2014 BOMSS Final Programme

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Jan 23, 2014 ... Company Exhibitors 2014. 35 - 41. Exhibition ... The BOMSS 2014 Annual Dinner will be held in the. Kenilworth Suite ..... Free Paper Sessions - Kenilworth .... have changed our practice to close all the mesenteric defects to avoid further events. We propose to follow a standardised technique to close these ...
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BOMSS COUNCIL January 2014 President: Honorary Secretary: Honorary Treasurer: Council Members:

Trainee Representative: Nurses/AHP Council Member:

Mr Richard Welbourn Mr Roger Ackroyd Mr Simon Dexter Mr Marco Adamo Mr Ian Beckingham Mr Duff Bruce Mr Vinod Menon Ms Sally Norton Mr Peter Small Mr Shaw Somers Mr Sean Woodcock Mr Alan Osborne Mr Ken Clare Ms Mary O’Kane Ms Gail Pinnock

Conference Secretariat: All enquiries should be addressed to: Specialty Managers Association of Upper Gastrointestinal Surgeons The Royal College of Surgeons of England 35 – 43 Lincoln’s Inn Fields London WC2A 3PE Tel: +44 (0)20 7304 4773 / +44 (0)20 7304 4786 Fax: +44 (0)20 7340 9235 Email: [email protected] / [email protected] Website: www.bomss.org.uk Microsite: http://www.bomss.org.uk/2014conference/

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Contents Page Presidential Address

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Information

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Scientific Programme Abstracts

6-7 8 - 33

Corporate Partners 2014

34 - 35

Company Exhibitors 2014

35 - 41

Exhibition Floorplan

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Chesford Grange Hotel - Conference Floorplan

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BOMSS Presidential Address We are particularly honoured to have a panoply of internationally recognised bariatric surgeons (and a physician), namely Dr Michel Gagner from Montreal, Dr Bruno Dillemans from Bruges, Dr George Fielding from New York and Prof John Dixon from Melbourne. They are leaders in the field - we welcome them and look forward to their debates and deliberations.

The 5th BOMSS Annual Scientific Meeting PRESIDENT’S WELCOME Welcome to our 5th Annual Scientific Meeting! In the four years since our Inaugural meeting the Society has witnessed many positive changes - growing not just in numbers, currently standing at well over 400, but also in the quality of its scientific profile and academic progress. Mr Vinod Menon, Ms Sally Norton and colleagues have put on a superb programme and arranged excellent hospitality here in Royal Leamington Spa, and we hope that holding the conference again in a venue that is just the right size, with all or most of the accommodation onsite is a recipe for a stimulating and enjoyable meeting. Mr Sean Woodcock and colleagues have once again organised an excellent training day.

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We are also delighted to welcome home grown experts: psychologist Prof Jane Ogden from Surrey, plastic surgeon Mr Mark Soldin from Kingston; and we welcome back anaesthetist Dr Euan Shearer from Liverpool. Political challenges continue to predominate and the current difficulties with providing and funding medical Tier 3 obesity clinics need urgent answers. We are very grateful to Prof John Wass, Academic Vice-President of the Royal College of Physicians and author of the RCP Action on Obesity report for coming to talk to us. We are also delighted to welcome Dr Jonathan Valabhji, National Clinical Director for Obesity and Diabetes to the world of bariatric surgery as he presses for more joined up pathways to help patients get the best and most efficient treatment. Please be kind to them as they are on the side of the bariatric patient! We are also delighted to be welcoming representatives from the Society for Obesity and Bariatric Anaesthesia (SOBAUK) in what we hope will be the start of

joint ventures between the multidisciplinary teams which care for bariatric patients. We would like to explore having a UK equivalent of the US Obesity Week perhaps with groups of physicians joining future ASMs. Our industry partners have again offered very strong support with Allergan and Ethicon as our Platinum sponsors and we urge you all to visit the trade stands. We are very grateful to them and our other sponsors for their continued sponsorship. This year we have attracted more abstracts than ever before. The mainstay of the conference is the contributions of the members and we have a very high quality of free papers, in particular for the Council Prize session. Increasing our academic profile by this means will see the sub-specialty of bariatric surgery go from strength to strength. Bariatric surgery has been recognised nationally for research funding by the Health Technology Programme and so we are delighted to welcome back Prof Jane Blazeby who will be asking for our expert help in developing a core outcome set for bariatric surgery outcome reporting. The Council joins me in welcoming you to the ASM and the conference dinners. Best wishes,

Mr Richard Welbourn President, BOMSS

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Information CONFERENCE VENUE The 5th BOMSS Annual Scientific Meeting will be held at: Chesford Grange Kenilworth, Warwickshire CV8 2LD Telephone: 01926 859331 Website: www.QHotels.co.uk/ChesfordGrange BOMSS SOCIAL PROGRAMME BOMSS Drinks Reception and Annual Dinner Thursday 23 January 2014 • Drinks Reception: 19:30 - 20.30 The drinks reception will be taking place in the Kenilworth Bar of the Chesford Grange Hotel. • Annual Dinner: 20:30 - 23.30 The BOMSS 2014 Annual Dinner will be held in the Kenilworth Suite in the Chesford Grange Hotel. Dress: Lounge suits Ticketed event (Entry with ticket only) Consultants: £60 All other status: £40 ABSTRACTS All selected abstracts can be found within this programme. Please refer to the Contents Page. AUDIO VISUAL (AV) All presentations are to be compiled using Power Point and should be saved to a USB stick. Please supply any video content which you may have separately either via USB or DVD. Speakers will be required to provide their presentations to the audio visual technician (MCL) in the room where they are presenting as soon as possible, on arrival. For those speaking in the morning, please ensure that your presentation is given in before the start of the morning session (before 09.30am on the Thursday and before 08:15am on the Friday), and for those presenting after lunch, please provide your presentation during the lunch break. Scott Evans from MCL will be present in the Kenilworth for the duration of the meeting.

CLOAKROOM FACILITIES Please contact the hotel reception if you wish to store luggage. CERTIFICATE OF ATTENDANCE Your Conference Passport (see also below) contains your Certificate of Attendance on the back page. No other certificate will be issued after the Meeting. CONFERENCE PASSPORTS A conference passport will be issued to you when you pick up your registration information. PLEASE RETAIN THIS. The Conference Passport acts as your Certificate of Attendance (please refer to the back page) and contains details of your registration and the additional events you have signed up for such as the Annual Dinner (please refer to the centre pages). Please bring the passport with you to all events during the meeting. REFRESHMENTS Morning and afternoon coffee and tea will be available during the meeting in the exhibition area, situated in The Grange Exhibition area. LUNCHES Lunches will be served each day in the Events Centre Foyer. POSTER EXHIBITION The poster exhibition will be displayed for the duration of the two day meeting in the Kenilworth 1 Room, situated on the ground floor (please follow signage). Posters should be put up where indicated on arrival on Thursday 23 January 2014. Posters should be taken down after 15.00 on Friday 24 January 2014 and we regret that BOMSS is unable to return any posters that are not collected from the Chesford Grange Hotel after this date. Electronic versions of posters will also be displayed. TAXIS Hotel reception at the venue would be happy to arrange a taxi for you.

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Thursday 23 January 2014 Time

Location

08:30 - 09:45 09:45 - 10:00

Speakers

Kenilworth

Welcome Address from President of BOMSS

Mr Richard Welbourn

10:00 - 12:00

Session 1 - Quality, Outcomes and Tier 3 services

10:00 - 10:20

Role of National Clinical Director for Obesity and Diabetes

Professor Jonathan Valabhji

10:20 - 10.40

Surgeon outcomes and NBSR

Mr Richard Welbourn

10:40 - 11.00

Quality is a team issue

Professor John Dixon

11:00 - 11:20

How important (or not) is the role of psychology in obesity surgery

Professor Jane Ogden

11:20 - 11:40

Tier 3 services - where are we?

Professor John Wass

11:40 - 12:00

Discussion

Mr Peter Small and Mr Simon Dexter

12:00 - 12:05

Kenilworth

IFSO 2017

Ms Sally Norton

12:05 - 12:30

Kenilworth

Guest lecture - Banding in adolescents

Dr George Fielding

Ms Sally Norton

LUNCH

12:45 - 13:05

The Grange

Allergan Lunchtime Symposia

13:05 - 13:25

The Grange

Ethicon Lunchtime Symposia

13:30 - 15:00

Kenilworth

Session 2 - Free Papers - Surgical / AHPs

15.00 - 15.30 15:30 - 16:20

Chairpersons

REGISTRATION

12:30 - 13:30

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Event

Mr Sean Woodcock, Dr Michel Suter and Mr Martin Wadley

TEA AND COFFEE BREAK Kenilworth

Session 3 - Updates

Prof Duff Bruce and Mr Raj Nijjar

15:30 - 15:45

What’s new in Anaesthesia

Dr Euan Shearer

15:45 - 16:00

National Guidance for Body Contouring Surgery

Mr Mark Soldin

16:00 - 16:15

Discussion

16:20 - 17:30

Kenilworth

Session 4 - DEBATE :BAND / BYPASS / SLEEVE

17:45 - 18:30

Kenilworth

Session 5 - Interactive voting for a core outcome set for obesity surgery & an update on the By-Band Study

19:30 - 20:30

Kenilworth Bar

DRINKS RECEPTION

20:30 - 23:30

Kenilworth

BOMSS ANNUAL DINNER

Dr George Fielding, Dr Bruno Dillemans, Dr Michel Gagner

Mr Sean Woodcock and panel, (Prof John Dixon, Prof Jane Ogden, Ms Mary O’Kane, Mr Ken Clare, questions from floor)

Professor Jane Blazeby

Mr Richard Welbourn & Prof John Dixon

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BOMSS - 5th Annual Scientific Programme Royal Leamington Spa 2014

Friday 24 January 2014 Time

Location

08:30 - 08:30

Event

Speakers

Chairpersons

REGISTRATION

08:30 - 09:50

Kenilworth

Session 6 - Free Papers - Surgical /AHPs

09:50 - 10:15

Kenilworth

Guest lecture Avoiding complications in gastric bypass

Dr Bruno Dillemans

Mr Vinod Menon

Session 7 - Bad Day at the Office

4 cases for disussion

Mr Paul Super & Mr Roger Ackroyd

Dr Michel Gagner

Mr Marco Adamo

10:15 - 11:00

Kenilworth

11:00 - 11:30 11:30 - 11:55

12:00 - 13:00

TEA AND COFFEE BREAK Kenilworth

Kenilworth

13:00 - 13:45 13:45 - 14:00

BOMSS Council Member and Mr FT Lam

Guest Lecture Controversies in Sleeve Gastrectomy Session 8 - Free Papers Council Prize Session

Mr Alberic Fiennes & Mr Roger Ackroyd

LUNCH Kenilworth

Council Prize / Poster Prize Presentations and closing remarks

14:00 - 15:00

Kenilworth

BOMSS Annual General Meeting

15:00 - 17:00

The Directors

NBSR Research and publications

Mr Richard Welbourn

Mr Richard Welbourn

BOMSS 5TH ANNUAL SCIENTIFIC MEETING CONCLUDES

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ABSTRACTS Council Prize Sessions - Kenilworth (Friday 24 January 2014 12:00 - 13:00) A01 The impact of Bariatric Surgery on Urinary Incontinence in Women Hayder Shabana, Colm J O’Boyle Department of Bariatric Surgery, Bon Secours Hospital, Cork, Ireland Background: Morbid Obesity is known to be a contributing factor to the development of stress urinary incontinence in women. We evaluated the urinary symptoms of morbidly obese patients pre and post bariatric surgery. Methods: Between January 2011 and January 2013, 47 morbidly obese women with incontinence underwent bariatric surgery. All 47 completed detailed urinary function questionnaires both pre- and post-operatively. Results: The median BMI was 48(39 -61) kg/m2. Thirty-two (68%) patients underwent gastric bypass, fourteen (30%) underwent sleeve gastrectomy and one underwent a banding procedure. Thirty-three patients (70%) reported urinary leaking on more than one occasion per day. Thirty-five (74%) required daily incontinence pads. Eighteen (38%) reported changing pads more than once per day. Nineteen (40%) reported moderate to severe leakage. Thirty-four (72%) reported leaking on sneezing or coughing. Eighteen (38%) reported significant interference with their daily life (>6/10, visual analogue). At a median 6(1- 12) months following bariatric surgery the median weight loss was 62(20 to 162) lbs. Eighteen patients (38%) reported complete resolution of their symptoms (p 100 day 1 post-operatively can predict major complications with 100% sensitivity and 95% specificity with a diagnostic accuracy of 0.98 (95% confidence interval: 0.944 - 1, p=0.001). Conclusion: Serum CRP accurately predicted post-operative complications on day 1 following laparoscopic gastric bypass. This can be used to support the early discharge of the majority of patients undergoing laparoscopic gastric bypass, or conversely, the expeditious identification of patients who may require further investigation.

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P24 Prospective Study: The R ole Of Endoscopy In P atients Who Have Undergone Laparoscopic Sleeve Gastrectomy Yiwen Loh, Rajesh Jain, Nimalan Sanmugalingam, Georgios Vasilikostas, Andrew Wan St George’s Healthcare NHS Trust, London, UK Background: Laparoscopic sleeve gastrectomy is an effective treatment for morbid obesity, however a proportion of patients represent with gastrointestinal symptoms requiring upper GI endoscopy (OGD) as a diagnostic and therapeutic tool. Methods: Using a prospectively collated database, we identified those bariatric patients who underwent endoscopy post sleeve gastrectomy between April 2010 and October 2013. We analysed the indications and findings of post-operative sleeve gastrectomy patients. Results: Seventeen post-sleeve gastrectomy bariatric patients were referred for OGD to investigate gastrointestinal symptoms. Indications were dyspepsia in 5, dysphagia in 4, abdominal pain in 3, nausea and vomiting in 3, cessation of weight loss in 1 and melaena in 1 patient. Nine of the 17 patients had normal findings, 4 were diagnosed with gastritis, 3 were discovered to have a kink in their sleeve and 1 patient had a healed ulcer in the staple line. Gastrograffin swallow revealed non-specific findings in patients with kinking on OGD including slow bowel transit. Following OGD, 6 out of 17 patients had a change in their management, including 2 who had repeat surgery (sleeve gastrectomy conversion to gastric bypass). Conclusion: OGD post bariatric surgery in those patients with nonspecific upper GI symptoms is a useful diagnostic assessment and changes the management of a significant proportion of patients. It is most beneficial in identifying those patients with kinking after having undergone sleeve gastrectomy. P25 Gastro-oesophageal reflux disease and bariatric surgery Cynthia-Michelle Borg, Jean Deguara 1University Hospital Lewisham, London, UK, 2Kingston Hospital NHS Foundation Trust, Kingston, UK Background: Morbidly obese patients have a higher incidence of hiatal hernias and gastro-oesophageal reflux disease (GORD) when compared to the general population. Most bariatric operations involve surgery near the hiatus of the diaphragm and this dissection may interfere with the function of the lower oesophageal sphincter (LOS) and the anti-reflux mechanisms. Methods: A systemic review of the literature was performed to investigate changes in the incidence of GORD symptoms and abnormal oesophageal physiology after bariatric surgery. Results: Sleeve gastrectomy (SG) : SG may interfere with the anti-reflux mechanism by weakening the phreno-oeshophageal ligament and changing the cardio-oesophageal angle. 8 studies in the literature showed increased prevalence of GORD after SG while 5 studies showed decreased prevalence. The extent of hiatal dissection to exclude a hiatal hernia was unclear in most of these studies. Gastric Banding (GB): 15 studies were found in the literature about changes in GORD after GB. Studies showed heterogeneity in terms of length of follow-up, investigations used to assess change in

oesophageal symptoms/function as well as technique and band employed. The incidence of oesophageal dilatation post-banding varied between 7.5 - 56% of patients. The incidence of reflux symptoms also varied greatly with some studies showing improvement, others no change and some worsening of GORD. Four studies evaluated oesophageal manometry in patients pre-and post GB. 2 of these studies showed no change in oesophageal motility while the other 2 showed weaker peristalsis and contractions in the lower oesophagus after GB. Pressure at the lower oesophageal sphincter was either unchanged or increased post-banding. Roux-en Y gastric bypass (R YGB): According to the literature, RYGB is the best operation in patients who had pre-operative GORD symptoms and is associated with the smallest risk of postoperative reflux symptoms. Conclusion: The literature is still somewhat controversial regarding the effects of gastric banding and sleeve gastrectomy on gastrooesophageal reflux and oesophageal motility. The incidence may vary with length of follow-up and surgical management of incidental hiatal hernias. RYGB has been shown to be an excellent treatment option for patients with pre-op symptomatic GORD. P26 Fast Track Laparoscopic Roux-en-Y Gastric Bypass Surgery