The Intersection of Bariatrics and Endoscopy General Surgery News
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The Intersection of Bariatrics and Endoscopy - General Surgery News
Category Archives: Bariatrics
Surgeon performs first robotic thoracic surgery in Brazos Valley – 25 News KXXV and KRHD
BRYAN, Texas Dr.Rodrigo Campana has only been with St. Joseph Regional Hospital for a few months, but he has already performed the first robotic thoracic surgery in the Brazos Valley.
"Previously, and what my partners have done, is doing a sternotomy, so opening up the chest completely, cutting through the rib cage, opening it up, exposing the heart and everything else," Dr. Campana said.
"With the robot, we just made four small incisions, actually three incisions, and we were able to take it out through those three small incisions.
Using the DaVinci Surgical Robot makes the procedure a lot less invasive, a lot safer, has a shorter recovery period, and allows patients to stay closer to home.
The goal would be to bring all the patients that normally would be sent to Houston for something specialized and have them be able to have that done here in College Station, Dr. Campana said.
In the Brazos Valley, the DaVinci Surgical Robot has been used in lots of other surgeries, like bariatrics, but never something as complex as thoracic surgeries.
I definitely wanted to bring the technology that the robot brings into the thoracic surgery world and into this local community, Dr. Campana said.
He and the DaVinci Robot performed the first thoracic surgery Oct. 11, and have already performed a second one since then.
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Surgeon performs first robotic thoracic surgery in Brazos Valley - 25 News KXXV and KRHD
The Emotional Impact of Bariatric Surgery: Helping Patients … – MedCity News
Bariatric surgery is a life-changing procedure. Its one of the most momentous decisions a person can make, and its one that should be carefully deliberated before reaching a final conclusion.
As people think about what their lives will look like post-surgery, theyre most excited about how the procedure will transform their bodies. They spend hours consulting with their medical teams, reading articles online, and following the success stories of other bariatric surgery patients to anticipate the benefits theyll soon enjoy themselves. And while its okay for them to lose themselves in the excitement, its essential they consider the risks too.
Im not going to discuss the medical risks of bariatric surgery in this article. Thats a conversation they should be having with you, their medical team. I want to discuss the less talked-about risk that comes after a complete physical transformation. Bariatric surgery can help get people closer to their dream bodies, but they dont often think about how it could impact their mental health.
As many as one in five patientsgain at least 15 percent of their weight back in the years following their procedure. But what people dont always know is that a number of patients also report feeling more depressed and anxious post-surgery. This shift doesnt always happen, nor does it always happen immediately, with most people experiencing a newfound sense of euphoria after their procedure. Its usually a gradual decline that occurs over several years. This isnt entirely uncommon given the biological, lifestyle, and social changes that patients have to learn how to navigate post-surgery. But a decline in mental health can actually sabotage the surgerys success.
We want our patients to be the best versions of themselves after bariatric surgery. Helping them understand the emotional impact it can have on their life can mentally prepare them for their transformation. Below are the most significant mental health triggers you should discuss with your patients.
Bariatric surgery buyers remorse
People believe that if they spend enough time thoroughly deliberating their decision and weighing their options, they can walk into their surgery with absolute confidence they made the right decision. But in the days, weeks, and months following their surgery, they may feel that assurance quickly fade as they find themselves regretting their choices. Many people wonder how its possible to second-guess themselves when they were so sure bariatric surgery was the best decision for them, but we know this as bariatric surgery buyers remorse.
Most patients feel buyers remorse as a response to their recovery difficulties. The strict guidelines they must follow as they learn how to eat and drink again with your new stomach might have felt worth it in their planning phase, but now that they have to follow these guidelines, its more overwhelming than they imagined.
Its our responsibility to inform them that this regret is usually temporary, but it can serve as a reminder of why its so important to surround themselves with a good support system. This support can include a partner, family, or friends, but it can also include their provider. Community and support are critical to a patients success, especially during the early stages of recovery. This is why at Be Slim Bariatrics, we provide ongoing support to our patients at no additional cost, medical and nutrition-wise. Our bariatrics packages also include access to a large peer support group which is supervised by our team of dedicated health professionals.
Losing food as a source of comfort
Most bariatric patients share a similar relationship with food. Some patients turn to food and eating for comfort. Food can bring cheer when one is depressed or anxious, but its also a crutch that can help bolster ones happiness and enjoyment.
Bariatric surgery changes this entire dynamic. Food can no longer be a source of comfort, which can stir up some complicated emotions that people have abetted by eating for so long. Bariatric patients can have a difficult time processing these unpleasant emotions while in the midst of a challenging recovery process. They might feel an intense urge to eat, and when they cant, they will grieve the loss of food.
Providers must work with patients to change their relationship with food and help them discover healthy coping mechanisms to aid in their recovery and long-term success, like prioritizing self-care activities, spending more time with their loved ones, or finding other habits to occupy their minds. Behavioral modification is essential in the weight loss journey of a bariatric patient. It should be provided through a medically supervised weight management program like Be Slim Bariatrics offers.
Reclaiming ones self-esteem
Bariatric surgery is not a magical cure-all for poor self-esteem. Bariatric patients might find themselves struggling even more with their self-confidence after their surgery than before. There are a few reasons for this.
First, patients often feel insecure that theyve had to turn to surgery to lose weight. Society tells us that through diet and exercise, all things are possible. This isnt only wrong, but its a dangerous mindset that continues to fuel harmful inaccuracies about weight loss. Opting to undergo surgery to get someone closer to their goal weight isnt taking the easy way out, its a personal commitment to achieving greater physical health. And second, losing excess weight can often elicit an identity crisis. It might take patients some time to believe they are actually the person who is staring back at themselves in the mirror and thats okay. It will take time for patients to reclaim their sense of self and learn how to love this new version of themselves. We should encourage them to give themselves grace and patience.
Bariatric surgery isnt just a physical transformation; its a mental metamorphosis. Our patients physical and mental well-being are interconnected, so helping them care for and heal both sides of themselves is crucial.
Photo:mi-viri, Getty Images
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A legacy that dates back to 1943- CT Plus – UT Southwestern – UT Southwestern
YearWinnerCurrent or last known positionSpecialty2022Cayenne Price, M.D.Resident, UTSWAnesthesiology and Pain Management2021Natasha Houshmand, M.D.Resident, Johns Hopkins MedicineSurgery2020Priyanka Gaur, M.D., M.P.H.Resident, Johns Hopkins MedicineObstetrics and Gynecology2019Bethany Werner, M.D.Physician, Texas Health PresbyterianObstetrics and Gynecology2018Philip D. Tolley, M.D.Resident, Univ. of Washington Medical CenterPlastic and Reconstructive Surgery2017Lauren Elizabeth Kolski, M.DUTSW/Parkland HealthRadiology2016Samuel T. Parnell, M.D.Assistant Professor, UTSWEmergency Medicine2016Donald W. Seldin, M.D.*Professor/Chairman Emeritus, UTSWInternal Medicine2015Laurie Seidel, M.D.Assistant Professor, Univ. of Colorado School of Medicine, Rocky Mountain Poison and Drug CenterPediatric Hospitalist Medicine and Medical Toxicology2014Andrew Avery, M.D.General surgeon, NashvilleAnesthesiology, Surgery2013David Leverenz, M.D.Rheumatologist, Assistant Professor Duke University HospitalRheumatology2012Thomas Heyne, M.D.Mass. General Hospital/Harvard Medical SchoolHospitalist Medicine2011Geof LeBus, M.D.Orthopedic specialist and surgeon, Texas Orthopaedic Associates, Fort WorthOrthopedic Surgery2010Michael Van Hal, M.D.Assistant Professor, Orthopaedic Surgery, UTSWOrthopedic Surgery2009(Stanley) Tyler Hollmig, M.D.Associate Professor of Dermatology, Dell Medical School; Director of Laser and Cosmetic Dermatology,Ascension TexasInternal Medicine2008Sara Lindsey, M.D.Radiologist, Christus Santa Rosa Health System-San AntonioRadiology2008Joshua D. Mitchell, M.D.Assistant Professor of Medicine and Dir. Cardio-Oncology Ctr. of Excellenceat Washington Univ. School of Medicine in St. LouisCardio-Oncology2007James B. Cutrell, M.D.Prog. Director, Infectious Diseases; Assoc. Prof., Internal Medicine, UTSWInfectious Diseases2006Hayden Schwenk, M.D.Clinical Associate Professor, Stanford Medicine, Childrens HealthPediatric Infectious Diseases2005Michael Paul Herman, M.D.Urologist, Rockville Centre, N.Y.Urology2004William F. Schmalsteig, M.D.Associate Professor, Prog. Dir., Adult Neurology Residency, Univ. of Minnesota Medical SchoolNeurology2003James Isbell, M.D.Thoracic Surgical Oncologist and Intensivist, Memorial Sloan Kettering Westchester, N.Y.Thoracic Surgical Oncology2002Christine Kulstad, M.D.Writer, Dallas areaEmergency Medicine2001Preeti Malladi, M.D.Bariatric surgeon, Malladi Bariatrics and Advanced Surgery, Dallas/PlanoBariatric, Obesity, General Surgery2000Kerry Brandt Dunbar, M.D., Ph.D.Section Chief, Dallas VA Medical Center; Professor of Internal Medicine, UTSWInternal Medicine1999Lance E. Oxford, M.D.Otolaryngologist, Ear, Nose, and Throat Specialty Care, DallasOtolaryngology1998Shannon Neville (Houghton), M.D.*Resident, Barnes-Jewish Hospital, St. LouisInternal Medicine1999Lance E. Oxford, M.D.Otolaryngologist, Ear, Nose, and Throat Specialty Care, DallasOtolaryngology1998Shannon Neville (Houghton), M.D.*Resident, Barnes-Jewish Hospital, St. LouisInternal Medicine1997David W. Wimberley, M.D.Private practice, Fondren Orthopedic Group, Houston
Neurosurgery and Orthopedic Spine
Gastroenterology
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A legacy that dates back to 1943- CT Plus - UT Southwestern - UT Southwestern
Health care for profit: How corporate pressures threaten … – Kevin MD
An excerpt from Confessions of a Surgeon: A Deeper Cut.
He screwed us over. I slowly sank deeper into my chair, attempting to digest the letter my group had received from the local hospital CEO. Thank you for your groups interest in our hospital. I appreciate your long-standing dedication to the care of our patients. However, our organization has decided to go in a different direction. I wish your practice the best of luck.
Months earlier, he approached us wearing a Grinch-like smile, talking about joining his team. Our practice was to be the next domino to fall. From the beginning, we were skeptical of his motives. When it came to following through with commitments to physicians, his performances over the last two decades were mediocre at best. Physicians in small towns have long memories, especially those who get undermined by broken promises. Still, we had no choice but to listen. Our referrals were already diminishing because of the competing surgeons hired by this very same CEO. His goal was to complete his surgical department by adding our group to his staff. The competing hospital across town was going through growing pains and had no interest in buying up practices.
Sadly, the sun was quickly setting on our group surgical practice. Despite our historical reputation for stellar surgical care, corporate competition, and salary inflation left us mortality wounded. Two of our senior partners were also retiring. We could not compete in the recruiting process to replace them. We had no extra financial incentives to entice new surgeons into joining our practice. In addition to the hospital using its clout to stifle our referrals, the bureaucratic costs of running a business were rising. It was a perfect storm blowing, affecting practices throughout the country. We had to let go of the past in order to survive the present.
Over the years, our group had managed to resist the economics forcing many surgeons in private practice to jump on the corporate ship. Our naivety, ego, or lack of foresight prevented us from seeing the rolling for-profit landscape of patient care. We knew we were late in coming to the company party. I hated being in this position. I never thought, in a million years, that I would be selling my services to the highest bidder. In our case, the only bidder.
Our group had been in business for close to a half-century, serving patients at two hospitals with no financial strings attached. For years, primary care doctors referred patients to us knowing they would get excellent care. Plain and simple. Money or employer pressure was never part of the equation. There were no promises to operate at a specific hospital in return for the patient business. We naively assumed doing what we do best would sustain our group forever and provide immunity to the pressures squeezing everyone else. Wrong assumption. They were political and corporate pressures that had nothing to do with the ability to efficiently remove a colon cancer or perfectly repair a complex hernia. They had nothing to do with a dedication to stay with a patients family for hours, offering support. These pressures had everything to do with controlling the services physicians provided and maximizing the RVUs. Hospitals were building higher fences around their around their physician-owned perimeters. Fences that locked patients in, restricted their choices, and maximized every dollar their illnesses generated. The concept of shark territoriality among competing hospitals was alive and well. The days of a patient choosing his or her own surgeon were on life support. They ended when hospitals started buying up practices, forcing patients to stay within their walled-off network. They ended when the community surgeon lost control of his or her own destiny.
Lately, the hospital had been buying up primary care doctors in town like it was Black Friday. The gatekeepers of patients, as they were once fondly penned, were also feeling the same financial pressures we were. Only their pressures to produce magnified once they became employed by corporate medicine. Primary care physicians are vital to a hospitals revenue stream. However, many cannot generate the daily revenue for hospitals that surgeons can. Operating rooms are big business for hospitals, crucial to their bottom line. As a result of their financial clout, each has its own unique personality, business model, and revenue stream. First and foremost, there is the robot room. It often is the largest. Robots need a lot of room to flex their titanium arms. The cardiac surgery room (along with its sister cardiac physiology suite) is also a heartful source of revenue for any operating room. The vascular suit also makes up part of this revenue brood along with the joint room and bariatrics room. General surgeons are the Rodney Dangerfields of any community operating room. Despite being necessary, we do not get any respect and often do not have our own room. Our cases get handed off like orphans to different rooms throughout the day.
In the end, of course, the hospital did not hire us. Its CEO never intended to hire us. From the beginning, he was eager to know how much revenue our group created each year. The future business plan for his hospitals surgical department never included our surgical group. His goal was to put us out of business. It was easy to do when you have deep pockets and own half of the primary care physicians in town. Teddy Roosevelts words in 1906 still ring true today. If youve got them by the balls, their hearts, and minds will follow. This CEO clearly had us. Yet, he had no intention of making our hearts and minds follow him.
Paul Ruggieri is a general surgeon and author of Confessions of a Surgeon: A Deeper Cut.
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Health care for profit: How corporate pressures threaten ... - Kevin MD