ACMOMS 2009

ACMOMS 2- ASIAN CONSENSUS MEETING ON SLEEVE GASTRECTOMY And LAPAROSCOPIC SLEEVE GASTRECTOMY TRAINING WORKSHOP
October 2 to 5, 2009 Jodhpur, Rajasthan 70 participants

Metabolic surgery is an ever evolving field. The advent of Sleeve Gastrectomy has led to a lot of enthusiasm within the surgical community.

Its popularity can be attributed to favourable early results. Hence surgeons from across the world are now offering it to an increasing number of patients. The benefits of sleeve gastrectomy seem to far outweigh its risks. It is a technically easier procedure with a lower learning curve. There are less chances of developing nutritional deficiencies and the stomach is always accessible for examination. Asian studies have already suggested better results in terms of weight loss and resolution of co-morbidities after a sleeve gastrectomy.

There exists an immense amount of data on the subject; however the cause for concern is that most of it is unorganized. Each surgeon has an individual series of a few hundred patients, the data on these patients is unconsolidated.

The aims of the second ACOMOMS summit were to collate the data on Asian patients and
  1. Redefining indications for Sleeve Gastrectomy for Asians
  2. Evaluation and standardization of techniques
  3. Evaluation of results- EWL, resolution of comorbidities
  4. Assessment of complications
  5. Assessment of newer developments- Gastric imbrication, SILS, NOTES, Endobarrier Sleeve
  6. Setting up of training modules
A total of 1,464 cases were reported by surgeons from all across Asia and Middle East. The data revealed that the weight loss results after sleeve gastrectomy were similar to roux en y gastric bypass at the end of 2 years. Resolution of comorbidities such as type 2 diabetes and hypertension was 88% and 93% respectively. The total complication rate including GERD was 3.21%.

Consensus Summary:
  1. LSG is a SAFE and EFFECTIVE bariatric procedure
  2. LSG is an acceptable PRIMARY bariatric procedure in most cases without comorbidities
  3. BOUGIE size   32-36   &  4-6 cm antral  preservation must be done
  4. LSG is the procedure of choice for BMI ≥ 60 & age ≥ 65 and adolescents
  5. In Type 2 Diabetics LSG has shown results comparable to RYGB at 1 year
  6. Severe GERD may be a contraindication
  7. SILS is here to stay
Link to CODS publications on sleeve gastrectomy:
http://www.ncbi.nlm.nih.gov/pubmed/19802646
http://www.ncbi.nlm.nih.gov/pubmed/21789509