Bariatric Times

FEB 2018

A peer-reviewed, evidence-based journal that promotes clinical development and metabolic insights in total bariatric patient care for the healthcare professional

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23 Bariatric Center Spotlight Bariatric Times • February 2018 like everything else, is always evolving. We offer our patients the latest options in the field. Nowadays, w ith more nonsurgical options, patients are looking for "less surgery" for the treatment of morbid obesity. As the interest and demand for more endoscopic procedures increases, t here will be an increase in investigation and implementation. However, the long-term success of these procedures warrants further study. AN INTERESTING CASE Dr. Fridman had an interesting and difficult case in his first few months out of fellowship. The patient w as a young woman who had undergone an LRYGB many years ago in South America. She presented with abdominal pain, nausea, and vomiting for several months. The patient had not seen a bariatric surgeon and had had numerous tests ordered by her primary care physician and gastroenterologist, of which all were negative. The patient then presented to an emergency room with the same symptoms. This time her computed tomography (CT) scan showed a questionable internal hernia and small bowel obstruction. There also appeared to be bowel ischemia. The patient was transferred to one of our facilities for a diagnostic laparoscopy. Intraoperative findings revealed an internal hernia through Petersen's space with ischemic roux limb and part of the common channel. Dr. Fridman consulted with Dr. Neil Floch, given the extent of the ischemia. A decision was made to excise the whole roux limb and to reverse the gastric bypass. The operation went well and was entirely laparoscopic. The patient recovered with no complications and was discharged home. At the 18 month follow-up visit, she was keeping her weight off and was doing well. CONCLUSION When a patient makes the decision to see one of our surgeons, they become a part of our team, our family. Our practice began with two brothers, and our "family" continues to grow. We embrace each patient and their individuality, continually encouraging and supporting them before, during, and after surgery, so that they can achieve the success they so richly deserve. Our strong support system offers many options to our "family members" as they travel on their weight loss journey to regain their health and recapture their lives. Throughout their journey, our patients are never alone. Our surgeons, physicians, and staff are w ith them every step of the way, helping our patients create a life that is full of health, happiness, and a dventure. We are grateful to share in the lives and success stories of so many family members. FUNDING: No funding was provided. DISCLOSURES: The author reports no conflicts of interest relevant to the content of this article. A UTHOR AFFILIATIONS: Dr Abe Fridman is a partner at Fairfield County Bariatrics and is the Director of Bariatric Surgery at Griffin Hospital in Derby, CT. ADDRESS FOR CORRESPONDENCE: Abe Fridman, DO, FACS, FASMBS; Email: abe@fcbariatrics.com BT We believe that bariatric surgery, like everything else, is always evolving. We take great pride in being able to offer our patients the latest and newst options in the field.

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