WEIGHT LOSS SURGERY A Primer on Current Options and Outcomes. Caitlin A. Halbert DO, MS, FACS, FASMBS April 5, 2018

Save this PDF as:
Size: px
Start display at page:

Download "WEIGHT LOSS SURGERY A Primer on Current Options and Outcomes. Caitlin A. Halbert DO, MS, FACS, FASMBS April 5, 2018"

Transcription

1 WEIGHT LOSS SURGERY A Primer on Current Options and Outcomes Caitlin A. Halbert DO, MS, FACS, FASMBS April 5, 2018

2 A Little Bit About Me Bariatric Surgical Services Reflux Surgery General Surgery

3 Overview Definitions and Epidemiology Surgical/Procedural Options Outcomes Associated Risks New Procedures Long-term Post Operative Care Special Guest Speaker

4 What is OBESITY? DISEASE OF EXCESSIVE FAT ACCUMULATION BECOMES A HEALTH ISSUE ABOVE 20% OF IDEAL BODY WEIGHT 78.6 MILLION AMERICANS ARE OBESE (34.9%) Delaware 30.7% (17 th in the nation)

5 Epidemiology Non-Hispanic blacks have the highest ageadjusted rates of obesity (47.8%) followed by Hispanics (42.5%), non-hispanic whites (32.6%), and non-hispanic Asians (10.8%) Obesity is higher among middle age adults, years old (39.5%) than among younger adults, age (30.3%) or adults over 60 or above (35.4%) adults.

6 What is MORBID OBESITY? 100 LBS OVER IDEAL BODY WEIGHT BODY MASS INDEX (BMI) OF 40 OR ABOVE KNOWN AS CLINICALLY SEVERE OBESITY RISK OF OTHER ILLNESSES/DEATH

7 WHAT CAUSES MORBID OBESITY? GENETIC FACTORS EATING HABITS LACK OF EXERCISE ENVIRONMENT

8 DANGERS OF OBESITY Pulmonary Disease Abnormal Function Obstructive Sleep Apnea Hypoventilation Syndrome Non-alcoholic Fatty Liver Disease Steatosis Steatohepatitis Cirrhosis Gall Bladder Disease Gynecologic Abnormalities Abnormal Menses Infertility Polycystic Ovarian Syndrome Urine leak Osteoarthritis Gout EARLY DEATH Idiopathic Intracranial Hypertension Stroke Cataracts Coronary Disease Diabetes Dyslipidemia Hypertension Severe Pancreatitis Cancer Breast, Uterus, Cervix, Colon, Esophagus, Pancreas, Kidney, Prostate Phlebitis Venous Stasis Blood Clots 10-41% increase

9 SOLUTION LOSE WEIGHT HOW??

10 Success Rate of Weight Loss Treatments for Morbid Obesity Treatment Average Weight Loss (% Total) % Excess Weight Loss at Five Years Placebo 4 6% 0% Diet/Behavior Modification 8 12% 1.6% (10 Years) Drug Therapy < 10% 10% Gastric Bypass 65 85% 65-85% Gastric Sleeve 60 80% 60-85% Gastric Band 45 50% 50%

11 WEIGHT LOSS SURGERY BEST MOST EFFECTIVE LONG LASTING TREATMENT

12 Who is a CANDIDATE? BMI > 40 BMI > 35 and 1 or 2 significant medical problems Failure of Non surgical means to lose weight COMMITTED to a lifetime of changes

13 Types of Bariatric Surgeries Roux-en-Y (RNY) Gastric Bypass Sleeve Gastrectomy Adjustable Gastric Banding (Lap-Band ) Duodenal Switch Revisional Surgery Band to bypass/sleeve Band over gastric bypass Bypass or sleeve to duodenal switch

14 Prevalence of Bariatric Surgery

15 GASTRIC BYPASS

16 GASTRIC BYPASS

17 SLEEVE GASTRECTOMY

18 SLEEVE GASTRECTOMY

19 GASTRIC BAND

20 DUODENAL SWITCH (DS)

21 GASTRIC BYPASS RISKS INFECTION BLEEDING LEAKS BLOOD CLOT ULCER HERNIA PAIN NAUSEA VOMITING DUMPING HAIR LOSS LACK OF VITAMINS 21

22 SLEEVE GASTRECTOMY RISKS INFECTIONS BLEEDING LEAKS BLOOD CLOT ULCER PAIN NAUSEA VOMITING HAIR LOSS REFLUX DILATION

23 ADJUSTABLE BAND RISKS INFECTION BLEEDING BLOOD CLOT DEVICE FAILURE SLIPPAGE EROSION POUCH DILATION POOR WEIGHT LOSS 20 % ADDITIONAL SURGERY W/IN 5 YEARS 33% REMOVAL RATE AT 10 YEARS 23

24 FANTASTIC RESULTS >50% EXCESS WEIGHT LOSS IMPROVEMENT IN QUALITY OF LIFE IMPROVEMENT IN SELF ESTEEM IMPROVEMENT IN ILLNESSES 24

25

26 New Options for Weight Loss

27 ReShape, Orbera, Obalon INTRAGASTRIC BALLOONS

28 What is it?

29 How is it performed?

30 How is it performed?

31 Does it Work? Balloon EWL 24%, Sham EWL 11% (p = 0.004) 66% of average weight loss achieved maintained for the 6 months after the Integrated Dual Balloon was removed 66% of trial patients said they would have SMART the Pivotal ReShape Trial Procedure again 75% said they would recommend it to 419 a friend subjects, in a 387 follow-up able to swallow capsule survey Balloon 198, Sham 189 Obalon Balloon System lost an average of 14.4 pounds (6.6% of their total body weight) Sham device lost an average of 7.4 pounds (3.42% of their total body weight).

32 Maestro Rechargeable System vbloc VAGUS NEUROMODULATOR

33 What is it? vbloc Therapy is a neurometabolic therapy delivered through an implantable device called the Maestro System Intermittently blocks the signals between your stomach and your brain, effectively controlling appetite. Still able to eat a normal variety of foods Non-anatomy altering Customizable, adjustable and reversible

34 What is it? vbloc Therapy intermittently blocks those signals, delivering consistent therapy to control hunger. Signals from the gut to the brain Affects perceptions of hunger satiety Satiation (Fullness) Energy metabolism Blood pressure regulation Signals from the brain to the gut Gastric acid secretion Digestive enzyme secretion Limits gastric expansion which reduces the amount of food that can be eaten Glucose regulation

35 How is it Performed? Laparoscopic, outpatient procedure Devices wires placed around the anterior and posterior vagus Neuroregulator implanted under the skin Titrate setting to reach goals Patients learn to charge their neuroregulator

36 Does it Work? EMPOWER Trial (N=294) ReCharge Trial (N=239) Clinically significant weight loss, 28% EWL at 12 months 10 Significant weight loss maintained across all trials up to 36 months

37 AspireAssist GASTRIC EMPTYING SYSTEM

38 What is it? Endoscopic placement of A tube that connects the inside of the stomach to a port (Skin-Port) outside of the abdomen About minutes after eating, the patient attaches the external components including the Companion, connector, tubing, and a water-filled reservoir, and drains the stomach s contents

39 What is it? Outpatient, anatomy-sparing, reversible procedure Intended for long-term use in conjunction with continuous medical monitoring and lifestyle therapy to help patients develop healthier eating habits and reduce caloric intake

40 How is it Performed? Endoscopic pull technique

41 LONG-TERM POST OPERATIVE BARIATRIC CARE

42 Post-operative visits 1 month, 3 months, 6 months, yearly (6 months for DS) Labs BMP, CBC, lipids, vit B12, vit D, calcium, vit A, folic acid, iron studies Consider copper, zinc, selenium, thiamine based on symptoms Bone density at 2 years Re-evaluation for ongoing medication Evaluate need for support groups Consider body contouring surgery

43 Vitamin Requirements

44 SUCCESS AFTER WEIGHT LOSS SURGERY COMMITMENT COMMITMENT COMMITMENT

45

Not over when the surgery is done: surgical complications of obesity

Not over when the surgery is done: surgical complications of obesity Not over when the surgery is done: surgical complications of obesity Gianluca Bonanomi, MD, FRCS Consultant Surgeon and Honorary Senior Lecturer Chelsea and Westminster Hospital London The Society for

More information

Access to Proven Therapies

Access to Proven Therapies Access to Proven Therapies Obesity is a life-threatening disease affecting 34% of adults in the U.S. Between 2000 and 2005, obesity increased by 24%, morbid obesity by 50%, and super obesity by 75%. 18%

More information

Bariatric Surgery. Options & Outcomes

Bariatric Surgery. Options & Outcomes Bariatric Surgery Options & Outcomes Obesity Obesity now leading cause of premature death & illness in Australia 67% of Australians are overweight or obese Australia 4 th fattest nation in OECD Obesity

More information

Viriato Fiallo, MD Ursula McMillian, MD

Viriato Fiallo, MD Ursula McMillian, MD Viriato Fiallo, MD Ursula McMillian, MD Objectives Define obesity and effects on society and healthcare Define bariatric surgery Discuss recent medical management versus surgery research Evaluate different

More information

Benefits of Bariatric Surgery

Benefits of Bariatric Surgery Benefits of Bariatric Surgery Dr Tan Bo Chuan Registrar, Department of Surgery GP Forum 27 May 2017 Improvements of Co-morbidities Type 2 diabetes mellitus Hypertension Hyperlipidemia Degenerative joint

More information

ADVANCE AT YOUR OWN PACE

ADVANCE AT YOUR OWN PACE ADVANCE AT YOUR OWN PACE Welcome and Introductions Obesity and Its Impact on Health Surgeon Introduction Surgical Weight Loss Options AGENDA OSVALDO ANEZ, MD 28 years of experience Performed approximately

More information

OBESITY AND WEIGHT LOSS SURGERY FOR THE PRIMARY CARE PHYSICIAN

OBESITY AND WEIGHT LOSS SURGERY FOR THE PRIMARY CARE PHYSICIAN OBESITY AND WEIGHT LOSS SURGERY FOR THE PRIMARY CARE PHYSICIAN Nicole Basa, M.D., F.A.C.S., F.A.S.M.B.S Assistant Professor of Surgery Texas A&M Medical School Bariatric Medical Director- Cedar Park Regional

More information

Weight Loss Surgery. Outline 3/30/12. What Every GI Nurse Needs to Know. Define Morbid Obesity & its Medical Consequences. Treatments for Obesity

Weight Loss Surgery. Outline 3/30/12. What Every GI Nurse Needs to Know. Define Morbid Obesity & its Medical Consequences. Treatments for Obesity 3/30/12 Weight Loss Surgery What Every GI Nurse Needs to Know Kenneth A Cooper, D.O. March 31, 2012 Outline Define Morbid Obesity & its Medical Consequences Treatments for Obesity Bariatric (Weight-loss)

More information

Obesity and Weight Loss Surgery for the Primary Care Physician

Obesity and Weight Loss Surgery for the Primary Care Physician Saturday General Session Obesity and Weight Loss Surgery for the Primary Care Physician Nicole Basa, MD Bariatric and General Surgeon Cedar Park Surgeons, PA Cedar Park, Texas Educational Objectives By

More information

Clinical Staging for Obesity. Raj Padwal Clinical Pharmacology and General Internal Medicine University of Alberta

Clinical Staging for Obesity. Raj Padwal Clinical Pharmacology and General Internal Medicine University of Alberta Clinical Staging for Obesity Raj Padwal Clinical Pharmacology and General Internal Medicine University of Alberta Disclosures Funding: CIHR, Heart and Stroke Foundation of Canada, University Hospital Foundation.

More information

Here are some types of gastric bypass surgery:

Here are some types of gastric bypass surgery: Gastric Bypass- Definition By Mayo Clinic staff Weight-loss (bariatric) surgeries change your digestive system, often limiting the amount of food you can eat. These surgeries help you lose weight and can

More information

SURGICAL MANAGEMENT OF OBESITY. Anne Lidor, MD, MPH Professor of Surgery Chief, Division of Minimally Invasive and Bariatric Surgery

SURGICAL MANAGEMENT OF OBESITY. Anne Lidor, MD, MPH Professor of Surgery Chief, Division of Minimally Invasive and Bariatric Surgery SURGICAL MANAGEMENT OF OBESITY Anne Lidor, MD, MPH Professor of Surgery Chief, Division of Minimally Invasive and Bariatric Surgery Multi-Factorial Causes of Morbid Obesity include: Genetic Environmental

More information

Surgical Therapy for Morbid Obesity. Janeen Jordan, PGY 5 Surgical Grand Rounds April 7, 2008

Surgical Therapy for Morbid Obesity. Janeen Jordan, PGY 5 Surgical Grand Rounds April 7, 2008 Surgical Therapy for Morbid Obesity Janeen Jordan, PGY 5 Surgical Grand Rounds April 7, 28 Obesity BMI > 3 kg/m 2 Moderate 35-4 kg/m 2 Morbid >4 kg/m 2 1.7 BILLION Overweight Adults in the world 63 MILLION

More information

Dr.Kamal Waheeb AlGhalayini MD, SCC Med. MSc-Card Associate professor, Consultant Cardiology. Head non-invasive lab. Vice dean for clinical affaires

Dr.Kamal Waheeb AlGhalayini MD, SCC Med. MSc-Card Associate professor, Consultant Cardiology. Head non-invasive lab. Vice dean for clinical affaires Dr.Kamal Waheeb AlGhalayini MD, SCC Med. MSc-Card Associate professor, Consultant Cardiology. Head non-invasive lab. Vice dean for clinical affaires King Abdulaziz University. Doc, I am fat because my

More information

A Bariatric Patient in my Waiting Room: Choosing the Right Patient for the Right Operation: Bariatric Surgery Indications

A Bariatric Patient in my Waiting Room: Choosing the Right Patient for the Right Operation: Bariatric Surgery Indications A Bariatric Patient in my Waiting Room: Choosing the Right Patient for the Right Operation: Bariatric Surgery Indications Shahzeer Karmali MD FRCSC FACS Associate Professor Surgery University of Alberta

More information

Mustafa W. Aman, M.D. Director, Bariatric Surgery Program Guthrie Robert Packer Hospital

Mustafa W. Aman, M.D. Director, Bariatric Surgery Program Guthrie Robert Packer Hospital 09/16/2017 presented by: Mustafa W. Aman, M.D. Director, Bariatric Surgery Program Guthrie Robert Packer Hospital I have no financial disclosures pertaining to any commercial interests Describe the role

More information

Effective Interventions in the Clinical Setting: Engaging and Empowering Patients. Michael J. Bloch, M.D. Doina Kulick, M.D.

Effective Interventions in the Clinical Setting: Engaging and Empowering Patients. Michael J. Bloch, M.D. Doina Kulick, M.D. Effective Interventions in the Clinical Setting: Engaging and Empowering Patients Michael J. Bloch, M.D. Doina Kulick, M.D. UNIVERSITY OF NEVADA SCHOOL of MEDICINE Sept. 8, 2011 Reality check: What could

More information

Gastrointestinal Surgery for Severe Obesity 2.0 Contact Hours Presented by: CEU Professor

Gastrointestinal Surgery for Severe Obesity 2.0 Contact Hours Presented by: CEU Professor Gastrointestinal Surgery for Severe Obesity 2.0 Contact Hours Presented by: CEU Professor 7 www.ceuprofessoronline.com Copyright 8 2007 The Magellan Group, LLC All Rights Reserved. Reproduction and distribution

More information

Page 2: Baker IDI. Page 4: Baker IDI. Global & Regional Obesity. High income English speaking Light Blue. Global & Regional Severe obesity

Page 2: Baker IDI. Page 4: Baker IDI. Global & Regional Obesity. High income English speaking Light Blue. Global & Regional Severe obesity Metabolic Update Patients selection and choice of procedure Professor John B Dixon MBBS, FRACGP, FRCP Edin, PhD NHMRC Senior Research Fellow Head of Clinical Obesity Research, Baker IDI Heart and Diabetes

More information

6/23/2011. Bariatric Surgery: What the Primary Care Provider Should Know. Case Presentation: Rachelle

6/23/2011. Bariatric Surgery: What the Primary Care Provider Should Know. Case Presentation: Rachelle Bariatric Surgery: What the Primary Care Provider Should Know 2,000 B.C. 2,000 A.D. Case Presentation: Rachelle 35 year-old woman with morbid obesity. 5 1 236 lbs BMI 44.5 PMHx: mild depression obstructive

More information

Bariatric Surgery MM /11/2001. HMO; PPO; QUEST 05/01/2012 Section: Surgery Place(s) of Service: Outpatient; Inpatient

Bariatric Surgery MM /11/2001. HMO; PPO; QUEST 05/01/2012 Section: Surgery Place(s) of Service: Outpatient; Inpatient Bariatric Surgery Policy Number: Original Effective Date: MM.06.003 09/11/2001 Line(s) of Business: Current Effective Date: HMO; PPO; QUEST 05/01/2012 Section: Surgery Place(s) of Service: Outpatient;

More information

Lecture Goals. Body Mass Index. Obesity Definitions. Bariatric Surgery What the PCP Needs to Know 11/17/2009. Indications for bariatric Surgeries

Lecture Goals. Body Mass Index. Obesity Definitions. Bariatric Surgery What the PCP Needs to Know 11/17/2009. Indications for bariatric Surgeries Bariatric Surgery What the PCP Needs to Know Mouna Abouamara Assistant Professor Internal Medicine James H Quillen College Of Medicine Lecture Goals Indications for bariatric Surgeries Different types

More information

FRESH START. Time For A BARIATRIC SURGERY! WHAT IS BARIATRIC SURGERY? UHS Medical Times EVERYTHING YOU NEED TO KNOW ABOUT علاج ال دانة وجراحة السمنة

FRESH START. Time For A BARIATRIC SURGERY! WHAT IS BARIATRIC SURGERY? UHS Medical Times EVERYTHING YOU NEED TO KNOW ABOUT علاج ال دانة وجراحة السمنة UHS Medical Times 1 Newsletter September 2018 علاج ال دانة وجراحة السمنة MINIMALLY INVASIVE Time For A FRESH START EVERYTHING YOU NEED TO KNOW ABOUT BARIATRIC SURGERY! While any surgical procedure carries

More information

Bariatric Surgery. Overview of Procedural Options

Bariatric Surgery. Overview of Procedural Options Bariatric Surgery Overview of Procedural Options The Obesity Epidemic In 1991, NO state had an obesity rate above 20% 1 As of 2010, more than two-thirds of states (38) now have adult obesity rates above

More information

Bariatric Surgery: Indications and Ethical Concerns

Bariatric Surgery: Indications and Ethical Concerns Bariatric Surgery: Indications and Ethical Concerns Ramzi Alami, M.D. F.A.C.S Assistant Professor of Surgery American University of Beirut Medical Center Beirut, Lebanon Nothing to Disclose Determined

More information

Depression, anxiety, and obesity

Depression, anxiety, and obesity Depression, anxiety, and obesity 5As Team Learning modules Depression and anxiety are two prevalent mood disorders that affect Canadians, with as many as 40-70% of overweight/obese individuals at high

More information

25/10/2017. Obesity Treatment Pyramid. Australian s BMI - 28% are obese. Bariatric-Metabolic Surgery: What the GP needs to know

25/10/2017. Obesity Treatment Pyramid. Australian s BMI - 28% are obese. Bariatric-Metabolic Surgery: What the GP needs to know Bariatric-Metabolic Surgery: What the GP needs to know Disclosures: Professor John B Dixon Professor John B Dixon Head of the Clinical Obesity Research Laboratory Baker Heart and Diabetes Institute, Melbourne

More information

10/28/11. Bariatric Surgery: What the Primary Care Provider Should Know. Case Presentation: Rachelle

10/28/11. Bariatric Surgery: What the Primary Care Provider Should Know. Case Presentation: Rachelle Bariatric Surgery: What the Primary Care Provider Should Know 2,000 B.C. 2,000 A.D. Case Presentation: Rachelle 35 year-old woman with morbid obesity. 5 1 236 lbs BMI 44.5 PMHx: mild depression obstructive

More information

10/16/2014. Normal Weight: BMI Overweight: BMI >25 Obese: BMI >30 Morbidly Obese: BMI >40 or >35 with 2 comorbidities

10/16/2014. Normal Weight: BMI Overweight: BMI >25 Obese: BMI >30 Morbidly Obese: BMI >40 or >35 with 2 comorbidities Brinton Clark, MD, MPH Department of Medical Education Providence Portland Medical Center October 25 th, 2014 Oregon Society of Physician Assistants Fall Conference 45 yo woman with BMI=40kg/m2 (weight

More information

Management of the Bariatric. Farah A. Husain MD, FACS, FASMBS Division Chief, Bariatric Services. Surgery Patient 2017

Management of the Bariatric. Farah A. Husain MD, FACS, FASMBS Division Chief, Bariatric Services. Surgery Patient 2017 Management of the Bariatric Farah A. Husain MD, FACS, FASMBS Division Chief, Bariatric Services Surgery Patient 2017 Financial Disclosures None Objectives Identify the most commonly performed bariatric

More information

OBESITY:Pharmacotherapy Vs Surgery

OBESITY:Pharmacotherapy Vs Surgery OBESITY:Pharmacotherapy Vs Surgery Dr. Ranajit Sen Chowdhury Associate Professor Department of Medicine Sir Salimullah Medical College & Mitford Hospital. 1 Historical Perspective Paleolithic Era > 25,000

More information

INFORMED CONSENT FOR LAPAROSCOPIC ADJUSTABLE GASTRIC BAND. Please read this form carefully and ask about anything you may not understand.

INFORMED CONSENT FOR LAPAROSCOPIC ADJUSTABLE GASTRIC BAND. Please read this form carefully and ask about anything you may not understand. Please read this form carefully and ask about anything you may not understand. I consent to undergo laparoscopic placement of a laparoscopic Adjustable Gastric Band for the purposes of weight loss. I met

More information

The Growing Epidemic of Diabetes

The Growing Epidemic of Diabetes The Ad Hoc Group for Medical Research Luncheon Briefing for Senate and House Staff The Growing Epidemic of Diabetes and What the NIH Is Doing About It Griffin. Rodgers, M.D., M.A.C.. Director National

More information

Page 2: Baker IDI. Page 4: Baker IDI. Global & Regional Obesity. High income English speaking Light Blue. Global & Regional Severe obesity

Page 2: Baker IDI. Page 4: Baker IDI. Global & Regional Obesity. High income English speaking Light Blue. Global & Regional Severe obesity Metabolic Surgery Update Patients selection and choice of procedure Professor John B Dixon MBBS, FRACGP, FRCP Edin, PhD NHMRC Senior Research Fellow Head of Clinical Obesity Research, Baker IDI Heart and

More information

Goals 1/9/2018. Obesity over the last decade Surgery has become a safer management strategy Surgical options for management

Goals 1/9/2018. Obesity over the last decade Surgery has become a safer management strategy Surgical options for management The Current State of Surgical Intervention in Management of Morbid Obesity Goals Obesity over the last decade Surgery has become a safer management strategy Surgical options for management 1 Goals Obesity

More information

Technique. Matthew Bettendorf, MD Essentia Health Duluth Clinic. Laparoscopic approach One 12mm port, Four 5mm ports

Technique. Matthew Bettendorf, MD Essentia Health Duluth Clinic. Laparoscopic approach One 12mm port, Four 5mm ports Matthew Bettendorf, MD Essentia Health Duluth Clinic Technique Laparoscopic approach One 12mm port, Four 5mm ports Single staple line with no anastamosis 85% gastrectomy Goal to remove

More information

DON T LET OBESITY SPOIL YOUR HEALTH AND YOUR LIFE

DON T LET OBESITY SPOIL YOUR HEALTH AND YOUR LIFE July 2015 Issue No.17 DON T LET OBESITY SPOIL YOUR HEALTH AND YOUR LIFE www.sghgroup.com JEDDAH RIYADH MEDINA ASEER HAIL SANAA DUBAI CAIRO Definitions Over View and General Facts General Key facts! Worldwide

More information

Laparoscopic Weight Loss Surgery (Bariatric Surgery) A simple guide to help answer your questions

Laparoscopic Weight Loss Surgery (Bariatric Surgery) A simple guide to help answer your questions Laparoscopic Weight Loss Surgery (Bariatric Surgery) A simple guide to help answer your questions Weight problems are growing in the US More than 100 million Americans are overweight Half of these people

More information

International Health Brief

International Health Brief International Health Brief Bariatric Surgery In this Health Brief, we look at the growing utilization of bariatric surgery as a means of achieving rapid weight loss, and consider if it should be covered

More information

Adipocytes, Obesity, Bariatric Surgery and its Complications

Adipocytes, Obesity, Bariatric Surgery and its Complications Adipocytes, Obesity, Bariatric Surgery and its Complications Daniel C. Morris, MD, FACEP, FAHA Senior Staff Physician Department of Emergency Medicine Objectives Basic science of adipocyte Adipocyte tissue

More information

The Surgical Management of Obesity

The Surgical Management of Obesity The Surgical Management of Obesity Omar al noubani MD,MRCS وك ل وا و اش ز ب وا و ال ت س رف وا األعراف ما مأل ابن آدم وعاء شر ا من بطنه Persons who are naturally fat are apt to die earlier than those who

More information

Chapter 4 Section 13.2

Chapter 4 Section 13.2 TRICARE Policy Manual 6010.60-M, April 1, 2015 Surgery Chapter 4 Section 13.2 Issue Date: November 9, 1982 Authority: 32 CFR 199.2(b) and 32 CFR 199.4(e)(15) Copyright: CPT only 2006 American Medical Association

More information

Jordan Garrison Jr. MD, FACS, FASMBS

Jordan Garrison Jr. MD, FACS, FASMBS Jordan Garrison Jr. MD, FACS, FASMBS A life-long progressive, lifethreatening, geneticallyrelated, costly, multifactorial disease of excess fat storage with multiple comorbidities ~ 25% industrialized

More information

11/11/2011. Bariatric Surgery for Sleep Apnea. Case Presentation: Rachelle. Case Presentation: Rachelle. Case Presentation: Rachelle

11/11/2011. Bariatric Surgery for Sleep Apnea. Case Presentation: Rachelle. Case Presentation: Rachelle. Case Presentation: Rachelle Bariatric Surgery for Sleep Apnea 2,000 B.C. 2,000 A.D. 35 year-old woman with morbid obesity. 5 1 236 lbs BMI 44.5 PMHx: mild depression obstructive sleep apnea (AHI 42, on CPAP) asthma polycystic ovarian

More information

Table Classification of body mass index (BMI) and risk of comorbidities in adults (WHO, 1998; WHO Expert Consultation,

Table Classification of body mass index (BMI) and risk of comorbidities in adults (WHO, 1998; WHO Expert Consultation, Table 7.13.1 Classification of body mass index (BMI) and risk of comorbidities in adults (WHO, 1998; WHO Expert Consultation, 2004) Classification BMI (kg/m 2 ) BMI (kg/ m 2 ) Asian origin Risk of comorbidities

More information

Bariatric surgery: Impact on Co-morbidities and Weight Loss Expectations ALIYAH KANJI, MD FRCSC MIS AND BARIATRIC SURGERY SEPTEMBER 22, 2018

Bariatric surgery: Impact on Co-morbidities and Weight Loss Expectations ALIYAH KANJI, MD FRCSC MIS AND BARIATRIC SURGERY SEPTEMBER 22, 2018 Bariatric surgery: Impact on Co-morbidities and Weight Loss Expectations ALIYAH KANJI, MD FRCSC MIS AND BARIATRIC SURGERY SEPTEMBER 22, 2018 Disclosures None Objectives Review expected weight loss from

More information

ACHIEVING HEALTH: AGENDA: Achieving Health: A Look at Your Weight Management Options

ACHIEVING HEALTH: AGENDA: Achieving Health: A Look at Your Weight Management Options ACHIEVING HEALTH: A Look at Your Weight Management Options Achieving Health: A Look at Your Weight Management Options AGENDA: Achieving Health: A Look at Your Weight Management Options Topic 1 Behavior

More information

Morbid Obesity A Curable Disease?

Morbid Obesity A Curable Disease? Morbid Obesity A Curable Disease? Piotr Gorecki, M.D. F.A.C.S. Associate Professor of Clinical Surgery Weill Medical College of Cornell University Chief of Laparoscopic Surgery New York Methodist Hospital

More information

Weight Loss Surgery Program

Weight Loss Surgery Program Weight Loss Surgery Program More than 500,000 Americans die prematurely each year from obesity-related complications, and it is one of the leading causes of preventable death. If you want to do something

More information

BARIATRIC SURGERY. Weight Loss Surgery. A variety of surgical procedures to reduce weight performed on people who have obesity. Therapy Male & Female

BARIATRIC SURGERY. Weight Loss Surgery. A variety of surgical procedures to reduce weight performed on people who have obesity. Therapy Male & Female BARIATRIC SURGERY Weight Loss Surgery A variety of surgical procedures to reduce weight performed on people who have obesity. Therapy Male & Female About Bariatric surgery Bariatric surgery offers a treatment

More information

Bariatric Surgery. The Oregon Bariatric Center Surgical Team

Bariatric Surgery. The Oregon Bariatric Center Surgical Team Bariatric Surgery The Oregon Bariatric Center Surgical Team Colin MacColl, MD, Medical Director, Bariatric Surgeon Jessica Folek, MD, Bariatric Surgeon I have no disclosures Disclosures Objectives What

More information

Considering Bariatric Surgery? Learn about minimally invasive da Vinci Surgery

Considering Bariatric Surgery? Learn about minimally invasive da Vinci Surgery Considering Bariatric Surgery? Learn about minimally invasive da Vinci Surgery The Surgery: Bariatric Surgery There are many non-surgical treatments for obesity such as dieting, exercise, and medicine.

More information

The Bariatric and Heartburn Center of Northeast Ohio

The Bariatric and Heartburn Center of Northeast Ohio The Bariatric and Heartburn Center of Northeast Ohio A message from Dr. Chlysta: Walter J. Chlysta MD, FACS, FASMBS 1900 23 rd Street, Suite 403 Cuyahoga Falls, OH 44223 Phone 330-926-3443 Fax 330-255-5092

More information

Understanding Obesity & Severe Obesity

Understanding Obesity & Severe Obesity Understanding Obesity & Severe Obesity Understanding Obesity & Severe Obesity You may have questions about obesity. This brochure can help answer those questions. On the following pages, you will learn

More information

Bariatric Surgery: How complex is this? Pradeep Pallati, MD, FACS, FASMBS

Bariatric Surgery: How complex is this? Pradeep Pallati, MD, FACS, FASMBS Bariatric Surgery: How complex is this? Pradeep Pallati, MD, FACS, FASMBS Nothing to Disclose Types of Bariatric Surgery Restrictive Malabsorptive Combination Restrictive and Malabsorptive Newer Endoluminal

More information

Bariatric Surgery: The Primary Care Approach

Bariatric Surgery: The Primary Care Approach The 8 th Annual Conference of the Lebanese Society of Family Medicine October 25 th 2009 Bariatric Surgery: The Primary Care Approach Bassem Y. Safadi, MD, FACS Associate Professor of Clinical Surgery

More information

Disclosures. Obesity and Its Challenges: Outline. Outline 5/2/2013. Lan Vu, MD Division of Pediatric Surgery Department of Surgery

Disclosures. Obesity and Its Challenges: Outline. Outline 5/2/2013. Lan Vu, MD Division of Pediatric Surgery Department of Surgery Obesity and Its Challenges: Bariatric Surgery: Why or Why Not I have nothing to disclose Disclosures Lan Vu, MD Division of Pediatric Surgery Department of Surgery Outline Growing obesity epidemic Not

More information

Laparoscopic Gastric Bypass Information

Laparoscopic Gastric Bypass Information 1441 Constitution Boulevard, Salinas, CA 93906 (831) 783-2556 www.natividad.com/weight-loss (Roux-en-Y Gastric Bypass) What is gastric bypass surgery? Gastric bypass surgery, a type of bariatric surgery

More information

Commonly Performed Bariatric Procedures in Singapore. Lin Jinlin Associate Consultant General, Upper GI and Bariatric Surgery Changi General Hospital

Commonly Performed Bariatric Procedures in Singapore. Lin Jinlin Associate Consultant General, Upper GI and Bariatric Surgery Changi General Hospital Commonly Performed Bariatric Procedures in Singapore Lin Jinlin Associate Consultant General, Upper GI and Bariatric Surgery Changi General Hospital Scope 1. Introduction 2. Principles of bariatric surgery

More information

Obesity: Pharmacologic and Surgical Management

Obesity: Pharmacologic and Surgical Management Obesity: Pharmacologic and Surgical Management ADRIENNE YOUDIM, MD, FACP ASSOCIATE PROFESSOR OF MEDICINE, UCLA ASSISTANT PROFESSOR OF MEDICINE, CEDARS SINAI MEDICAL CENTER JANUARY 2018 Defining Obesity

More information

Gastric Balloon for Weight Loss. Karol A Gutowski, MD, FACS Hot Topics

Gastric Balloon for Weight Loss. Karol A Gutowski, MD, FACS Hot Topics Gastric Balloon for Weight Loss Karol A Gutowski, MD, FACS Hot Topics Disclosures None related to this topic Will use brand names due to lack of distinguishing generic names Presentation Level of Evidence

More information

Obesity and Cancer Survivorship. Cynthia Thomson, PhD, RD Professor-Mel & Enid Zuckerman College of Public Health University of Arizona

Obesity and Cancer Survivorship. Cynthia Thomson, PhD, RD Professor-Mel & Enid Zuckerman College of Public Health University of Arizona Obesity and Cancer Survivorship Cynthia Thomson, PhD, RD Professor-Mel & Enid Zuckerman College of Public Health University of Arizona Objectives Describe the relationship between obesity, weight gain

More information

Chapter 4 Section 13.2

Chapter 4 Section 13.2 Surgery Chapter 4 Section 13.2 Issue Date: November 9, 1982 Authority: 32 CFR 199.2(b) and 32 CFR 199.4(e)(15) 1.0 CPT 1 PROCEDURE CODES 43644, 43770-43774, 43842, 43846, 43848 2.0 HCPCS PROCEDURE CODES

More information

Restrictive Procedures: Band and Sleeve

Restrictive Procedures: Band and Sleeve Restrictive Procedures: Band and Sleeve Jin S. Yoo M.D. Assistant Professor of Surgery Jin.Yoo@duke.edu Disclosures Speaker for Cook Medical, Covidien, W.L. Gore Consultant for Musculoskeletal Transplant

More information

Bariatric Surgery: A Cost-effective Treatment of Obesity?

Bariatric Surgery: A Cost-effective Treatment of Obesity? Bariatric Surgery: A Cost-effective Treatment of Obesity? Shaneeta M. Johnson MD FACS FASMBS 2018 NMA Professional Development Seminar Congressional Black Caucus Foundation Annual Legislative Conference

More information

Learning To Lean On Others

Learning To Lean On Others Learning To Lean On Others Finding the right support system in your surgical journey Tracy Martinez RN,BSN,CBN Bariatric and Metabolic surgery has been proven to be the most effective therapy in the treatment

More information

It s More Than Surgery. It s a Life Changer. Scripps Clinic Center for Weight Management is the most comprehensive weight loss program in San Diego.

It s More Than Surgery. It s a Life Changer. Scripps Clinic Center for Weight Management is the most comprehensive weight loss program in San Diego. It s More Than Surgery. It s a Life Changer. Scripps Clinic Center for Weight Management is the most comprehensive weight loss program in San Diego. Now that you have your guide, how about taking one more

More information

Weight Regulation after Bariatric Surgery

Weight Regulation after Bariatric Surgery Weight Regulation after Bariatric Surgery New Jersey Chapter of the American Association of Clinical Endocrinologists 11 th Annual Meeting October 6, 2018 Judith Korner, MD, PhD Professor of Medicine Director,

More information

3 Things To Know About Obesity Surgery

3 Things To Know About Obesity Surgery 3 Things To Know About Obesity Surgery Dr Jon Armstrong 1st Edition Introduction... 3 1. Am I A Candidate?... 4 2. What Are The Options?... 5 3. How Does It Work?... 6 Conclusion... 9 Follow me here...

More information

Bariatric Surgery. Bariatric surgery could be your best option for living a healthy life. Let s find out together.

Bariatric Surgery. Bariatric surgery could be your best option for living a healthy life. Let s find out together. Bariatric Surgery Bariatric surgery could be your best option for living a healthy life. Let s find out together. 1 What is obesity? Obesity is a complex health issue, characterized by an excessive amount

More information

An Introduction to Bariatric Surgery

An Introduction to Bariatric Surgery An Introduction to Bariatric Surgery What is bariatric surgery? Bariatric surgery is a treatment used to help people with obesity manage their health and weight. Why use surgery to manage obesity? Obesity

More information

I want to be a good example for my daughters.

I want to be a good example for my daughters. I want to be a good example for my daughters. I chose weight loss surgery because I want to be healthy. I was very overweight, often short of breath and experienced hip and knee pain from carrying around

More information

Metabolic & Bariatric Surgery Program Information Session

Metabolic & Bariatric Surgery Program Information Session Metabolic & Bariatric Surgery Program Information Session Why have Bariatric Surgery at MUSC? The Expert Experience Most established program in the area Dedicated interdisciplinary team Recognized and

More information

Policy Specific Section: April 14, 1970 June 28, 2013

Policy Specific Section: April 14, 1970 June 28, 2013 Medical Policy Bariatric Surgery Type: Medical Necessity and Investigational / Experimental Policy Specific Section: Surgery Original Policy Date: Effective Date: April 14, 1970 June 28, 2013 Definitions

More information

Steps of the Laparoscopic Roux-en-Y Gastric Bypass: Steps of the Laparoscopic Gastric Sleeve:

Steps of the Laparoscopic Roux-en-Y Gastric Bypass: Steps of the Laparoscopic Gastric Sleeve: Welcome to our virtual seminar about bariatric surgery with our practice, William A. Graber, MD, PC. This seminar is about 25 minutes long, so it might be a good idea to grab a pen and paper to jot down?s

More information

National Position Statement

National Position Statement National Position Statement Weight Loss Surgery (Bariatric Surgery) and its Use in Treating Obesity or Treating and Preventing Diabetes Background Approximately twenty five per cent (25%) of Australian

More information

Safety of Laparoscopic Vs Open Bariatric Surgery. Dr. Kishore Nadkarni Director Nadkarni Group of Hospitals Killa Pardi, Vapi, Valsad, Surat

Safety of Laparoscopic Vs Open Bariatric Surgery. Dr. Kishore Nadkarni Director Nadkarni Group of Hospitals Killa Pardi, Vapi, Valsad, Surat Safety of Laparoscopic Vs Open Bariatric Surgery 1 Dr. Kishore Nadkarni Director Nadkarni Group of Hospitals Killa Pardi, Vapi, Valsad, Surat Surgical Treatment of Obesity 2 Bariatrics is the branch of

More information

LOSE WEIGHT WITHOUT SURGERY

LOSE WEIGHT WITHOUT SURGERY THE THE 100% 100% NON-SURGICAL NON-SURGICAL SOLUTION SOLUTION LOSE WEIGHT WITHOUT SURGERY O V E R 2 2 0 B A L L O O N S P L A C E D, 0 0 0 #1 GASTRIC BALLOON I D E W O R L D W ORBERA Lose helped 3x patients

More information

Bariatric Surgery Guide

Bariatric Surgery Guide Bariatric Surgery Guide Lisa and Shawn Lost 147 lbs. & 183 lbs. Take the first step toward a healthier you and register for a free weight loss surgery seminar. 866-965-4957 Take the first step toward a

More information

Outline. Types of Bariatric Surgery. Adjustable Gastric Band (LAP-BAND) Bariatric surgery

Outline. Types of Bariatric Surgery. Adjustable Gastric Band (LAP-BAND) Bariatric surgery Bariatric surgery Rona Osborne, Specialist Obesity Dietitian Glasgow and Clyde Weight Management Service November 2012- Weight Management Training Outline Types of Bariatric surgery Evidence Clinical Guidelines

More information

What's Obesity all about?

What's Obesity all about? Disclaimer This movie is an educational resource only and should not be used to make a decision on Obesity management. All decisions about obesity management should be made in conjunction with your doctor

More information

Baritec Inc. Baritec GaBP Ring Certification. Marcio Café, M.D. Mark J. Kannia, Sales / Marketing Director C.Bruce Fields, Project Engineer CSTO

Baritec Inc. Baritec GaBP Ring Certification. Marcio Café, M.D. Mark J. Kannia, Sales / Marketing Director C.Bruce Fields, Project Engineer CSTO Baritec Inc Baritec GaBP Ring Certification Marcio Café, M.D. Mark J. Kannia, Sales / Marketing Director C.Bruce Fields, Project Engineer Presented to Minister of Heath. Brazil. December 2005 C.S.T.O.

More information

The Obesity Epidemic. John Ganser, MD, FACS Associate Professor UNSOM.

The Obesity Epidemic. John Ganser, MD, FACS Associate Professor UNSOM. The Obesity Epidemic John Ganser, MD, FACS Associate Professor UNSOM www.westernbariatricinstitute.com The Obesity Epidemic - Outline Statistics of the Epidemic Magnitude of the problem Mechanisms of Obesity

More information

Obesity Management Workshop for Health Professionals

Obesity Management Workshop for Health Professionals Obesity Management Workshop for Health Professionals 17 th November 2017 Dr Graeme Rich Gastroenterologist Director of Bariatrics Australia Is a procedure the magic bullet? Energy in >> Energy out Accepted

More information

JAMA February 10, 2010 Laparoscopic Adjustable Banding in Severely Obese Adolescents: A Randomized Trial

JAMA February 10, 2010 Laparoscopic Adjustable Banding in Severely Obese Adolescents: A Randomized Trial JAMA February 10, 2010 Laparoscopic Adjustable Banding in Severely Obese Adolescents: A Randomized Trial Daniel DeUgarte, MD Division of Pediatric Surgery Surgical Director, UCLA FIT Program Bariatric

More information

Bariatric Surgery for Weight Loss

Bariatric Surgery for Weight Loss #60982 Bariatric Surgery for Weight Loss COURSE #60982 5 CE CREDITS Release Date: 06/01/18 Expiration Date: 05/31/21 Bariatric Surgery for Weight Loss Faculty John J. Whyte, MD, MPH, is currently the Director

More information

MEDICAL POLICY No R5 SURGICAL TREATMENT OF OBESITY

MEDICAL POLICY No R5 SURGICAL TREATMENT OF OBESITY SURGICAL TREATMENT OF OBESITY Effective Date: May 10, 2017 Review Dates: 8/11, 12/11, 2/12, 2/13, 2/14, 11/14, 2/15, 2/16, 2/17 Date Of Origin: August 10, 2011 Status: Current Note: This medical policy

More information

Consent Form for. Bariatric weight-losing surgery

Consent Form for. Bariatric weight-losing surgery Consent Form for Version 03/17 Bariatric weight-losing surgery Morbid obesity is a risk factor for the development of diseases such as diabetes, hypertension, sleep apnea, excess lipids in the blood, heart

More information

Bariatric Surgery Corporate Medical Policy

Bariatric Surgery Corporate Medical Policy Bariatric Surgery Corporate Medical Policy File name: Bariatric Surgery File code: UM.SURG.01 Origination: 07/2008 Last Review: 06/2018 Next Review: 06/2019 Effective Date: 10/01/2018 Description/Summary

More information

Effect of Bariatric Surgery on Cardio-Metabolic Outcomes

Effect of Bariatric Surgery on Cardio-Metabolic Outcomes Effect of Bariatric Surgery on Cardio-Metabolic Outcomes Disclosure Research support from Bariatric Advantage (supplements donated for research study) Anne Schafer, MD Associate Professor of Medicine and

More information

One. Bariatric Surgery Guide

One. Bariatric Surgery Guide One Bariatric Surgery Guide Lisa and Shawn Lost 147 lbs. & 183 lbs. Take the first step toward a healthier you. Our Team is Your Team To lose weight, sometimes it takes more than just willpower and a lifestyle

More information

Pete Avara, MD, FACS South Mississippi Surgical Weight Loss Center

Pete Avara, MD, FACS South Mississippi Surgical Weight Loss Center Pete Avara, MD, FACS South Mississippi Surgical Weight Loss Center Obesity Disease State and Prevalence Economic & Medical impact Treatment Options Bariatric Surgery & Advancements in Surgery Safety &

More information

Obese Patients & Bariatric Surgery

Obese Patients & Bariatric Surgery Obese Patients & Bariatric Surgery Jenny Bramhall, Consultant Nurse Pre-Operative Assessment Heart of England Foundation Trustcurrently on secondment to the NHS Institute of Innovation & Improvement What

More information

You can lose weight.

You can lose weight. BARIATRIC CENTER You can lose weight. And our bariatric team will support your every step. Lauren 135 lb. weight loss Gastric Sleeve This was the best decision I ve made. My only regret was not doing it

More information

Kerri Wade, RN, MSN, PPCNP-BC Children s Mercy APRN Annual Conference October 7, The Children's Mercy Hospital, 2016

Kerri Wade, RN, MSN, PPCNP-BC Children s Mercy APRN Annual Conference October 7, The Children's Mercy Hospital, 2016 12345 Fit-Tastic: A Tool for Combating Childhood Obesity Kerri Wade, RN, MSN, PPCNP-BC Children s Mercy APRN Annual Conference October 7, 2016 The Children's Mercy Hospital, 2016 Disclosure I am a nurse

More information

Gastric Bypass Surgery

Gastric Bypass Surgery Gastric Bypass Surgery Introduction Obesity is associated with many diseases such as diabetes, high blood pressure, heart problems, and degeneration of the joints. These diseases and the obesity itself

More information

Nutritional Trends and Implications for Weight Loss Surgery

Nutritional Trends and Implications for Weight Loss Surgery Nutritional Trends and Implications for Weight Loss Surgery https://learn.extension.org/events/2550 This material is based upon work supported by the National Institute of Food and Agriculture, U.S. Department

More information

The Weight is Over. Surgical Weight Loss Options

The Weight is Over. Surgical Weight Loss Options The Weight is Over Surgical Weight Loss Options Meet the Team Surgeons: Dr. Lenz and Dr. Henson Bariatric Program Coordinator: Jessica Carter Surgical CMA: Heather Ballentine Behavioral and Mental Health

More information

7th International Congress of the Spanish Society of Obesity Surgery. Valladolid Spain May, 2004.

7th International Congress of the Spanish Society of Obesity Surgery. Valladolid Spain May, 2004. 7th International Congress of the Spanish Society of Obesity Surgery. Valladolid Spain May, 2004. DIMINISHING POSTOPERATIVE RISKS OF GASTRIC BYPASS Stenosis Stenosis Leak Leak Bleeding Bleeding Stenosis

More information