Should Patients Lose Weight Before Undergoing Bariatric Surgery?

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From the desk of Dr. Alexander Abkin

I recently read the article, published by American College of Surgeons (ACS). It compared results of Bariatric surgery, such as Sleeve Gastrectomy and gastric bypass in patients, who were required to lose weight before surgery and who were not. It may come as a surprise to some, but some insurance companies and some Bariatric practices mandate weight loss beforehand of surgery approval. That has never been our practice routine, so to speak, unless patients surgery results (safety) can be improved, and in those patients we require them to lose about 10% of their weight, but for the most part we never (in 20 years) mandated it.

The study examined nearly 500,000 patients outcomes and found that small weight loss or no weight loss resulted in LESS complications that large weight loss prior to surgery! Again, it appears to me that our approach at Advanced Laparoscopic Surgeons of Morris has been the BEST PRACTICE for sleeve gastrectomy and gastric bypass ALL ALONG!

Click here to read the full article.

Effect of Oral Ursodeoxycholic Acid on Cholelithiasis Following Laparoscopic Sleeve Gastrectomy

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American Society for Bariatric Surgery recently published an article which compared the chances of gallstones formation after weight loss surgery, such as sleeve gastrectomy, in 2 groups of patients- one which was given the medication to prevent it, and one which wasn’t. Conclusion was obvious, at least to us at Advanced Laparoscopic Surgeons of Morris – only 6% chance of gallstones with medicine, vs 40% without!

It has been our protocol for 20 years(!!!) to give the medication to ALL the patients (who still have their gallbladders) and I am very happy to report the article speaks to the fact that we always were and continue to be in the lead when it comes to care of the patients who undergo gastric sleeve or gastric bypass.

Click here to read the full article.

Metabolic Surgery and Reduced Mortality in Diabetic Patients

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I recently reviewed the article, which compared mortality in patients with Type 2 Diabetes who underwent Metabolic Surgery, such as gastric bypass and sleeve gastrectomy, in comparison to medical management.

Results are summarized below – and they are almost frightening to me, as a Bariatric surgeon – because surgery is so superior to medications, and yet only a small fraction of patients are being referred for surgery! Yet we see commercials on TV advertising these medications all the time, with majority of patients depicted being morbidity obese!

HIGHLIGHTS OF THE ARTICLE:

  • Metabolic surgery reduces mortality in patients with T2D compared to medical therapy
  • Both overall and cardiovascular mortality are reduced by > 66%
  • The risk for non-lethal cardiovascular events is also reduced by about two-thirds
  • These findings support the pivotal role of metabolic surgery in the treatment of T2D

Click here to read the study

Predictive factors of complications in revisional gastric bypass surgery

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I recently reviewed the article about correlation between length of surgery and complications in Bariatric surgery.

It compared outcomes in patients who had gastric bypass and gastric sleeve done. As expected by me, conclusion was that surgeries which took longer that 1.5 hours for gastric bypass and an hour for sleeve gastrectomy will possibly be linked to complications.

Good news for our patients at Advanced Laparoscopic Surgeons of Morris is that both myself and Dr. Jawed are very efficient in the operation, leading to the operative times much less that discussed in the article. So, as one commercial says, “you are in good hands”!

Click here for the full article

Association of Metabolic Surgery With Major Adverse Cardiovascular Outcomes

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Journal of American Medical Association (JAMA) recently published a study investigating the relationship between metabolic surgery and incident major adverse cardiovascular events (MACE) in patients with type 2 diabetes and obesity.

It confirmed what we, Bariatric Surgeons at Advanced Laparoscopic Surgeons of Morris, LLC, have known for years about weight loss surgery, – that patients with diabetes, when they undergo bariatric surgeries, such as gastric bypass and gastric sleeve, experience 40 % less chance of developing significant complications from cardio-vascular events, including death, stroke, heart attack, need for interventions, such as stents placement in the coronary arteries. This is HUGE, and given the fact that weight loss surgery has become much safer in the past decade, with risk of significant complications related to surgery less than 0.1%,

I feel inspired to share this information with you and hope that, once you read it, more people you who know, can make the call to our office, come for consultation, have life-saving surgery and enjoy healthier life for many years to come.

Click here to read the full article.