South Jersey Bariatrics
Patients From Afar Streaming to Lourdes Weight Loss Surgeons
Those GPS mapping devices seem to be marking a lot more Xs at the Lourdes Medical Center of Burlington County recently. Out-of-state license plates—Virginia, North Carolina and Illinois to name a few—have been showing up with increasing frequency in the Lourdes parking lot in Willingboro, New Jersey.
The reason? Word has been spreading via the Internet and word of mouth about a trio of experienced surgeons who are making available at Lourdes a full spectrum of bariatric surgery. Suddenly, Lourdes is an attraction for local and far-flung persons looking for choice in obesity surgery.
"What makes us unique is that we do everything, all the surgeries, we do them well and we passed a rigorous examination to receive Center of Excellence designation from the American Society for Metabolic and Bariatric Surgery," said David Greenbaum, M.D.
Many of Dr. Greenbaum's out-of-state patients had previous, unsuccessful bariatric surgery and now seek a revision to the more effective duodenal switch surgery. The revision is a highly complex procedure performed by only a small circle of surgeons. Dr. Greenbaum honed his skills in the duodenal switch revision surgery during a six-month study program in California.
Dr. Greenbaum and his associates, Samuel Wasser, M.D., and Richard Ing, M.D., have done about 1500 weight loss procedures and presently perform all of the bariatric operations including: the gastric bypass; the laparoscopic adjustable gastric band; the duodenal switch; the vertical (sleeve) gastrectomy; and revisional bariatric surgery. All of these can be performed both in the open and the minimally invasive (laparoscopic) technique.
Dr. Greenbaum said he began doing an earlier-used procedure, vertical banded gastroplasty, in 1987 and by 1997, when he was doing open gastric bypass surgery, he joined the certifying group, now the American Society for Metabolic and Bariatric Surgery.
"There were probably only 300 doctors in the world who were members then, and I was one of the few doctors in this whole region who was doing this with good results," he said.
"Now you can't walk around the block without hearing about bariatric surgery, so patients who come in know a little about options. We do all the surgeries, so we don't talk anyone into or out of an option, just give them information to make the best choice."
He helped create an "at a glance" table [18K PDF] comparing the various surgeries, which then leads into a detailed discussion that includes descriptions of each surgery, success rates and medical benefits and finally, risks and complications. Each procedure has unique advantages and qualities that must be considered, said the surgeon.
The gastric band, for example, "is the safest and simplest" procedures, he said, but is most effective for patients who do not have an extremely high BMI and is least effective with patients carrying enormous amounts of excess weight. (The BMI is a popular index, using height and weight calculations, to estimate health risk related to weight. The upper limit normal BMI is 25. See a BMI calculator here.)
The most commonly-performed bariatric surgery, Roux-en-Y gastric bypass, has a higher-success rate than the gastric band, but patients must make a major lifestyle change to eat the strict diet required by the new stomach created by that operation—a stomach with a two-ounce capacity. (Success in bariatric surgery has been described as keeping off 50 percent of the initial excess weight several years after surgery.)
Dr. Greenbaum said he has a seen a higher success among duodenal switch surgery patients, whose reshaped stomachs can hold four to five ounces. The aggressive operation, on the other hand, is more complicated and has a higher risk than the other two.
The gastric band procedure is termed a purely restrictive procedure because its only role is to restrict the amount of food consumed. The other two procedures are a combination of restrictive and malabsorptive, which means that the calories from some food ingested are not absorbed by the body.
Dr. Greenbaum said the possible curative results of successful weight loss surgery - diabetes often disappears, for example—is leading some to redefine the field as "metabolic surgery." He referred to the growing evidence of medical benefits of gastric bypass surgery in particular.
Calling bariatric surgery "a wonderful field," Dr. Greenbaum said his practice understands the challenges bariatric surgery patients face in maintaining the required lifestyle, which is one of the reasons the physicians offer support meetings the first Monday of every month. Among the benefits of that group is a clothing exchange clearinghouse that serves patients who are losing weight more quickly than their clothing budget can accommodate.
For more information about this practice, visit South Jersey Bariatrics.
To locate a Lourdes Health System bariatric surgeon by phone, call 1-888-LOURDES.
