2nd International MGB Consensus Conference Preliminary Data

2nd International MGBConsensus Conference

Preliminary Data

35 Surgeons, 200 cases/yrExperience with 7,000 cases/yr

MGB Technique

Opinion of MGB Surgeons

Fear that MGB patients can have an increased risk of gastric cancer

MGB Surgeons

Non-MGB Surgeons

Non-MGB Surgeons Not Knowledgeable, Not Well Informed

Non-MGB Surgeons 1 in 4 WRONG

Cognitive Bias: Refuses to Admit Data that opposes their belief system

• Confirmation bias (also called confirmatory bias or myside bias) is a tendency of people to favor information that confirms their belief

• Confirmation biases contribute to overconfidence in personal beliefs and can maintain or strengthen beliefs in the face of contrary evidence. Poor decisions due to these biases have been found in political and organizational contexts.

Cognitive Bias: Refuses to Admit Data that opposes their belief system

• Research on “confirmation bias” shows that people actively avoid evidence or simply shut their ears to anything that opposes their views

• When we make mistakes, we must calm the cognitive dissonance that jars our slef view.

• People refuse to admit mistakes because it harms their view of them selves as “good” people.

Cognitive Bias: Refuses to Admit Data that opposes their belief system

• Most of us are biased to think of ourselves as smart and, therefore, not subject to such biases. This bias (self-deception) prevents us from realizing the confirmation bias.

• - so deeply that they transform their own brains? ... Their discussion of confirmation bias, one of the worst breeders of bad ... to information that confirms our beliefs while discounting contrary data)

Fear of the Hot Dog vs Billroth II

Hot Dog vs Billroth II

Lack of Knowledge

Knowledge of H. Pylori and Gastric Cancer MGB Surgeons:

Non-MGB Surgeons 25% Error Rate:

Gastic Band Sleeve RNY MGB

Number Cases (#) 29.3 91.7 75.3 272.0

Avg BMI 36.3 44.2 44.6 46.9

Avg Op Time

(Min.)35.2 57.4 109.8 81.3

Gastic Band Sleeve RNY MGB

Hosp Stay 1.4 4.5 5.4 4.8

1y DM Resolve 24.3 72.4 73.7 87.5

PreOp GE Reflux (%) 13.0 10.9 27.7 23.1

Gastic Band Sleeve RNY MGB

PreOp GERD (%) 13.0 10.9 27.7 23.1

PostOp GE Reflux 20.9 21.2 4.3 7.6

Excess Weight Loss (%)

46.1 66.3 68.2 75.2

Gastic Band Sleeve RNY MGB

EWL (%) 46.1 66.3 68.2 75.2

5yr Wt. Loss Fail 36.6 24.9 31.1 8.9

Lost > 50% EBW 32.4 61.6 65.5 71.6

Fear of Cancer after Bariatric Surgery

• Esophageal Cancer–Rising rapidly around the world–Directly related to ACID Reflux

• Stomach Cancer–Declining rapidly arouoond the

world–Almost entirely prevetable

Sleeve/Band Esophageal Cancer

Gastic Band Sleeve RNY MGB

N/V, Dyspepsia 25.5 20.7 10.1 6.8

Ulcers % 1.2 0.7 2.7 2.0

SBO (%) 0.2 0.1 3.3 0.2

Marginal Ulcer

Gastic Band Sleeve RNY MGB

N/V, Dyspepsia 25.5 20.7 10.1 6.8

Ulcers % 1.2 0.7 2.7 2.0

SBO (%) 0.2 0.1 3.3 0.2

Small Bowel Obstruction

Gastic Band Sleeve RNY MGB

N/V, Dyspepsia 25.5 20.7 10.1 6.8

Ulcers % 1.2 0.7 2.7 2.0

SBO (%) 0.2 0.1 3.3 0.2