,5 steps 2 mm

Surgeon Statements in Portugal >A good calibrated pouch doesn't need a ring >Ring is better to use in initial surgery >Ring is better to use after pouch dilatation >Not good at all >I am afraid of erosion > Better then to do a conversion bypass to duodenal switch >Problems start after 3 years implantation 11

Present Discuss about way to use ring: >Leave it loosen >6,5 women >7,5 men 12

Competition in Portugal >Fobi Ring – needs 3 different references in stock > >Minimizer – adjustable 13

Minimizer Ring 14

Fobi Ring 15