title: Treatment of morbid obesity with the Transcend Implantable Gastric Stimulator (IGS): a prospective survey.
abstract: BACKGROUND
  The implantable gastric stimulator (IGS), a pacemaker-like device, has been found to be safe and effective to induce and maintain weight loss. We present our experience with 20 morbidly obese patients.
  
  
  METHODS
  Between September 20 and November 22, 2002, 20 patients (F/M 12/8), mean age 40.3 years (23-62) underwent IGS implantation. Mean BMI was 40.9 (33.9-48.2), mean weight 115.0 kg (87.0-137.0) and mean excess weight (EW) 51.3 kg (35.6-70.1).Co-morbitidies were: 3 cases of hypertension, 1 diabetes, 1 dislipidemia and 1 depression. Mean operative time was 58.5 min (37-85). The IGS was actived 30 days after implantation. Patients were advised to follow a low calorie diet and behavior modification (to avoid fat and to ingest more liquids during meals, to chew slowly, to eat vegetables before main meals, and to perform exercise daily).
  
  
  RESULTS
  Mean +/- standard error percent excess weight loss (%EWL) was: 10.6+/-1.8 at 1 month; 15.0+/-2.3 at 2 months; 16.6+/-2.6 at 3 months; 18.1+/-3.5 at 4 months; 15.5+/-3.5 at 6 months; 18.9+/-3.5 at 8 months; and 23.8+/-5.0 at 10 months. There were no intra-operative surgical or long-term complications. There were 3 intra-operative gastric penetrations, observed by gastroscopy, without sequelae. One patient with hypertension ceased his medical therapy at the 4th month.
  
  
  CONCLUSIONS
  IGS can be implanted laparoscopically with minimal perioperative complications. The observed weight loss is comparable to other noninvasive procedures. If weight loss is maintained, IGS could be considered as a first choice therapy in the treatment of morbid obesity in selected patients.
authors.affiliation: Department of Medical and Surgical Sciences, University of Padua, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Favretti
authors.forename: Maurizio
authors.initials: M
authors.lastname: De Luca
authors.forename: Gianni
authors.initials: G
authors.lastname: Segato
authors.forename: Luca
authors.initials: L
authors.lastname: Busetto
authors.forename: Andrea
authors.initials: A
authors.lastname: Ceoloni
authors.forename: Alessandro
authors.initials: A
authors.lastname: Magon
authors.forename: Giuliano
authors.initials: G
authors.lastname: Enzi
mesh_terms: D000328:Adult; D001521:Behavior Therapy; D015992:Body Mass Index; D004599:Electric Stimulation Therapy; D004567:Electrodes, Implanted; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000628:therapy*; D011446:Prospective Studies; D015431:Weight Loss