No Surprise: Laparoscopic Sleeve Gastrectomy Most Performed Operation in Asia-Pacific Region

| May 11, 2015

A Message from Dr. Raul J. Rosenthal

Raul J. Rosenthal, MD, FACS, FASMBS, Clinical Editor,
Bariatric Times; Chief of Staff, Professor of Surgery and Chairman, Department of General Surgery; Director of Minimally Invasive Surgery and The Bariatric and Metabolic Institute; General Surgery Residency Program Director; and Director, Fellowship in MIS and Bariatric Surgery, Cleveland Clinic Florida, Weston, Florida


Dear Friends and Readers:
I just returned from Seoul, Korea where I had the opportunity to attend the 11th annual meeting of the The International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) Asia-Pacific Chapter (APC). The story goes that 11 years ago, while attending the meeting as a course director, I went to an industry sponsored meeting on bariatric surgery in Seoul. I was surprised to see that most, if not all, Asian-Pacific countries were represented. I thought this was a unique opportunity to create a working group, and we voted on a president, vice president, and secretary. Dr. Wei Jei Lee became the President, Fred Zehng from China the Vice President, and all in attendance including myself became founding members of the IFSO APC. I cannot tell you how impressed I was this year to see such a phenomenal conference and vibrant society, one that has grown and matured to help its members deliver best practices in bariatric surgery. See photos from my trip at the end of this message.
The prevalence of obesity and the number of bariatric procedures are staggering in the Asia-Pacific region. Not to my surprise, sleeve gastrectomy is the most common procedure being performed there. Dr. Seung Ho Choi Congress President, and the organizing committee of IFSO-APC 2015 put together an excellent scientific program and very entertaining gala event. I congratulate my dear colleagues for their achievement. I wish the new IFSO-APC President Dr. Lilian Kow best of luck in her year as a regional leader.

This month, we feature an exciting new column titled, “The History of Bariatric Surgery.” Dr. Daniel Jones approached me and asked if I would be interested in publishing a column on the history of bariatric surgery, inviting those who “made it happen” to write and submit their stories. I immediately felt that it was an excellent idea. We are proud to present you with the first installment of this column featuring “the father of bariatric surgery” and a most unbelievable thinker, Dr. Ed Mason. It is true, Ed, that “against your thoughts and desire, we chose to use an irreversible procedure to treat severe obesity.” But isn’t obesity a chronic disease that will otherwise recur?

In one of my personal conversations with Ed, he mentioned to me how important hypoxia can be in recognizing early complications in the postoperative period. Two articles in this issue—Obesity’s Effects on Respiratory mechanics in the perioperative period by Geneviève Chartrand and Early technical and peri-operative complications of bariatric surgery by Drs. Tammy L. Kindel and Corrigan L. McBride—are perfect examples of Ed’s comments. As mentioned in previous editorials and published in Obesity Surgery, our experience is that tachycardia has been the most important sign to help identify complications. Sustained tachycardia above 120 beats per minute will make us suspect a leak while unsustained and intermittent tachycardia will point toward a bleed; however, none of these are an indication for immediate surgery unless the patient is hemodynamically unstable.

We present another new feature, a series of interviews with leaders in T2DM and obesity research and therapy,, that serves as a countdown to a phenomenal event that will bring two meetings together. The World Congress on Interventional Therapies for Type 2 Diabetes (WCITT2D) and 2nd Diabetes Surgery Summit (DSS) will take place September 28 to 30, 2015 in London, United Kingdom. We debut the series presenting an interview with Dr. Francesco Rubino who is Director of the WCITT2D and Co-director of the DSS. This series should give you a flair of what will be happening at the meeting and in the field. Mark your calendars! Those who are able to attend this unique meeting can look forward to also enjoying the Rugby World Cup!

Sincerely,
Raul J. Rosenthal, MD, FACS, FASMBS

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