1. Prof. Antonio Catona Soft Basket Band: a Novel Technique for Gastric Banding

2. biggest problem: 5% pouch dilatations in 1050 laparoscopic gastric band procedures Reasons for New Developments Most common complications after gastric banding:  pouch dilatation  slippage  band migration  mechanical malfunction

3. second problem: 1,8% slippage * in our 1050 laparoscopic gastric band procedures (reoperation needed) Reasons for New Developments Most common complications after gastric banding:  pouch dilatation  slippage  band migration  mechanical malfunction * In literature, actual slippage of 4-6 % is usually found

4. New Development Traditional Soft Adjustable Gastric Band New Soft Basket Band

5. Design Advantages of the Soft Basket Band proximal basket (soft material) extremely soft material on stomach adjustable gastric band pre-shaped

6. Study Setup  Start: June 2004  Basked Bands implanted: 97  Average initial BMI: 39,10  Follow-up:  1 month  3 months  6 months  12 months (detailed figures follow)  24 months (detailed figures follow)  36 months (detailed figures follow)

7. PEWL is similar to regular gastric bands, if not better Clinical Results I 313624 12 6 Months Percentage

8. Clinical Results II PatientsExc. Wgt. PO 9785% Patients 1 yrPEWL 1 yr PEWL > 50% 1 yrPEWL > 60% 1 yrPEWL > 70% 1 yr n%n%n% 8045,6% 3443%1924%911% Patients 2 yrsPEWL 2 yrs PEWL > 50% 2 yrsPEWL > 60% 2 yrsPEWL > 70% 2 yrs n%n%n% 5358,6% 3260%2343%1630% Patients 3 yrsPEWL 3 yrs PEWL > 50% 3 yrsPEWL > 60% 3 yrsPEWL > 70% 3 yrs n%n%n% 1561,2% 960%853%533% Updated October 10, 2008Initial AVG BMI: 39,10

9. Clinical Results III The Soft Basket Band was created to reduce most common complications Type of complication Basket Band (n=97) Swedish Band (n=1050) Pouch Dilatation 0 %5 % Slippage0 %1,8 %

10. Conclusion  Main problems of AGB are complications such as:  proximal pouch dilatation which negatively affects quality of life  slippage which requires an emergency re-operation  One possible solution to prevent proximal pouch from enlargement may be a mesh tied to a regular band to envelope the upper part of the stomach.  Results of this preliminary series are encouraging, considering that:  With the Soft Basket Band we had no gastric pouch dilatation or slippage, no disphagia, no need for re-operation for complications