An Interview with:

Dr. Walter Pories,Professor of Surgery, East Carolina University School of Medicine, Department of Surgery, Greenville, North Carolina, Past President, ASMBS

Dr. Neil Hutcher, Commonwealth Surgeons, Ltd., Richmond, Virginia; Past President, ASMBS

Dr. Ricardo Cohen, Director, The Center for the Surgical Treatment of Morbid Obesity and Metabolic Disorders, Hospital Oswaldo Cruz, and Baros Institute,
São Paulo, Brazil

Introduction by Joy C. Bunt, MD, PhD; and Robin Blackstone, MD, FACS Read the rest of this article »

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Interviewed by
Cynthia Alexander, PsyD

When Bariatric Times asked me to interview Dr. David Sarwer, I jumped at the chance. There are only a handful of psychologists who really understand the field of bariatric psychology. Anyone keeping up with bariatric research will be familiar with David B. Sarwer, PhD. He is Clinical Psychologist and Associate Professor of Psychology in Psychiatry, University of Pennsylvania, Philadelphia, and also the Director of Clinical Services for the Center for Weight and Eating Disorders and the Director for Stunkard Weight Management Program. His research and expertise have been guiding forces in bariatric psychology. Of particular interest is his research on plastic surgery and the bariatric patient, as well as on psychological issues related to plastic surgery. I would like to thank Dr. Sarwer personally and on behalf of Bariatric Times for the time he invested in this interview. I am sure this exchange of questions and enlightening responses will be of interest to a wide variety of professionals working with bariatric patients, and should help us all better understand our patients in an effort to provide improved and informed multidisciplinary care.

-Cynthia Alexander, PsyD Read the rest of this article »

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For how many years have you been the executive director of ASMBS?
It will be 13 years as of January 1, 2009.

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What do you think expanding the society’s realm to metabolic surgery has accomplished?
Actually, it has always been about metabolic surgery. We just changed our name to be more descriptive and accurate about what we were doing. The name change has done well to focus our efforts and resolve in making access to care a primary objective. As bariatric surgery accomplishes so much to improve the health and longevity of our patients, how can we ethically stand by while insurance companies deny coverage?
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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 »

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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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To what do you attribute the growth of obesity in our population?

Dr. Wittgrove: Obesity is such a complex disease. It is certainly rooted in genetics, but there are so many environmental issues that influence the overall expression of the genetic potential. The fact that we are less active and have more carbohydrates in our diet does not help. I believe that if you are so genetically encoded and you get about 40 percent over your ideal body weight, you no longer have the physiologic feedback of satiety and that makes it impossible (or nearly impossible) to stay on a diet unless you receive the tool of surgical intervention.

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