Difficult Decisions in Bariatric Surgery

A patient, a surgeon, and an insurance agent walk into a bar.- Evidence-Based Medicine and Decision Making.- Bariatric surgery for uncontrolled hypertension.- Diabetes is an indication for bariatric surgery.- Procedure choice for treatment of diabetes.- Should patients with obesity hypoventilation syndrome undergo bariatric surgery.- Heart failure and bariatric surgery.- Cornary Artery Disease and bariatric surgery.- What are there nutritional "red flags" to look out for prior to bariatric surgery?.- Are there psychiatric diagnoses that preclude safe bariatric surgery?.- Does weight loss prior to surgery accurately predict success following bariatric surgery?.- The ideal weight loss diet for preparing a patient for bariatric surgery.- Is routine upper endoscopy and H. pylori testing indicated in advance of bariatric surgery?.- Manometry is useful prior to bariatric surgery.- Smoking cessation is essential prior to bariatric surgery.- Is the insurance requirement for supervised weight loss prior to bariatric surgery an ethical strategy to prevent non-compliant patients from undergoing surgery?.- Bariatric surgery in the young pediatric population.- Gastric banding, what happened?.- What is the role of bariatric surgery in the management of nonalcoholic steatohepatitis?.- Is Roux in Y gastric bypass less safe than sleeve gastrectomy?.- The national shift to sleeve gastrectomy - long term disappointment and recidivism?.- Single-stage Duodenal Switch Is Better Than Two-Stage.- Reoperation for repair of anastomotic leak.- Gastric sleeve stricture, twist or kink, now what? .- Hiatal hernia complicating bariatric surgery.- Duodenal switch and reflux control.- Endoscopic management of the dilated gastrojejunal anastomoses.- When to include medical therapy for late failure after bariatric surgery.- Does resizing the gastric pouch aid in weight loss?.- Does stoma size matter after gastric bypass?.- Indications, choice of operation and outcomes of metabolic and bariatric surgery in children..- Pediatric bariatric surgery and developmental milestones.- Surgical approaches for adolescents vs adults, which specialist should perform bariatric surgery in adolescents?.- Will deep brain stimulation eventually replace bariatric surgery?.- How manipulating the microbiome can affect the outcome following bariatric surgery.

This book provides a practical guide to decision making within bariatric surgery. Through uniform and well-structured chapters, topics relating to patient selection, preoperative preparation, the ethics of bariatric surgery, choice of procedure, complications, late failure and management, malabsorptive procedures, and pediatric bariatric surgery are discussed and examined.

Difficult Decisions in Bariatric Surgery aims to help readers navigate an increasingly complex surgical specialty and come to reasoned and evidence-based conclusions. This book is of interest to practicing and trainee surgeons, endocrinologists, endoscopists, and pediatricians.

Dr. Alverdy is the Sarah and Harold Lincoln Thompson Professor of Surgery and Executive Vice-Chair of the department of surgery at the University of Chicago. Dr Alverdy is the director of the Center for Surgical Infection Research at the University of Chicago that studies the microbial pathogenesis of infections that develop following surgery including sepsis, wound infection, and anastomotic leak. He has been funded by the NIH for this work since 1999. He is the co-PI on a T32 training grant and has trained over 30 postdoctoral fellows in his laboratory over the last 25 years. Dr Alverdy is the co-associate director of the Digestive Disease Research Center Core (DDRCC- Eugene Chang MD Director) and a fellow of the Institute of Molecular Engineering at the University of Chicago. He is past president of the Surgical Infection Society North America.

Dr. Alverdy attended medical school at the Autonomous University of Guadalajara and Loyola University and received his surgical training at the Michael Reese Hospital/University of Chicago. He completed a surgical research fellowship at the University of California San Francisco. Dr Alverdy has an active gastrointestinal surgery practice involving minimally invasive surgery of the foregut including esophagus, stomach and pancreatobiliary tree.

Dr. Vigneswaran is an assistant professor of advanced gastrointestinal and bariatric surgery in the department of surgery at the University of Chicago. She received degrees in chemical engineering and molecular & cellular biology at the University of Illinois at Champaign-Urbana and received her medical degree from Rush University. She completed surgical training at the University of Chicago and surgical fellowship in minimally invasive gastrointestinal surgery at the Oregon Health & Sciences University. In addition, she received a masters in public health sciences at the University of Chicago with which she continues to study clinical outcomes in gastrointestinal surgery. Dr Vigneswaran maintains a busy clinical practice in bariatric and advanced gastrointestinal surgery, including complex esophageal and foregut diseases as well as revisional bariatric surgery. Her practice of minimally invasive surgery includes a robust robotic surgery practice and she continues to advance the field in minimally invasive surgery.