Our very own Dr. Boyce, Knoxville bariatric surgeon, was recently awarded The Patient’s Choice distinction, an awarded given to physicians with the highest rated patient feedback. This honor is given to only 5% of U.S physicians who have received rave reviews across the board in areas such as bedside manner, doctor-patient face time, and overall opinion.
“When Dr. Rosalind Cadigan decided to have surgical weight loss surgery, she didn’t have far to go.
Cadigan, who specializes in obstetrics and gynecology at Parkwest Medical Center, would find herself as a patient on the same floor where she often makes patient rounds. She entrusted her own health to the same caregivers she works beside each and every day” Click Here to Read Full Article
Gastric Bypass surgery has evolved over the past forty years and the technique used today is better than ever before. Unfortunately, previous versions of the bypass made it possible for the patient to develop an enlarged pouch or a dilated gastrojejunal anastomosis (connection of the small bowel to the gastric pouch). A dilated pouch allows the patient to eat too much and a dilated stoma removes the restrictive component of the operation also allowing excessive food intake. Both of these conditions lead to weight re-gain after successful gastric bypass surgery. Weight re-gain is terribly demoralizing for the gastric bypass patient and previously available options for treatment of weight re-gain have been invasive and only marginally effective.
I am proud to announce that there is now a non invasive option to repair the dilated gastric pouch and dilated anastomosis. The ROSE procedure is an incision-less endoscopic (through the mouth) option that allows the surgeon to plicate the pouch and or the stoma to aid the patient with losing the re-gained weight. ROSE stands for Revision Obesity Surgery Endoscopic. I was selected to be trained on this new procedure along with a small number of surgeons in the United States. I believe that it provides options not previously present for properly selected patients to help them lose weight.
Weight re-gain can occur for a variety of reasons. Sometimes the patients behavior is the cause. If a patient stops exercising and begins snacking weight re-gain will occur. Food choices and using the tool correctly (not drinking while you eat) are also important. Other causes include overeating causing pouch dilation, formation of a gastro-gastric fistula, and technical errors by the surgeon such as making the pouch too big or the Roux limb too short to begin with. Above are examples of why patients must be properly evaluated before undergoing any form of revision surgery whether it is endoscopic, laparoscopic or open. Evaluation includes:
For the properly selected patient, the operation is performed as an outpatient procedure. After undergoing general anesthesia, a transport tube is place through the patients mouth into the gastric pouch. The transport has channels through which an endoscope, graspers, and suturing instruments may be passed. In this way permanent suture anchors are placed to plicate or shrink down the pouch and stoma.
Post operatively, patients return home and can usually return to work the next day. Many patients experience a sore throat that quickly goes away.
Other options for treating weight re-gain exist as well. I routinely perform revision operations on patients from other practices and I know that a thorough evaluation of the patient is necessary in order to tailor the treatment to their needs. Having said that, I am also very excited to have this cutting edge technology available for the properly selected patient!
From the Desk of Dr. Boyce
Weight loss surgery patients can expect fewer complications and lower costs for obesity surgery, reported a new study by the Department of Health & Human Services’ (HHS) Agency for Health care Research and Quality (AHRQ).
Between 2002 and 2006 the average rate of post-surgical and other complications from weight loss surgery declined 21 percent, according to an AHRQ study published in the May 2009 edition of Medical Care. Hospital payments also dropped by 13 percent during that time period.
“This is good news for obesity surgery patients,” said Dr. Stephen Boyce, surgeon and medical director of the Covenant Weight Management Center. “Thanks to less invasive surgical procedures and increased surgeon experience, we are seeing fewer complications.”
The post-surgical infection rate has dropped 58 percent, the study reported. Complications such as staple leakage, respiratory failure and pneumonia decreased by between 50 percent and 29 percent.
In 2008, Tennessee ranked sixth in obesity nationally with 29 percent of the population considered obese, according to a study by Trust for America’s Health.
“Hopefully this study will encourage people in our community to explore their weight loss options,” Boyce said.
The Covenant Weight Management Center offers two weight loss options: the medically supervised diet and exercise program and advanced weight loss surgery performed at Parkwest Medical Center, a Bariatric Surgery Center of Excellence. Free seminars on weight loss surgery are held monthly in Knox, Anderson and Sevier Counties. For information, call us today!
(865) 694-9676
200 Ft. Sanders West Blvd
MOB 1, Suite 200
Knoxville, TN 37922
