Tips for Finding the Right Surgeon for You

Almost any surgery can cause serious complications, so you always want to be in good surgical hands. With so many doctors, how do you know which is the right surgeon for you?

One indicator to note is how often surgeons perform a procedure. That can be vital for operations that are relatively new, such as gastric bypass surgery for treating obesity. While many surgeons have started performing the operation, not all are qualified. A September 2009 study found that the risk of serious complications from the most common form of gastric bypass surgery fell by 10 percent for every additional 10 cases per year the surgeon had performed.

However, quantity isn’t the only or even most important measure of quality. A May 2009 study of 81,289 adults who had heart bypass surgery, for example, found that success depended more on how well surgeons and hospitals adhered to various markers of surgical excellence—such as using the appropriate technique during the operation and prescribing the right medications before and afterward—than the number of procedures performed.

Don’t be afraid to question your doctor. Ask your prospective surgeon these questions before going under the knife:

  • Is surgery really necessary? The best way to avoid surgical errors is to avoid surgery entirely, so ask about the effectiveness and safety of alternatives. Compare those with the risks of surgery and the chance that it will help you.
  • Is your board certification up to date? Look for a surgeon who has undergone the necessary training, even after being in clinical practice, to maintain board certification in his or her specialty.
  • What’s your experience? Ask how many operations the surgeon has performed in the past year and how that compares with his or her peers. You don’t have to find the busiest, most experienced surgeon in North America, but it’s important to avoid the doctor who does very few of the procedures, especially in a place that does very few.
  • What are your success, failure, and complication rates? Not all will be able or willing to tell you, but the good ones should be.
  • What’s the hospital’s infection rate? Seventeen states now make that information public, and many hospitals report their rates voluntarily.

doctor-650534_960_720Just remember to worry less about bedside manner and more about the final outcome. If you have to choose between a nice surgeon and a highly skilled surgeon, the skilled surgeon is the better bet.

If you live in the Las Vegas area and are looking for a surgeon who is both compassionate and highly skilled, Dr. Tsuda at VIP Surg is everything you’re searching for. Whether you have general surgery needs or are interested in bariatric surgery, he and his team of experts have the experience and skill for you to have an excellent outcome.

Bariatric Surgery: Impacting High Blood Pressure Through More Than Weight Loss

According to the Centers for Disease Control, about one in three U.S. adults has high blood pressure (hypertension). Risks include family history, advancing age, poor diet, consuming excessive amounts of alcohol, and being overweight or obese.

Lifestyle changes are a big part of controlling high blood pressure. The main tenets include:

  • Following a healthy diet, which may include reducing salt. The DASH (Dietary Approaches to Stop Hypertension) diet is often recommended. In addition to lowering salt intake, DASH is replete with fruits, vegetables, and low-fat or nonfat dairy. The diet emphasizes whole grains and is rich in potassium, magnesium, calcium and fiber.
  • Exercising regularly.
  • Maintaining a healthy weight.
  • Keeping stress levels at bay. (Stress can cause us to engage in unhealthy blood pressure-raising behaviors.)
  • Drinking only moderate amounts of alcohol.
  • Taking your medications as prescribed.

There are many types of prescription medications that can help control blood pressure and reduce the risk of heart attack or stroke. These medications may need to be taken for life to maintain their effect.

New research is showing, however, that bariatric surgery can allow obese people taking a lot of antihypertensive medications to cut way back on them. Study subjects’ blood pressure was maintained in the normal range with only one agent or even without drugs.

Within a year, those in a recent trial who had bariatric surgery were more than six times as likely to have cut back on their number of blood pressure (BP) medications by hypertension-867855__340about a third. Half of the surgical patients didn’t need any antihypertensive meds to maintain their BP at healthy levels. On the other hand, all of the “standard-care” patients in the study needed antihypertensive medications to keep BP that low, and half of them needed at least three different ones.

Interestingly, most patients in the gastric-bypass group achieved the primary end point in the first month of the postop period. That seems to indicate that something more is happening beyond just weight loss.

That something is likely to be related, at least in part, to the metabolic changes in the surgery group compared with the control group, which included significant improvements in fasting plasma glucose, HbA1c, LDL cholesterol, triglycerides, and high-sensitivity C-reactive protein in addition to the lowering of blood pressure.

If you live in the Las Vegas area and are wondering if bariatric surgery might be right for you, schedule an appointment at VIP Surg. Dr. Tsuda and his team can help find the right treatment for your unique situation.

 

Tips for Choosing the Right Surgeon for You

Whether you need a complicated, invasive surgery or a simple out-patient operation, choosing the right surgeon can seem overwhelming. Even what should be relatively straightforward procedures such as gallbladder removal or hernia repair can sometimes result in serious complications, so you always want to be in good surgical hands. Here are some tips on finding the surgeon and hospital that are best for your situation.

Once you have narrowed down your list of potential surgeons, schedule a consultation. If you have a fairly urgent need for surgery, you may have to cross surgeons off of your list purely because of the wait for a visit. Otherwise, plan to meet with at least two surgeons and discuss your potential surgery.

Things to ask:

  • Is surgery necessary? The best way to avoid surgical errors is to avoid surgery entirely, so ask about the effectiveness and safety of alternatives. Compare those with the risks of surgery and the chance that it will help you.
  • Is your board certification up-to-date? Look for a surgeon who has undergone the necessary training, even after being in clinical practice, to maintain board certification in his or her specialty.
  • What’s your experience? Ask how many operations the surgeon has performed in the past year and how that compares with his or her peers.
  • What are your success, failure, and complication rates? Not all will be able or willing to tell you, but the good ones should.
  • What’s the hospital’s infection rate?
  • Does the hospital follow best practices? The federal Centers for Medicare and Medicaid Services tracks how frequently hospitals give antibiotics on schedule, control blood sugar in heart-surgery patients, prepare skin properly before incisions and take other steps proven to help prevent surgical complications.Make the right choice.

You may be expected to schedule a surgery at the end of the consultation. If you are not confident that you have found your ideal surgeon, do not schedule the surgery. Either way, it’s fine to ask for a day to consider everything the doctor has said before making the surgery official.

If the surgeon you consulted with is not your ideal surgeon, schedule a consultation with a different surgeon. Even if you think the first surgeon is your best choice, a second opinion from another surgeon can be valuable. Most types of insurance will allow for two or three consultations. If you believe you have found your ideal surgeon you can schedule your surgery, confident in your decision.

If you’re looking for an experienced general surgeon in the Las Vegas area, Dr. Shawn Tsuda specializes in minimally invasive surgical techniques including the laparoscopic Roux-en-Y gastric bypass, laparoscopic adjustable gastric band, sleeve gastrectomy, foregut surgery, ventral and inguinal hernia repairs, endoscopy, and basic laparoscopy. Schedule a consultation to learn what he can do for you.

 

 

The Laparoscopic Technique

The Laparoscopic Technique | Dr. Shawn TsudaMany surgeries are being done these days without having to use the traditional large incision that leaves large scars and long recovery times. Laparoscopic surgery is the umbrella term that is used for this type of surgery. Laparoscopic techniques have revolutionized the field of surgery with benefits that include decreased postoperative pain, earlier return to normal activities following surgery, fewer postoperative complications, and the added bonus of being virtually scarless. Laparoscopic surgery, sometimes called keyhole surgery or minimally invasive surgery (MIS), is a widely accepted surgical technique that uses small incisions and long pencil-like instruments to perform operations with a camera.

Today, almost all abdominal surgeries are performed laparoscopically including:

  • hernia repairs
  • gastric bypass
  • bowel resection
  • organ removal

Laparoscopic surgery has successfully replaced open surgery as the preferred treatment option for issues such as bariatric surgery and gallbladder removal. The treatment of gastroesophageal reflux disease (GERD) is now also carried out using laparoscopic techniques too.

Laparoscopic surgery is also known as MIS because the surgeon is able to use a laparoscope with a small camera on it to go directly where the surgery is needed. This allows surgeons to find out where or even if a larger incision is needed to perform an operation.

Laparoscopic surgery involves several small incisions, which is why it is sometimes called keyhole surgery. The Laparoscope goes into one small incision and special surgical instruments go into the others. The scope is attached to a video monitor, so the surgeon can see what is going on inside the body part that is being examined.

Because of the less invasive nature of the surgery, laparoscopic surgery recovery time is shorter than that of traditional surgery. Most laparoscopic surgery can be done on an outpatient basis, although depending on the specific surgery, an occasional hospital stay is necessary.

As with any surgery, it is normal to feel tired for a few weeks after a procedure. Your specific recovery time will depend on your physical condition when you went in for the surgery.

If you are considering surgery, contact Dr. Tsuda to see if a laparoscopic procedure is right for you.

Read more online at: http://www.surgery.usc.edu/divisions/tumor/pancreasdiseases/web%20pages/laparoscopic%20surgery/WHAT%20IS%20LAP%20SURGERY.html

Consider the LINX System to Resolve GERD

Consider the LINX System to Resolve GERDGastroesophageal Reflux Disease (GERD), also called reflux, is a chronic disease that affects an estimated 1 in 5 U.S. adults. If you are one of them, you know how life-altering this condition can be.

GERD is caused by a weak lower esophageal sphincter (LES) that allows acid and bile to move up, or “reflux”, from the stomach into the esophagus, often causing injury to the lining of the esophagus and symptoms such as, heartburn, chest pain, regurgitation, sore throat, and cough. When left untreated, GERD can lead to serious complications including narrowing/stricture, Barrett’s esophagus, and esophageal cancer.

The LES is a muscle at the junction of the esophagus and stomach that functions as the body’s natural barrier to reflux. The LES acts like a valve, allowing food and liquid to pass through to the stomach. Normally, the LES resists opening to gastric pressures to prevent reflux, but in people with GERD, the LES is weak and allows acid and bile to reflux from the stomach into the esophagus.

Normal LES
Normal LES

LES of GERD Sufferers
LES of GERD Sufferers

GERD can be debilitating, causing daily pain, leading to poor sleep, affecting food tolerance, and limiting daily activities.

Medications for GERD are designed to control or suppress acid production in the stomach. They don’t address the cause of GERD and may not prevent reflux. Studies show that approximately 40% of GERD sufferers continue to have symptoms while taking medications for it.

Now there is a surgery to help GERD sufferers solve the problem permanently without taking medications for it. The LINX® System is a small, flexible band of magnets enclosed in titanium beads. The beads are connected by titanium wires. The magnetic attraction between the beads helps keep the weak LES closed to prevent reflux. Swallowing forces temporarily break the magnetic bond, allowing food and liquid to pass into the stomach. Magnetic attraction closes the LES after swallowing, to reinforce the body’s natural barrier to reflux.

If you are one of the many people suffering from uncontrolled GERD, schedule a consultation with Dr. Tsuda to see if the LINX® System is an option for you.

Read more online at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm296923.htm

Bariatric Surgery and Gastric Reflux

Bariatric Surgery and Gastric RefluxIn the last two decades, the world has seen a striking rise in both obesity and the number of people suffering from acid reflux, also known as gastroesophageal reflux disease (GERD). Many studies have convinced scientists that along with all of the other health problems caused by obesity, it also contributes to acid reflux. Several studies have shown that being overweight nearly doubles the possibility for GERD symptoms such as heartburn, regurgitation of acid, chest pain, and difficulty swallowing. According to Texas GERD Institute, one recent study maintains that obese people can be up to six times more likely than normal weight people to have gastroesophogeal reflux.

How does obesity make GERD more likely? Researchers aren’t sure, but some theorize that excess body fat compressing the stomach, diets with fatty and other irritation-causing foods, and hernias could be to blame.

If not controlled, GERD can result in serious problems, including an increased risk of esophageal cancer. Obese people are about three times more likely than normal weight individuals to develop esophageal cancer. Nearly two-thirds of American adults are currently overweight, and esophageal cancer has quadrupled in the last twenty years. GERD is most commonly treated with over-the-counter and prescription medications. However, these drugs do not always work, and taking them for long periods of time can cause other side effects, including weakened bones and gastrointestinal infections.

Losing weight can greatly improve symptoms. According to the Nurses’ Health Study, losing as little as eight pounds can dramatically reduce heartburn. Weight-loss surgeries may also improve GERD. Some studies have shown that the Roux-en-Y gastric bypass is the most effective weight-loss surgery for consistently reducing GERD.

If you have noticed an increase in acid reflux symptoms as your weight has increased, don’t lose heart. Acid-blocking medications may supply short-term aid, and surgery may be an effective option. Bear in mind that in any case, losing weight may also provide relief. Make an appointment with Dr. Tsuda to see if weight-loss surgery is a good option for you.

Read more on this topic at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3801365/

Changing Trends in Bariatric Surgery

Changing Trends in Bariatric SurgeryObesity is arguably one of the biggest health problems in the United States, and according to the Centers for Disease Control, more than one-third (34.9% or 78.6 million) of U.S. adults are obese. Obesity-related conditions including heart disease, stroke, type 2 diabetes, and certain types of cancer are some of the leading causes of preventable death. As this national health crisis worsens, doctors and scientist are searching for effective ways to treat these patients. Surgical treatment of obesity has been found to be more effective and to produce longer lasting outcomes than medication therapy or counseling. Weight-loss surgeries have been reported to alleviate chronic medical conditions such as diabetes as well as improving quality of life. Experts agree that bariatric surgery is considered the only long-lasting treatment for morbid obesity, but research is ongoing and techniques and procedures have changed significantly over the years.

There have been three major phases in the evolution of bariatric surgery. The pioneer phase was mostly characterized by discovery of weight loss procedures from procedures done for other purposes. The second phase can be identified with the advent of laparoscopic techniques. The metabolic phase derives from the improved understanding of the mechanisms of actions of the bariatric operations at the hormonal and molecular level.

As they have evolved, the surgeries have become less and less invasive. The safety of the laparoscopic approach, along with the better understanding of metabolic changes obtained postoperatively, has led to a more individualized approach. Now there are several very effective weight loss operations done with laparoscopy and minimally invasive techniques that lend themselves to an outpatient environment.

If you are considering bariatric surgery to improve your health and quality of life, schedule a consultation with Dr. Tsuda. He can help you choose the best option for you and help you on your way to a new healthier you. Read more online at: http://www.yourbariatricsurgeryguide.com/trends-weight-loss/