Thursday, December 23, 2010

Nice synopsis of the limits of Sleeve

Just doing some reading of back issue links, and I think this article gives a good insight into the "art" of surgery and medicine that we physicians have to deal with when the data is not sufficient to give all answers.

I agree with the author though - the sleeve is a reasonable balance of risk vs benefit for a large number of patients, but they should each understand that there is a chance that it may require future revision. "Failure" of the operation does not mean that the patient, surgeon or the operation deserves any "blame" however. Unfortunately, it is usually the poor patient who blames him or herself - often unfairly.

No perfect operations, including sleeve!

Monday, December 20, 2010

"SLIMBRICATION" - Dr Dan Cottam Salt Lake City

Wow - what a great visit on Friday to see Dr Dan Cottam perform a laparoscopic gastric imbrication. This is a very exciting newer procedure that is probably the least invasive intervention yet. It will be some time before we have good medium and long term data though.

In the meantime, expect to see it offered in people who have a failed Lap Band, or who are reluctant to have the Gastric Bypass or Sleeve procedures.

Here is his great video - likely soon he will be performing a combination sleeve and imbrication - Slimbrication!

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and here is the link to his YouTube Channel



I have also started a WMedlinMD YouTube Channel, though it currently has instructional lectures, not an updated information session. My old information session from 2007 is linked on the right side of this page, and here. Since it was on Google Video, I havent' figured out how to put it on YouTube yet...


CHAPTER 1 - INTRO / BMI



CHAPTER 2 - BAND & BYPASS OPERATIONS



CHAPTER 3 - LAPAROSCOPY




CHAPTER 4 - BENEFITS AND RISKS




CHAPTER 5 - SUCCESS HABITS



CHAPTER 6 - CHALLENGES




CHAPTER 7 - PROGRAM STEPS, SUMMARY

Doing some Canadian reading

I have been getting acquainted with Vancouver a bit over the last year. I have avoided making too many direct contacts for fear of the lack of control of my billing as an employee surgeon. Now that I am independent, we can set some reasonable prices for consultation and Lap Band fills, followup for Out-of-Country patients, etc (planning to offer Vertical Sleeve Gastrectomy and Gastric Imbrication for competitive prices)


Anyhow, I found Dr Yoni Freedhoff's blog through CTV... havent' contacted him yet, but he is absolutely on base regarding the loss of access to care for Ontario residents!

Shout out to my friends in Thunder Bay!

False savings in access-restricting "cost containment" measures by Ontario


DR YONI'S BLOG

Monday, December 06, 2010