The GaBP Ring™ DeviceFor

Banding The Pouch in Gastric Bypass

and Sleeve Gastrectomy Operations

Bariatec Corporation• P.O Box 4257• Palos Verdes Peninsula, • CA 90274• 1 562 809 1020

www.bariatec.com

GaBP Ring™

The GaBP Ring™ is a prefabricated, caliberated and sterilized silicone coatedimplantable device that is designed specifically to control the reservoir capacity in gastric operation for obesity.

The Gastric Bypass operation is the Gold standard of weight loss operations

Reports show that 15- 25% of patients do not achieve successful * weight loss in the short term 1-3yrs after the operation.

• Reports also show that this rate increases to 25-40% in patients followed longer than three years because of weight regain.

*Successful weight loss; > 50% excess weight loss and or attainment of a BMI<35.

The inadequate weight loss and weight regain observed in the gastric bypass operation have been attributed mostly to the increase in the gastric reservoir size due to dilation of the pouch, stoma and the proximal small bowel.

Reservoir sizeReservoir size

change with change with timetime

Non-banded Roux-en-Y GBPNon-banded Roux-en-Y GBP

Post op>3 yrs post op

Reservoir sizeReservoir size

change with change with timetime

GaBP Ring™ Banded Gastric Bypass

GaBP Ring™ Banded Gastric Bypass

Post Op > 3 yrs Post op

Non Banded Gastric bypass

Dilated stoma converts the pouchand the proximal small bowelinto a neo-pouch that can accommodate as much as the initial Stomach.Causing inadequate weight loss andweight regain after gastric bypass

Non Bandeddilated Stoma andproximal Smallbowel becomepart of neopouch

Banded vs. Non banded Gastric Bypass

GaBP Ring™ Device

Placement of a prosthetic device around the pouch to function as the stoma has been shown to not only reduce the pouch size but also to prevent the development of this large gastric reservoir.

Banding the pouch

Banding the pouch creates a smaller pouch

Banding the pouch minimizes pouch dilatation

GaBP Ring™

Banded

Gastric Bypass

The Ring controls the Reservoir size

in the gastric bypass operation

The Ring controls the Reservoir size

in the gastric bypass operation

GaBP Ring™ BandGaBP Ring™ Band

Gastrojejunostomy AnastomosisGastrojejunostomy Anastomosis

Proximal Pouch 10-20 cc

Proximal Pouch 10-20 cc

Interposing Limb of Jejunum used as a Serosal PatchInterposing Limb of Jejunum used as a Serosal Patch

Fobi et alWorld J.S1998;22:925-35

GaBP Ring™ Device Reports have shown increased eight loss in more patients and

less weight regain with the prevention of the formation of this

large gastric reservoir.

Since Roux-en-Y Gastric Bypass is primarily a restriction operation,

just as with VBG, it is important that the outlet of the pouch does not stretch.”

( E.Mason . Obesity Surgery 1994;4:66-72)

Based on these reports , MacLean in 1997 stated that:

The most promising technique based on a large series at this time is that described by

Capella and Capella

“Banded Gastric Bypass”

MacLean J Am Coll Surg 97;185:1-7

Banding the Gastric Bypass Operation

Fisher after an in depth review concluded in 1999 that:

• “ Long-term results suggest that a silastic ring encircling the stomach pouch proximal to the gastroenterostomy may improve the outcome following gastric bypass surgery, resulting in more weight loss by a greater number of patients sustained for a longer time”

• Fisher BL, Barber AE, Eur J Gastroenterol Hepatol 1999; 11:93-97

PEWL for standard RYGBP and its two hybrid forms of LL-RYGBP and B-RYGBP

(* P < 0.05).

[O’Brien P.E:Systemic review of mdium term-weight loss after bariatric surgery; Obesity Surgery:2006;16;1032-40]

In a systemic review, banded gastric bypass resulted in more weight loss and better weight loss maintenance

Banded Gastric Bypass

Non Banded Sleeve Gastrectomy

Non Banded Sleeve Gastrectomy

Banded Sleeve Gastrectomy

Banded Sleeve Gastrectomy

GaBP Ring™

The GaBP Ring™ is easily placed inopen or laparoscopicoperations.It is an auto lock Device <1/10 the size of any of theadjustable bands

1. Increased Weight Loss

2. More weight loss in more patients

3. Enhances weight Loss Maintenance

4. Decreases the incidence of gastric outlet stenosis

5. Decreases the severity of postprandial dumping

6. Minimizes the incidence of reactive hypoglycemia7. Success Rate 90+%. (90+% of pts with >50PEWL after 5 years of F/U)*

1. Increased Weight Loss

2. More weight loss in more patients

3. Enhances weight Loss Maintenance

4. Decreases the incidence of gastric outlet stenosis

5. Decreases the severity of postprandial dumping

6. Minimizes the incidence of reactive hypoglycemia7. Success Rate 90+%. (90+% of pts with >50PEWL after 5 years of F/U)*

Controls the Pouch SizeControls the Pouch Size

(GaBP Ring™ Designed for the banded gastric bypass)

Banding the Pouch in GBP :

Banding the Pouch in GBP :

* GBP 70+% BPD 90+% LAGB 50+% SG N.A

Cross Section through the RingCross Section through the RingBanded Pouch Gastric Bypass Operation For Obesity

GaBP RING™ designed for the Gastric Bypass and The Sleeve Gastrectomy

Prefabricated , Standardized and available in 4 sizes

GaBP RING™ designed for the Gastric Bypass and The Sleeve Gastrectomy

Prefabricated , Standardized and available in 4 sizes