Fig. 1: two closing positions
For instance, the decision as to which size of band to use, i.e. which diameter of the gastric band will be best-suited for a specific patient can only be made during the operation.
The MiniMizer Extra, with its two-sizes in-one concept offers the possibility to choose the correct size during the procedure by closing the band in either position 1 (diameter 31mm) or position 2 (diameter 26mm). (see fig. 1)
Being able to choose the correct size from the beginning one avoids early refilling of the band or avoid refilling at all as was demonstrated by Claessens (1).
Direct Fixation of Band to Stomach
Another issue in gastric banding is created by the formation of the gastro-gastric plication, which can inadvertently be made too tight or too loose.
The retaining loops (see fig. 2) allow for direct fixation to the stomach, securing the gastric band against slipping as described by Collet (2), Claessens and Szewczyk (3). The gastro-gastric plication is not required anymore, therewith avoiding too tight or too loose plications.
Even if the loops are not directly fixed to the stomach, tissue ingrowth will create a form of auto-fixation, making sure the band will not slip.
Fig. 2: Loops allow for direct stomach fixation
Predictable Band Formation
The filling compartment of the MiniMizer Extra is an integral part of the band, embedded in the rugged outer silicone ring (see fig. 3).
This prevents the compartment from being pushed outward by the stomach, like is the case with traditional gastric bands, which have a separate band and a separate and wider filling compartment.
With traditional gastric bands, many of the milliliters injected go the unsupported sides of the compartment, which are easily pushed back by the filled stomach, therewith not contributing to a reduction in the stomach’s diameter.
Fig. 3: Comparison of in vitro and in vivo
Selection of Adjustment Ports
The MiniMizer Extra comes with a selection of ports:
MiniMizer Port Small
The smallest port on the market (diameter 13mm) for subcutaneous placement or replacement of larger ports after extensive weight loss.
MiniMizer Port Medium
The most commonly used port (diameter 18mm) with the widest membrane on the market, especially suited for deeper placement on the fascia.
MiniMizer Titanium Port
The top model, with its slim shaped body and metal cover as protection against inadvertent puncturing of the catheter.
Gastric Calibration tubes come in various sorts and sizes
The MiniMizer Calibration Tube is specifically designed for the use in gastric banding procedures with the aim to define the exact positioning of the gastric band.
The balloon at the distal end of the tube can be filled with 25ml of fluid, will deploy in a 3600 fashion (see fig. 4) and will flatten out once the force exceeded by the surrounding tissue surpasses 20N (see fig. 4). This will help avoid oesophagus rupture.
The MiniMizer Calibration Tube has a tip of 36Fr and a body of 34Fr. It does not allow for irrigation and suctioning.
- Laparoscopic adjustable gastric banding without plication (166 kb)
Dr. Frank Claessens, January 2006
- Laparoscopic Adjustable Gastric Banding Results after 2 Years with Two Different Band Types
D. Collet; A. Rault; A. Sa Cunha; D. Larroude; B. Masson
- Gastric banding with fixation but without plication (90 kb)
Frank Claessens, Steven Bessemans, Tomasz Szewczyk
- Dr. Claessens MiniMizer Video (67 MB)
MiniMizer Gastric Ring
In banded gastric bypass and banded gastric sleeve a non-adjustable gastric ring should be used which should be easy to place. more