[Vision2020] Surgery Webcast in Greenville features questions on gastric bypass

[Richard Schmidt]

In case anyone watched.

Dick Schmidt 

Surgery Webcast in Greenville features questions on gastric bypass 

By Jennifer White
The Daily Reflector

Wednesday, November 16, 2005

More than 2,000 people logged on to a live Webcast Tuesday featuring local surgeons performing gastric bypass surgery at Pitt County Memorial Hospital.

Dr. Kenneth G. MacDonald, chief of gastrointestinal surgery and surgical endoscopy at the East Carolina University Brody School, moderated the 5 p.m. Webcast and answered questions posted by online viewers. The hospital received more than 150 e-mails during the procedure, which treats morbid obesity.

"We didn't really have an expectation on how many would watch," said Claire Tyson, media specialist at the hospital. "We were very pleased with viewer turnout and feel it was a very successful Webcast."

The Webcast was publicized in national medical journals by SLP-3D, a company that coordinates Webcasts for organizations nationwide. It was also publicized in local print media and television broadcasts.

"As more and more patients learn about the potential benefits of gastric bypass surgery, we hope that this Webcast will encourage potential candidates to talk to their doctors about whether the procedure is appropriate for them," MacDonald said.

Dr. William H. Chapman III, director of the Minimally Invasive and Robotic Surgery Center and assistant director of the Bariatric Surgery Fellowship Program at ECU, and Dr. John Pender, assistant professor of surgery at the medical school, performed the 80-minute procedure on a female patient. The surgery, which the doctors said was successful, will be followed by a two-day stay in the hospital.

Gastric bypass is a nonreversible treatment option for individuals who weigh at least 100 pounds above their ideal body weight, have a body mass index of 35, and suffer from associated health problems such as hypertension, diabetes, sleep apnea and joint pain.

Patients who have a body mass index of 40, with no associated health conditions, also are considered candidates for the procedure.

During the procedure, surgeons create a small stomach pouch with less than one ounce capacity. They then attach a portion of the small intestine to the pouch, leaving a small hole through which food can pass.

After surgery, a patient will experience a full sensation after eating only a small amount of food and will stay full longer after a meal. Because the small hole between the pouch and small intestine prohibits food from exiting the stomach too quickly, patients experience less hunger between meals.

Bobbie Lou Price, the medical school's bariatrics program coordinator, said risks include leakage from where the intestine is reattached, infections from the incisions, blood clots that can spread to the heart and lungs, internal hernias, and staples coming loose.

Most patients have less than a 2 percent chance of dying from the surgery, but the risk increases with age and weight, Price said.

In a study published last month in the Journal of the American Medical Association, people in their 30s to 50s showed death rates between 3 percent and 5 percent.

The study involved 16,155 Medicare patients between ages 35 and 44 who underwent the surgery between 1997 and 2002. More than 5 percent of men and 3 percent of women died within a year after surgery. Slightly higher rates were seen in patients age 45-54.

Dr. Neil Hutcher, president of the American Society for Bariatric Surgery, said that Medicare patients are probably sicker than the general U.S. population and that complication rates have declined as surgeons' expertise has increased.

Price said Pitt County Memorial Hospital performs about 200 gastric bypass surgeries a year.

Many people who e-mailed questions asked how much weight they can expect to lose after the procedure.

"Usually patients lose about 75 percent of their excess weight," Price said.

People also asked about the length of the procedure, which Price says normally runs between two and three hours.

People also asked how to adequately nourish themselves after surgery.

"Patients considering gastric bypass surgery must have a clear understanding of how the surgery works, the recommended post-surgery diet, exercise regimen and vitamin protocol, as well as the importance of routine follow-up with the surgeon," MacDonald said. "All of these components work together to help the patient have a successful surgical outcome."
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