Introducing “International Perspective: Obesity and Bariatric Surgery Trends Around the World”—A New Series of Exclusive Interviews and Reports Dedicated to Providing Updates on the Global State of Obesity

Dear Readers of Bariatric Times:

I just returned from Upsala, Sweden, after attending the 2nd Nordic Conference on Bariatric Surgery. The venue and presentations were outstanding, as expected, and the company was superlative. I send my congratulations to Dr. Magnus Sundbom for the excellent organization of the meeting. Meeting highlights included the disappointing news that, in Denmark, the BMI cutoff to become a candidate for bariatric surgery was raised to 50kg/m2. The latter has had a significant impact on the number of bariatric procedures performed in Denmark, affecting bariatric patients and surgeons. Another important impression I collected from the meeting was that gastric bypass is still the most frequently performed procedure in Scandinavia. I invite you to read Dr. Sundbom’s interview and report in our debut installment of a new series titled “International Perspective: Obesity and Bariatric Surgery Trends Around the World.” Upcoming installments will report on the state of obesity and bariatric surgery in the United Kingdom, Italy, and Belgium, to name a few.

Under the direction of Dr. Michel Gagner, the International Federation for the Surgery of Obesity and Metabolic Disorders will be hosting its 19th World Congress, August 26 to 30, 2014, in Montréal, Québec, Canada. As always, I am sure the program will be excellent and the venue will be terrific. I visited Montréal a few years ago and was amazed by its beauty. In this issue, Dr. Gagner provides a preview of the meeting. He also gives his history with the city and his own recommendations for where to go and what to do while in town.

In this month’s installment of “Checklists in Bariatric Surgery,” we share our current checklist on procedure choice in bariatric patients with gastroesophageal reflux disease (GERD) and motility disorders, which is certainly a hot topic in the era of sleeve gastrectomy. I must acknowledge that when we wrote the consensus article on technique for laparoscopic sleeve gastrectomy (LSG), we found our recommendation for LSG to be an absolute contraindication in patients with Barrett’s esophagus, a controversial topic. As you will read in the checklist, if a patient is elderly, has multiple comorbidities, and needs a bariatric procedure to achieve rapid weight loss and enable him or her to get a second nonbariatric procedure, LSG is certainly an option unless there is high-grade dysplasia. I am sure you will disagree with us in many situations, but nevertheless, it is a start. Please note the language we use, i.e., “possible, might, could,” as we are not defiant in our conclusions. In fact, there is no level 1 evidence to support this algorithm and I welcome your thoughts and criticism.

In “Ed Mason at Large,” Dr. Mason continues to amaze us when looking into metabolic syndrome and the effects of LSG on type 2 diabetes. Dr. Mason answers a reader’s question, “Is diabetes a motility disorder?” He also provides his thoughts on a new procedure called gastric fundus invagination (GFI). Staying on the same subject of bariatric surgery, obesity, and diabetes, Dr. Elliot Fegelman comments on the most recent studies and publications that support the surgical treatment of type 2 diabetes. He concludes that these data give us the opportunity to work together and change the conversation about obesity treatment from weight loss to health beneifits.

I close this editorial by inviting you all to come to Miami, Florida, for the American Society for Metabolic and Bariatric Surgery (ASMBS) Spring Educational Event, June 19 to 21, 2014. Program directors Drs. Dan Herron and Aurora Pryor have put together an exciting academic schedule that I am sure you will enjoy. Remember, it will be hot, humid, and inexpensive. It is also a great opportunity to invite your team to enjoy sunny Florida. You shouldn’t miss taking a walk around South Beach and seeing the Wolfsonian Museum (my favorite). You could visit the new Perez Museum near the Miami Airlines Arena, see the Art Walk in Wynwood, the Design District, or just hang out on the beach. I look forward to seeing you there.

Sincerely,

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

Tags: Dr. Raul Rosenthal

Category: Editorial Message, Past Articles