You place a high level of importance on the multidisciplinary team and mention that this is an important part of the Betsy Lehman Report. Why is it so important to have a multidisciplinary care team within bariatric surgery?
Severe obesity is a multifaceted disease; thus the treatment needs to be multidimensional. Staff that make up a multidisciplinary care team use the expertise in their respective fields to provide input and evaluate and manage the patient throughout the surgery and follow-up period. More information about our multidisciplinary team can be found at www.BIDMC.Harvard.edu/WLS. Read the rest of this article »

JONES: Laparoscopic vs. Open Roux-en-Y Gastric Bypass: Does the Data Support One Method Over the Other?

Kenneth B. Jones, Jr., MD, FACS, is Clinical Assistant Professor of Surgery, Louisiana State University, Health Sciences Center, Shreveport, Louisiana.

The term “minimally invasive, open Roux-en-Y gastric bypass with a left subcostal incision (RYGBP-LSI)” appears to be an oxymoron. “Open RYGBP” means a xiphoid to umbilical midline incision, but that may not always be the case. Many bariatric surgeons use a much smaller incision, and in over 4,000 bariatric cases (including various gastroplasties earlier on and then RYGBP in the past 20 years), I have used a left subcostal incision exclusively, which levels the laparoscopic versus open playing field, relative to abdominal access.

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Interviewed by Kelvin Higa, MD, FACS

The US experience with the jejunoileal (J-I) bypass was bittersweet. It was an effective weight loss and metabolic instrument, but the side effects, complications, and nutritional consequences gave us a healthy respect for malabsorption. I was recently invited to the Società Italiana di Chirurgia dell’Obesità in Florence, Italy, celebrating the 30th anniversary of the biliopancreatic diversion (BPD). As I am intrigued by the European interest in the gastric bypass and possess great admiration for Professor Scopinaro, I accepted the great honor of interviewing him on this subject. The following represents an annotated conversation that actually began over six years ago between Dr. Scopinaro and myself, and serves as a reflection for those of us in the field of bariatric surgery today who enjoy delving into the history and ideology behind some of its biggest developments. -Kelvin Higa, MD, FACS

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