Nissen-Sleeve operation, is it an option?

Nissen-Sleeve operation, is it an option?

David Nocca, MD, head of Bariatric Surgery department at the University of Montpellier in France is currently conducting an international bariatric workshop about a new weight loss procedure: Nissen-Sleeve operation. The French team have already published a pilot study in SOARD in 2016 demonstrating Nissen-sleeve surgery feasibility and safety in 25 patients. The authors advocate that this approach eliminates acid reflux following gastric sleeve surgery with comparable weight loss outcomes to the traditional sleeve gastrectomy. A secondary advantage of Nissen-sleeve surgery is a decrease in the risk of staple line leak at the angle of His. The authors further advocate that the risk of remnant gastric fundus ischemia in Nissen-sleeve surgery is low given the rich blood supply of the stomach. Continue reading “Nissen-Sleeve operation, is it an option?”

Is Pyloroplasty a Reasonable Solution for Gastroparesis?

Bill asked us this interesting question this week: Can you please provide me with more information about gastric resection for treatment of gastroparesis?

I have severe refractory gastroparesis. My GI doctor and surgeon want me to do a pyloroplasty despite no evidence of vagal nerve damage. My issue is slowed motility. I already have a G and J tube. I’m very interested in your work with gastric fundus resection. I would like to learn more. I have an aunt who lives in Houston. Thank you. Continue reading “Is Pyloroplasty a Reasonable Solution for Gastroparesis?”

Is Food Consumption Changing in the US?

Is Food Consumption Changing in the US?

Major food companies like Kraft Heinz, Nestle, Campbell Soup and J.M. Smucker are reporting weak sales in the US market. American consumers are turning to healthier meals and snacks. The demand for fresh and healthier food is rising and food makers are struggling to adapt. For many years, processed food rich in sugar, salt and hydrogenated fat has been easy and cheap to produce and sell. Hard pressed consumers living in a fast pace modern life were easily sucked in the “buy one get one free” promotions for TV dinners. As processed food replaced traditional food home cooking vanished. Continue reading “Is Food Consumption Changing in the US?”

Gastric Bypass Long-term Complications

Gastric Bypass Long-term Complications

I am a 64 y/o female, 20 years post roux-en-y gastric bypass. I have GERD, a “small” hiatal hernia, Barrett’s esophagus, nighttime bile regurgitation, and bilious vomiting after any decent sized meal. I continue to get worse each year. My GI doctor does not believe it is possible for a gastric bypass patient to have GERD. He believes I simply misunderstand the meaning of GERD. I am so frustrated and miserable. Where should I go from here? Continue reading “Gastric Bypass Long-term Complications”

Gastric Sleeve Surgery in Houston is Here to Stay

JAMA Obesity Theme Issue: Gastric Sleeve Surgery Is Here to Stay

The Journal of the American Medical Association, JAMA, current issue is entirely devoted to the medical problem of obesity. I was particularly interested by two published randomized studies comparing gastric sleeve to gastric bypass surgery with a 5-year follow-up. The Swiss Multicenter Bypass or Sleeve Study, SM-BOSS, and the Finnish Sleeve vs Bypass, SLEEEPASS, study showed similar weight loss and type 2 diabetes remission rate at 5 years. Reoperation rate was similar to both gastric sleeve and bypass patients in both studies. Repeat surgery was mainly for GERD in gastric sleeve patients and internal hernia for gastric bypass patients. Continue reading “JAMA Obesity Theme Issue: Gastric Sleeve Surgery Is Here to Stay”

Best Diet for 2018

Best Diet for 2018

It is the beginning of a new year, and for most Houstonians, weight loss is a priority. The new year resolution for a healthier lifestyle is synonymous with a good diet and the question of what plan to follow for year 2018 assails most of us. Indeed, deciding what to eat on a daily basis has become a dilemma for most of us. Should we adopt a high protein or vegan diet? Should we buy organic or conventional apples? Should we eat butter and cheese or avoid dairy products altogether? Is sugar bad for me even in moderation? And how about soy products, food additives, frozen meals… Continue reading “Best Diet for 2018”

Modern Economics Has Given Us Abundance and Obesity

Modern Economics Has Given Us Abundance and Obesity

I read with great interest the book review published this week in the wall street journal. The Economists’ Diet: The Surprising Formula for Losing Weight and Keeping It Off is the book title written by two economists: Chris Payne and Rob Barnett. Both Chris and Rob suffered from obesity and managed to lose a combined weight of 120 pounds. They did not follow a particular diet or exercise program but rather applied what they know best: economic principles to build healthy habits and keep the weight off. Continue reading “Modern Economics Has Given Us Abundance and Obesity”

Gastric Sleeve Surgery and GERD

I read with great interest the commentary on evaluating the feasibility of phrenoesophagopexy during hiatal hernia repair in sleeve gastrectomy patients. The commentary was recently published in SOARD by Dr. Jose Ferrer from the Bariatric and Metabolic Surgery Center in Valencia, Spain. The author reports his concern about the development of GERD, severe reflux esophagitis, and Barrett’s esophagus following gastric sleeve surgery. Ferrer recommends hiatal hernia repair during gastric sleeve surgery. However, herniorrhaphy alone is not enough sometimes. Additional techniques have been developed such as phrenoesophagopexy, Hill gastropexy, Teres ligament pexy, and different forms of fundoplications to augment the anti-reflux barrier. Continue reading “Gastric Sleeve Surgery and GERD”