Presenting the 9th Annual Bariatric Times Buyers Guide

Dear Readers:
Time is moving fast and we are only four months away from our first Obesity Week Clinical Congress in Atlanta, Georgia. I recommend, if you are planning to attend Obesity Week, that you make hotel reservations now. From what I am hearing, it looks like we are going to break all-time records with attendance. During Obesity Week, the American Society for Metabolic and Bariatric Surgery (ASMBS) Foundation will hold their first annual L.E.A.D. (Leadership, Education, Advancement, and Dedication to the Field of Bariatric Surery) Awards Luncheon. During this event, we will hand out some important awards, including the 2013 Outstanding Achievement Award to recipient Dr. Alan Wittgrove. Can you believe that it has been 20 years since Alan’s first laparoscopic gastric bypass? What an opportunity to celebrate this major achievement in gastrointestinal surgery. I am convinced that after Dr. Edward Mason, Dr. Alan Wittgrove will become the father of modern bariatric surgery. Our outcomes would have never achieved the level they have and bariatric surgery would have never become the specialty it is nowadays if it wasn’t for the introduction of advanced laparoscopic surgery to the bariatric armamentarium. I also believe that the introduction of “laparoscopic gastric bypasss” motivated and enabled surgeons to do many other advanced procedures by pushing us to achieve perfection in stapling, dissecting, and suturing. Thank you Alan and congratulations from all of us at Bariatric Times.

In this issue, Dr. Walter Pories, our father of metabolic surgery, presents us with another provocative topic in his column titled, “Let’s Get Real.” As stated by Dr. Pories, there are so many variations when it comes to how to perform a gastric bypass that it is difficult to compare outcomes. That is why I have my personal reservations when it comes to evaluating meta-analyses of different series of GBP. It is always so refreshing to read a single author series.

Next, Dr. Peter Benotti, my mentor, reviews the etiology, diagnosis, and implications of pulmonary hypertension (PH) in bariatric patients. I personally see PH as an indication to preoperative placement of an inferior vena cava (IVC) filter and have done so for many years with no adverse events.
Also in this issue, Dr. Dene Berman presents a case of clinical anxiety following a patient’s successful bariatric surgery.

In this month’s “Checklists in Bariatric Surgery,” we chose to review a rare but important topic—the patient with right upper quadrant (RUQ) pain after GBP. The differentials are not many, but the diagnostic and treatment algorithm is complex. We have seen patients who had cholecystectomies in the past and present to our emergency room or consultaton with significant RUQ pain. When an ultrasound, computed tomography, and/or magnetic resonance cholangiopancreatography (MRCP) show dilated biliary tree and intermittent elevated liver function tests, we perform a transgastric remnant endoscopic retrograde cholangiopancreatography (ERCP) and papillotomy, with patients having immediate relief. We discussed this clinical picture with our gastroenterologists at length, and the explanation to support our management and results are based on biliary dikinesia. There is still plenty to discuss, learn, and research on this unusual clinical picture.
Lastly, we present you with our 9th annual Bariatric Times Buyers Guide, which I am sure you will enjoy reviewing.

Currently, I am excitedly packing and getting ready to fly to Istanbul, Turkey, for the upcoming 18th World Congress Of International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) meeting taking place August 28 to 31, 2013. The program looks outstanding, with the inclusion of great lectures and live surgery sessions. If you are attending IFSO, I look forward to seeing you there!

Sincerely,

Raul J. Rosenthal, MD, FACS
Editor, Bariatric Times

Tags: Dr. Raul Rosenthal

Category: Editorial Message, Past Articles