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Bariatric surgery continues to advance with improvements in procedures and techniques that can benefit patients with safer, quicker, and better surgical outcomes.

One of the latest advances to emerge in weight loss surgery is a new surgical platform known as the STARR Treatment. STARR, an acronym for Surgical Tiny Access and Rapid Recovery is not a new type of weight loss surgery, but an innovative laparoscopic system that improves upon current techniques for minimally invasive weight loss surgery.

The STARR Treatment is made possible with the SPIDER Surgical System and the SPIDER MicroLap line of tools from the medical device company TransEnterix. Using this newer laparoscopic system, bariatric surgeons can perform laparoscopic weight loss surgery through a small, single incision usually located in the patient’s belly button.
Since bariatric surgery patients experience fewer and smaller incisions with STARR weight loss surgery than with conventional laparoscopic surgery, they can potentially benefit from reduced post-operative pain, a quicker recovery, and a virtually scarless aesthetic outcome.

The term laparoscopic surgery, also known as minimally invasive surgery, refers to a surgical technique that allows operations in the abdomen to be performed through a series of small incisions, rather than the larger incisions needed for laparotomy, or open surgery. The development of laparoscopic surgery in the 1990?s was a significant advancement in surgical techniques and is generally the preferred option compared to open surgery for the majority of patients.

Now, the SPIDER Surgical System used in combination with the SPIDER MicroLap line of tools is set to advance laparoscopic surgery even further.

  • The SPIDER Surgical System is a flexible laparoscopic platform that allows multiple instruments to be used through a single, small incision approximately the same size as a dime (18mm); conventional laparoscopic surgery requires five to six across the patient’s abdomen.
  • The SPIDER MicroLap tools are significantly smaller, measuring only 2.7mm in diameter; conventional laparoscopic tools are typically 5mm to 10mm in diameter.

To perform laparoscopic surgery using the SPIDER system, the surgeon makes a small incision in the belly button and inserts the surgical device into the body. Once inside, the system expands like an umbrella, creating room at the surgical site for the surgeon to manipulate the tiny surgical tools so that they bend and move in a wide range of motion. When the procedure is complete, the system is collapsed; then the tools and system are removed from the body through the original incision.

Since patients receive fewer incisions with SPIDER surgery than with conventional laparoscopic surgery, they are expected to have less scarring, a faster recovery, and less post-operative pain. As with any type of surgery, however, every patient is different and surgical outcomes vary between patients. In some cases, more than one incision may be necessary. Patients are instructed to discuss their procedures and expectations with their surgeon.

The STARR Treatment has been successfully used to perform gastric banding and gastric sleeve weight loss procedures.

Find out more about all the latest in weight loss procedures and the best procedure for you by contacting the experts at Central Baptist Surgical Weight Loss Center in Lexington. 

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But the surgeon performing the operation also makes a difference, an expert says

MONDAY, Jan. 16 (HealthDay News) — Gastric bypass surgery results in faster and longer-lasting weight loss than does gastric banding, according to a new study by Swiss investigators.

A gastric bypass operation called Roux-en-Y involves reducing stomach size with staples and connecting the smaller “pouch” directly to the small intestine. It is irreversible.

Gastric banding, as its name implies, involves placing a band around part of the stomach to reduce its size. This procedure is reversible, the researchers noted.

“Both gastric banding and gastric bypass are currently performed for morbid obesity,” said lead researcher Dr. Michel Suter, chief surgeon at Chablais Hospital in Aigle.

“Bypass is more effective in terms of directs results such as weight loss, but a bit more dangerous immediately than banding,” he said.

However, banding often leads to long-term complications requiring some sort of major re-operation, Suter said.

“In addition, many bands are not going to stay in place for much more than 10 years; hence, banding is unlikely to be the only weight-loss procedure the patient will be submitted to,” he said. “Patients should make a choice knowing this, and decide whether they accept a slightly higher early risk to improve their results, or if they want the least invasive procedure, but then accept a high risk of further surgery at a later time.”

The report was published in the Jan. 16 online edition of the Archives of Surgery.

For the study, Suter’s team followed for six years 442 patients who had either gastric bypass surgery or banding.

Although there were more early surgical complications among those who had Roux-en-Y surgery, these patients lost more weight faster than those who had gastric banding, the researchers found.

After bypass surgery, about 17 percent of the patients had complications, compared with more than 5 percent of those who underwent banding, the researchers noted.

But at six years there were more problems with gastric banding, including about 48 percent who had weight gain or the procedure reversed, compared with about 12 percent who had bypass surgery, the study found.

Gastric banding was associated with more long-term complications (more than 42 percent versus 19 percent) and more new procedures than bypass surgery (about 27 percent vs. 13 percent).

Cholesterol levels among those who had gastric bypass surgery were consistently lower than among those who had gastric banding, who saw no change over time, the researchers add.

This finding implies that blood sugar levels were also lower among those who underwent gastric bypass surgery, the study authors said.

Suter is concerned that many patients are only offered banding and not told of its drawbacks.

“There is, in the United States, an extensive campaign promoting gastric banding as ‘the solution’ for obesity, which is far from being true,” he said.

It can result in significant weight loss, but it remains a surgical procedure, and is certainly associated with significant risks, both in the short and long term, Suter said.

“Patients must be informed that surgery alone is not sufficient to achieve significant weight loss, and they must be instructed about other things they have to do such as changing their eating and lifestyle habits,” he said.

In addition, Suter said, “Patients calling or referred for gastric banding must be informed about the other available procedures for morbid obesity, and not offered band only, as is the case in several places.”

Depending on the actual operation, either procedure costs between $10,000 and $20,000 plus follow-up costs, and insurance coverage is very inconsistent, according to Dr. Edward Livingston, who serves as the Dr. Lee Hudson-Robert R. Penn Chair in Surgery at the University of Texas Southwestern Medical Center, in Dallas.

Hospital stay for bypass is usually two days, and banding usually one day, but this can vary depending on surgeon, hospital and complications.

Dr. Jacques Himpens, from the European School of Laparoscopic Surgery at Saint Pierre University Hospital in Brussels and author of an accompanying journal editorial, is less concerned with a particular procedure than with the specific surgeon.

“Not all surgeons can do bypasses,” he said. “Maybe they don’t have the skills or the experience, but in any case it’s not the best option because they are not up to it,” he said. “That’s the case for many surgeons.”

In addition, it is not clear what the long-term results of a bypass are, because there is evidence that although a bypass “cures” diabetes, it does come back after time, Himpens said.

“The bypass is a very good procedure, but not everyone can do it and we have to be very careful and watch what the long-term effects of the procedure are,” he said.

Also, while a gastric bypass causes changes in metabolism, banding does not, Himpens said.

“But the good thing is that it is reversible. When you take out the band, no harm has been done and you can still do another procedure if you need to,” he said.

However, among patients who receive bands, only 40 percent retain them after 10 years, either because of complications or the desire to have it removed, Himpens said.

To find out more about weight loss procedures and which one is right for you, contact Central Baptist Hospital Surgical Weight Loss Center.

SOURCES: Michel Suter, M.D., chief surgeon, Chablais Hospital, Aigle, Switzerland; Edward Livingston, M.D., the Dr. Lee Hudson-Robert R. Penn Chair in Surgery, University of Texas Southwestern Medical Center, Dallas; Jacques Himpens, M.D., European School of Laparoscopic Surgery, Saint Pierre University Hospital, Brussels, Belgium; Jan. 16, 2012, Archives of Surgery, online

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Bariatric surgery leads to significant weight loss in the obese patient. Exercise has been shown to improve weight loss and body composition in non-surgical weight loss programmes. The role of exercise to improve weight loss following bariatric surgery is unclear. The objective of this review is to systematically appraise the evidence regarding exercise for weight loss in the treatment of obesity in bariatric surgery patients.

MEDLINE, AMED, CINAHL, EBM Reviews (Cochrane Database, Cochrane Clinical Trials Register) were searched, obesity-related journals were hand-searched and reference lists checked. Studies containing post-surgical patients and exercise were included with the primary outcome of interest being weight loss. A literature search identified 17 publications exploring exercise in bariatric surgery patients. All studies were observational; there were no intervention studies found. The most commonly used instruments to measure activity level were questionnaires followed by telephone interview, surgeon reporting and clinical notes.

There was a positive relationship between increased exercise and weight loss after surgery in 15 studies. Meta-analysis demonstrated in patients participating in exercise a standardised mean of 3.62 kg (CI?=?1.28, 5.96) greater weight loss compared to the minimal exercise groups. Observational studies suggest that exercise is associated with greater weight loss following bariatric surgery. Randomised controlled trials are required to further examine this relationship.

Find out more about the Support Groups and schedules at Central Baptist Surgical Weight Loss Center.  Click here to find out more.

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Roughly one-third of Americans say they have made a New Year’s resolution to lose weight in the last five years and 42 percent of people who said they smoke regularly in that time frame pledged to quit the habit, according to the Thomson Reuters-NPR Health Poll.

Thomson Reuters and NPR conduct a monthly poll to gauge attitudes and opinions on a wide range of health issues.

The survey, which asked respondents their opinions and experiences with New Year’s resolutions focused on weight loss and smoking, found that 57 percent of Americans who have made a pledge to lose weight in the last five years were successful.  Respondents who made a resolution to lose weight said most often that their goal was between 10 and 29 pounds (48 percent). The second most popular weight loss goal was 30-49 pounds (21 percent).

One in four respondents said they smoked regularly in the last five years. Forty two percent of that group said they resolved to quit smoking over that time and 36 percent said their plan was successful.

Americans are still making resolutions as they look forward to 2012.  Fifty one percent of all respondents indicated that they will make a resolution to exercise more in the upcoming New Year. Thirty five percent said they will make a pledge to lose weight and 9% of smokers indicated that they will make a resolution to quit smoking.

“As the country re-evaluates ways to reduce runaway healthcare spending, it is time for all Americans to be resolved to take better care of themselves and others.  Data demonstrates that the majority of medical costs can be traced back to poor lifestyle issues such as obesity and tobacco use,” said Raymond Fabius, M.D., chief medical officer at the healthcare business of Thomson Reuters.  “While we know it often takes several attempts to lose weight and quit smoking, it is encouraging that many survey participants are taking strides to improve their health in 2012.  Let’s celebrate and support those who have resolutions to lose weight, stop smoking, eat better and exercise.  If they can meet these New Year goals they will be healthier and wealthier for it as well as helping to solve America’s healthcare crisis!”

To date, the Thomson Reuters-NPR Health Poll has explored numerous health topics, including generic drugs, abortion, vaccines, food allergies, and organic and genetically modified foods. NPR’s reports on the surveys are archived online at the Shots health blog here.

Thomson Reuters maintains a library of poll results here.

The Thomson Reuters-NPR Health Poll is powered by the Thomson Reuters PULSE(SM) Healthcare Survey, an independently funded, nationally representative telephone poll that collects information about health-related behaviors and attitudes and healthcare utilization from more than 100,000 US households annually. Survey questions are developed in conjunction with NPR. The figures in this month’s poll are based on 3,015 participants interviewed from December 1-13, 2011. The margin of error is 1.8 percent.

If you need more information about weight loss and weight loss surgery in the Louisville area, give us a call today.  The trained professionals at Central Baptist Surgical Weight Loss Center are here to assist you with your questions.

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Dec
22

The Vertical Sleeve Gastrectomy

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Lexington Herald Leader/LMS

John S. Oldham, Jr., MD, FACS, FASMBS
Bluegrass Bariatric Surgical Associates
Medical Director of Bariatric Surgery at Central Baptist Hospital]

December 4, 2011 

According to the Centers for Disease Control in Atlanta, two thirds of Americans are overweight and 100 million or more Americans are obese.  Morbid obesity is defined as having a Body Mass Index (BMI) greater than 35, or being about 80 lbs. or more overweight.   Kentucky is currently the sixth most obese state in the nation, with an obesity rate greater than 35%. In addition to a decreased life expectancy, increased risk of heart disease and cancer,  and overall decreased quality of life, morbid obesity is associated with multiple illnesses such as diabetes, high blood pressure, high cholesterol, obstructive sleep apnea, arthritis, and fertility problems to name a few.

For select motivated patients, weight loss surgery (bariatric surgery) provides a tool to patients that can result in improved quality of life and resolution or improvement in many of these medical problems.

Although most people are familiar with gastric bypass and maybe even adjustable gastric bands such as the LapBand®, there is now a relatively new procedure called The Vertical Sleeve Gastrectomy (VSG) that has revolutionized weight loss surgery.

The VSG is an important new tool in weight loss surgery because it results in weight loss similar to gastric bypass 1) without a lot of the short- and long-term complications of gastric bypass and 2) without the need for a foreign body band or adjustments as with adjustable gastric banding.   The name “Vertical Sleeve Gastrectomy” is misleading in that no “sleeve” is placed.  Rather, through small laparoscopic incisions, the outer 85% of the stomach is surgically removed turning the stomach from a large storage reservoir into a small tube, about the size of a banana.  Patients are left with their own stomachs, but now holding only 10% of what a normal stomach would hold.  The natural connections of the stomach to the esophagus and to the small intestine are left undisturbed.  There is no re-routing of the intestines or foreign bodies.   The procedure takes about an hour and patients usually stay in the hospital 1-2 days and can return to full activities within three weeks.

Initially, the VSG was designed as a first step procedure in high risk patients.  The VSG has since been performed as a primary weight loss surgery for about 8 years in the United States and is recognized as an appropriate weight loss surgery procedure by the American Society of Metabolic and Bariatric Surgery.  The VSG is a covered benefit by the vast majority of insurers that cover bariatric surgery and is an offered procedure by all the Bariatric Programs in the Greater Lexington area.

For more information on VSG, contact Central Baptist Surgical Weight Loss Center today!

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Preparing Favorite Holiday Foods with Stevia instead of Sugar Cuts Calories

 

ATLANTA, Dec. 8, 2011 /PRNewswire/ – December often means a calendar packed with holiday parties and high-calorie foods. While in the thick of the holiday season, many can find themselves getting thicker around the middle.

Weight gained over the winter holidays is not typically lost during the following year.  Experts say that the average one pound gained between Thanksgiving and New Year’s Day can add up to five, ten, even 20 extra pounds over the years.  However, making some new changes to favorite recipes can help cut calories and keep weight gain at bay. Award-winning author, culinary expert and internationally-recognized chef Amy Riolo recommends substituting stevia, a zero-calorie sweetener, in place of sugar in some holiday classics, such as pumpkin pie.

“With the holidays here, it’s always a struggle to eat right. By replacing the added sugar with stevia, we’ve already cut way down on calories,” said Riolo. In the new video series at SteviaBenefits.org, Riolo prepares several recipes with stevia, including pan-Seared ahi tuna, fresh fruit yogurt parfait and whole wheat oat apple cranberry muffins as well as the holiday favorite. The website also features other holiday favorites with stevia as a sugar substitute such as cheesecake, brownies and red velvet cupcakes.

While used abroad for many years, stevia has more recently caught on in the United States as a sweetener. And in November, the European Commission approved stevia as a sweetener in foods and beverages. “Stevia provides the food and beverage industry with a wider repertoire for delivering zero-calorie sweetness and offering additional variety and choice for consumers,” said Haley Stevens, Ph.D., President of the Calorie Control Council, a non-profit international trade association of manufacturers of low-calorie and sugar-free foods and beverages.

Made from leaves of a plant of the Chrysanthemum family, the stevia plant (Stevia rebaudiana) is native to Paraguay and is grown today in many countries around the world. Steviol glycosides are found in the leaves of the stevia plant and each has a particular taste profile and sweetness intensity. Rebaudioside A is one of the many steviol glycosides in stevia leaves that provide sweetness.

As a safe zero calorie alternative to sugar in foods and beverages, experts also say stevia works well for individuals with diabetes because it doesn’t affect blood glucose levels.

For more information about stevia and how it can be used in recipes, visit steviabenefits.org.

Contact: Calorie Control Council, 404- 252-3663

Learn more about the Support Groups available with Central Baptist Hospital Surgical Weight Loss Center.

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Nov
28

Men should develop healthy eating habits

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Most men do not pay attention to their health as women do. In comparison to women, men are more likely to smoke and drink, make unhealthy or risky choices and put off regular check-ups with their physician.

The good news is that it is never too late to make different choices to support a healthy lifestyle. There are some simple things, all men can do to change and improve their overall health. It can begin with good nutrition, including these suggestions:

— Eat more fruits and vegetables. A 14-year study found that men whose diets were highest in fruits and vegetables had a 70 percent lower risk of digestive-tract cancers. How to reach your quota: Never eat a meal that doesn’t contain a vegetable or fruit. And no, fries don’t count.

— Try to have pasta with tomato sauce in your weekly routine, as two to four servings of tomato sauce can cut prostate cancer risk by 37 percent.

— Eating one serving of fish per week can halve your risk of a sudden fatal heart attack. The secret ingredient in fish is omega-3 fatty acids. Salmon is especially high in them.

— Breakfast is also an important component of the daily routine as a survey of more than 2,000 people who lost an average of 67 pounds and kept the weight off for more than 5 years found that 78 percent ate breakfast 7 days a week.

— You’re less likely to make bad eating choices at lunch if you eat properly in the morning, so start the day off with a breakfast of champions. Try a bowl of oatmeal and cup of low fat yogurt, or a poached egg with whole grain toast and fresh fruit.

— Most American men also need more fiber in their diets. Fiber not only has a host of important health benefits but also promotes satiety — the feeling of fullness that can keep you from overeating.

One simple way to increase fiber intake is to power up on bran. Bran from many grains is very rich in dietary fiber. Oat bran is high in soluble fiber, which has been shown to lower blood cholesterol levels. Wheat, corn  and rice bran are high in insoluble fiber, which helps prevent constipation.

Bran can be sprinkled into your favorite foods—from hot cereal and pancakes to muffins and cookies. Many popular high-fiber cereals and bars are also packed with bran.

There are other great fiber sources including: beans, berries, nuts and seeds, whole grain food products, peas, green leafy vegetables, squash, broccoli, cauliflower, kale, cabbage, brussels sprouts, russet potatoes, sweet potatoes and a variety of fruits.

— Make wise choices for protein. Several times a week, eat skinless chicken or fish. Choose only lean cuts of beef and pork. You only need six to nine ounces of protein daily in order to meet your daily requirement, states the USDA. One serving is the size of a card deck. If you are body building, this amount is increased by only three to five ounces.

— Lower your intake of saturated and/or trans fats as part of your healthy eating plan. Saturated fats are mainly found in animal products, as well as deep-fried foods, many fast foods, commercially prepared baked goods, boxed cereals, processed meats and processed foods. Trans fats are found in hardened fats such as shortening and partially hydrogenated oils. Avoid, or limit, foods made with these items. Many restaurant-prepared foods contain trans fats, and you will not know this without asking your server.

The Clark County Health Department supports healthy eating and active lifestyles. For more information about support with nutrition or activity options, contact the department at 744-4482. Visit the website at www.clarkhealthdept.org.

Central Baptist Hospital Weight Loss Center is a surgical weight loss center who provides weight loss surgery in Lexington.  Contact us today for more information.

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THE FACTS

Sleep apnea causes disrupted breathing in the middle of the night for more than 12 million Americans. Fatigue, high blood pressure and weight gain are some of its more familiar symptoms.

But a growing body of research has also found that sleep apnea can be a drain on intimacy, causing erectile dysfunction in men and loss of libido in women.

Scientists suspect this may have to do with sex hormones like testosterone, which rise with sleep and fall when there is a lack of it. Because it causes intermittent waking and chronic sleep deprivation, apnea may directly drive down levels of these hormones, causing sexual dysfunction.

In the most recent study, published last month in The Journal of Sexual Medicine, scientists compared 80 women with obstructive sleep apnea between the ages of 28 and 64 with 240 women without the condition. They found that the apnea patients had significantly higher rates of sexual dysfunction. Their findings echoed those of earlier studies on women and apnea.

In a study in 2009, researchers looked for signs of sexual problems in 401 men who showed up at a clinic for suspected sleep apnea. Of those who received the diagnosis, about 70 percent also had erectile dysfunction, compared with 34 percent in those without sleep apnea.

But on the bright side, treatment can make a difference. Patients who undergo surgery to correct facial abnormalities that contribute to apnea see improvements in intimacy, and those who start using masks at night that administer continuous positive airway pressure also report benefits in their sexual relationships.

THE BOTTOM LINE

Sleep apnea can raise the risk of sexual dysfunction.

The Central Baptist Weight Loss Surgery Team is composed of a diverse group of medical professionals trained specifically to meet the needs of pre and post bariatric surgery patients.  Get in touch with us today to find out how we can help you with your weight loss needs.

By: ANAHAD O’CONNOR

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