PARIS — Opening side-by-side at the Palais des Congres last week were the 109th French Surgical Congress and the annual meeting of the Société Nationale Française de Gastroentérologie (SNFGE).

French start-ups, from small- to medium-sized enterprises, were out in force — some at both events — with product updates and some innovative devices.

And while one American, Said Hilal from Applied Medical (Rancho Santa Margarita, California), said he was finding his first year in France “exceptionally rewarding,” he also was experiencing déjà vu in Europe over bundling practices linking products and prices by major medical device distributors (see sidebar, page 8).

“France was the first country for us in Europe when we opened in January,” Hilal told Medical Device Daily. Hilal said that Applied Medical France (Paris) was joined by operations in Germany in June, the UK in late July, and that an office serving the Benelux countries would be opened before the end of the year. “Europe, but especially France, is exceptionally important for surgical trends. We are deliberately getting closer to this market.”

A tour of the exhibition areas at the two congresses backed recent statistics showing that indeed, the French are getting fatter, or at least heavier (though it’s not evidenced much on Parisian streets). With French men (and women) no longer immune to the global wider-waist trend, surgical devices and instruments for obesity procedures were widespread in the exhibition hall.

• Helioscopie (Vienne, France), holder of 38 patents for obesity intervention devices, displayed adjustable gastric bands and intra-gastric balloons at the surgery conference, simultaneously exhibiting at another booth downstairs at gastroenterology annual meeting downstairs.

An intra-gastric balloon for radical non-surgical intervention for severe obesity, the Heliosphre is being rolled out progressively in Europe and the rest of the world, said Chantal Belin, scientific director for the company.

But Helioscopie isn’t looking to win FDA approval for any of its gastric implants — “at least not anytime soon,” she told MDD. “It is very expensive, and the U.S. experience with an air-inflated gastric balloon was not positive back in the 1980s.”

The silicon construction of Heliosphere has proven effective as well as far lighter, she said, eliminating the post-operative complications of materials used 20 years ago.

Markets are opened progressively by Helioscopie, usually in partnership with a distributor to clear the way with approvals. Mexico, in July, became its newest market. Greece is one of the company’s better customers in Europe, with a specialized clinic serving the greater Balkan region. Export sales account for almost two-thirds of Helioscopie’s sales, up from only 40% two years ago, when the privately held firm last reported figures.

The company started in 2000 with gastric rings and received CE-marking for the gastric balloon technology in 2004. Isère magazine in March 2006 reported Helioscopie sales at €7 million ($10 million) and 11,000 implants.

• Covidien (formerly Tyco Healthcare; Pembroke, Bermuda) rolled out its new identity for Tyco Healthcare France at the surgery event but “no new products,” according to Frédéric Bonnet, senior director for surgical products.

“We are only surgery now and new products for 2008 will begin with Force Triad and LigaSure thermo fusion,” he said, pointing to the operating room suite as the centerpiece for an exhibit stand grouping six former Tyco divisions under the new brand.

The European rollout is just under way for the Force Triad unit from the former Valleylab (Boulder, Colorado) division. The product links an electrosurgical generator with the LigaSure tissue fusion technology for vessel and tissue sealing (MDD; Nov. 29, 2006). Covidien said it will make aggressive investments in R&D and consider acquisitions as it expands its offerings in Europe and elsewhere for surgical, respiratory and energy-based devices (MDD; July 6, 2007).

• SimSurgery (Oslo, Norway) reported a contract to deliver eight surgical simulator systems to the International Center for Endoscopic Surgery (CICE), affiliated with the Clermont-Ferrand University Hospital (CF-CHU; Clermont-Ferrand, France).

“This is one of the largest single contracts of surgical simulators in Europe,” said Vidar Sørhus, chief executive of SimSurgery.

Two portable units that can be attached to an ordinary laptop were included in the delivery of the SimSurgery Education Platform installed at CICE in September.

• A new mouth guard featuring oxygen and aspiration channels built into an endoscopic guidance slide from the Werfen Group (Barcelona, Spain) was promoted at the congress by distributor ABS-Bolton Medical (Saint Michel sur Meurthe, France).

The Safety Guard, manufactured in France by Prince Medical (Ercuis Oise), debuted at the French Anethesiology Society meeting in Paris the previous week.

The innovative feature of the plastic device, equipped with two nozzles for oxygen tubes, delivers oxygen to the patient before the start of the procedure, thereby confronting the challenge of oxygen de-saturation that becomes increasingly critical as the length of the procedure and the health or age of the patient increase.

Once the patient is anesthetized, a plastic slide that depresses the tongue and guides the endoscope is inserted. The slide features two channels, one for a deeper delivery of oxygen in the throat, and a second for aspiration by the patient.

“Please do not say the patient is sedated,” said Georges Bau, head of ABS-Bolton Medical. “In France only an anesthesiologist must be present for each procedure and is the only one allowed by law to administer the anesthesia, not the gastroendoscopic physician.”

Also introduced at the congress was what Bau called “a clever device from the Czechs,” the ELLA esophageal stent extractor from ELLA-CS (Hradec Kralove, Czech Republic).

A bare extractor running through an over-sheath tube is inserted through the working channel of the endoscope. Performed under fluoroscopic guidance, the wire is used to hook a loop on the SX ELLA stent. The endoscope is removed and the internal wire running through the sheathing tube is retracted, collapsing the stent and retrieving it through the tube.