Month: June 2020
Dr. Husain Abbas, FACS
Everybody knows that there is a surge of cases in Florida, but these tend to be in the younger population. We have not seen an increase in hospitalization. We do everything that needs to be done to make sure that our patients are protected.
- The first thing that we do is we’ve limited the number of visitors – specifically unnecessary visitors. And even when patients come in, we are trying to limit who actually comes and who doesn’t.
- Universal mask wearing. Everybody must wear a mask. The mask is really not for me. This mask does not protect me, but I’d like to think that by wearing this mask, I am protecting others. That has been adopted at our hospital here in Jacksonville.
- Everybody gets tested for COVID-19. I myself and my group have been very liberal with testing everybody. We would rather know if somebody’s positive because they may be asymptomatic and of course we can just delay the surgery.
So, all of these factors have been put in place because we truly believe it’s extremely important not to delay something (bariatric surgery, other general surgical procedures) that could give patients such a tremendous benefit.
If we do feel that perhaps the risks are starting to go up and we start seeing increasing hospitalizations, we will be the first to tell our patients. Just like we did not too long ago. We, in fact, stopped all elective cases until we figure out what exactly is this virus what it does…how does it affect patients? We stopped all elective surgery for six weeks.
What I can tell you is if I was a patient, or if I had a family member, I would happily bring them here because I do believe we’re doing everything possible to ensure the safety, which is the number one priority of our patients. And, of course, the second is delivering excellent care and getting the patient in the hospital and out of the hospital in a timely but efficient fashion.
For many decades, the gastric bypass has been the gold standard in resolution of many of the diseases associated with morbid obesity, as well as being the benchmark by which we measure the weight loss potential of any bariatric surgery. However, the nature of the gastric bypass, and to a lesser degree, the gastric sleeve, meant that many patients experienced a number of uncomfortable postoperative realities including dumping syndrome, potential for nutritional deficiencies, and some shorter-term complications such as leaks in the staple line.
Soon after the advent of laparoscopic surgery, the gastric band was developed. The first of these was known as the Lap-Band, and shortly thereafter, the Realize Band was developed as a competitor. Early on, it seemed like an excellent option for those who were not comfortable altering the anatomy of their gastrointestinal tract. Further, the Lap-Band offered the potential for adjustments and was completely reversible if the patient did not tolerate it well. The trade-off for this versatility was that the overall weight loss and disease resolution potential was somewhat lower than that of more-traditional, stapled procedures like the gastric bypass and the gastric sleeve. However, the Lap-Band got an additional boost when the FDA approved it as the only weight loss surgery for patients with a BMI as low as 30, as long as they had co-morbid conditions.
Transcript (slightly edited for ease of reading)
Jenny: Just talking about bariatric surgery. Who is a candidate for bariatric surgery?
Dr. Abbas: Generally speaking, anybody that has a BMI greater than 35. And the way you calculate your BMI is… Everybody has a smartphone now – just type in your height and type in your weight in a BMI calculator and you’ll actually get your BMI. So, BMI greater than 35 with a medical condition such as diabetes, hyperlipidemia which is elevated cholesterol or hypertension or if somebody has a BMI of 40. So, again, if you just type in BMI calculator in your Google search, you’ll find it. It is your weight relative to your height. So, BMI stands for the Body Mass Index.
So those are the patients who are actually on our candidates for bariatric surgery.