The Complexity of Obesity

People generally assume that obesity is strictly the product of bad choices about physical activity and diet. That kind of thinking gets in the way of dealing with obesity as a health condition.

Obesity is a very complicated condition. About 50 to 70% of one’s risk of obesity is genetically determined. You can make choices that make it better or worse, but that’s just like any other chronic disease. When the blame and shame that is so common gets in the way, it makes it hard to improve the health of people living with obesity.

A lot of health plans have broad, blanket exclusions for obesity, thinking that it is a cosmetic condition. However, the rise in the prevalence of obesity over the last 3 decades has made it clear that it’s creating a burden of chronic disease ranging from cardiovascular disease to diabetes to many cancers.

Because weight-based stereotypes and prejudice so often come from thinking that obesity is caused and sustained by personal characteristics such as laziness or lack of willpower, there is a need for increased public awareness and education about the complex biology of obesity and the significant obstacles present in efforts to achieve sustainable weight loss. The prevailing societal and media messages that reinforce blame on obese persons need to be replaced with messages that obesity is a chronic disease with a complex etiology. Obesity is a lifelong condition for most people who are overweight or obese.

Several studies have consistently demonstrated that experiencing weight stigma increases the likelihood of engaging in unhealthy eating behaviors and lower levels of physical activity, both of which exacerbate obesity and weight gain. Among youths, studies have demonstrated that overweight children who experience weight-based teasing are more likely to engage in binge eating and unhealthy weight-control behaviors compared with overweight peers who are not teased, even after control for variables such as BMI and socioeconomic status. 

Other research has consistently documented a positive association between weight-based victimization and eating disorder symptoms and bulimia. Weight-based victimization among overweight youths has been linked to lower levels of physical activity, negative attitudes about sports, and lower participation in physical activity among overweight students.

If you’re looking for treatment for this very real, physical disease, contact VipSurg for an appointment. Our expert team understands the complexity of obesity and all the issues that come with it. We can help find the right treatment for you.

Doctor writing word OBESITY with marker, Medical concept

Could Robotic Gallbladder Surgery Be Right for You?

If you experience pain in the upper right side or middle of the abdomen, you might think it’s a gas pain because you feel especially full, or maybe it’s bad indigestion because you also feel nauseous and are vomiting. These are all symptoms of a problem with the gallbladder. If the pain and/or nausea isn’t enough to send you to your doctor or the emergency room, symptoms such as fever, clay-colored stool, or yellowing of skin and whites of eyes (jaundice) should be assessed by a medical professional as soon as possible.

Gallbladder disease is very common, affecting about 10-15% of adults. Treatment for gallbladder disease may include lifestyle changes and medication. However, if your symptoms worsen, your doctor may recommend surgery to remove your gallbladder.

Fortunately, your gallbladder is an organ that you can live without. 

The surgery to remove the gallbladder is called a cholecystectomy. This surgery can be performed using open surgery through one large incision or through minimally invasive surgery (laparoscopy). 

Minimally invasive surgery can be done either through a few small incisions in your abdomen or one incision in your belly button. In laparoscopic procedures, surgeons use long-handled instruments to reach your gallbladder. One of the instruments is a tiny camera that takes images inside your body and sends them to a video monitor to guide surgeons as they operate.

Cholecystectomy through the belly button can be done using traditional single- incision laparoscopy or da Vinci® Single-Site® Surgery. The da Vinci System features a magnified 3D high-definition vision system and flexible instruments. These features enable your doctor to operate with enhanced vision and precision.

It is important to discuss all treatment and surgical options with your doctor, as well as the risks and benefits of each. If your doctor believes you are a candidate for da Vinci Single-Site Surgery, your doctor removes your gallbladder using state-of-the-art precision instruments. With da Vinci, surgery is performed through one incision in the belly button, which dramatically limits visible scarring.

As a result of da Vinci technology, da Vinci Single-Site Cholecystectomy offers the following potential benefits compared to traditional laparoscopy:

  • Low rate of major complications
  • Low conversion rate to open surgery
  • Virtually scarless surgery
  • High patient satisfaction
  • Minimal pain

Though it is often called a robot, da Vinci cannot act on its own. Surgery is performed entirely by your doctor. This state-of-the-art technology must be operated by an experienced and specially trained surgeon like Dr. Tsuda.

If you need gallbladder surgery, contact VIPSurg to see if you are a candidate for this type of procedure. Da Vinci surgery lets you get back to normal life much more quickly than you could with traditional open and even laparoscopic surgeries.

3d illustration of Human body Gallbladder anatomy

Weight-loss Surgery or Diet and Exercise? Long-term Results Can Save Your Life

To maintain a healthy weight medical professionals emphasize that diet and exercise are key. If you want to lose weight, you must control calories and expend more by exercising. This has been the standard approach for decades. Recent research is telling a different story.

A growing number of studies, including one published in Medical News Today, are finding that for those who are obese, weight-loss/bariatric surgery may be more effective at reducing body weight than the old idea of changing habits and watching what you eat. The findings also suggested that bariatric surgery also increased remission rates in obese patients with Type 2 diabetes as well as heart disease.

 Bariatric surgery helps you lose weight and lowers your overall risk of associated medical problems in one of two ways:

  • Restriction. Surgery is used to physically limit the amount of food the stomach can hold, which limits the number of calories you can eat.
  • Limiting the absorption of nutrients including calories. Surgery is used to shorten or bypass part of the small intestine, reducing the amount of nutrients and number of calories the body absorbs.

Some of the more popular weight-loss surgeries are:

  • Gastric bypass – involves the creation of a small pouch in the top of the stomach. The pouch is the only part of the stomach that receives food. The small intestine is then cut a short distance below the main stomach and connected to the new pouch. Because food now bypasses a portion of the small intestines, absorption and calories are reduced.
  • Gastric banding – involves placing an inflatable balloon (band) around the top part of the stomach; this creates a small stomach pouch above the band with a narrow opening to the rest of the stomach. A port is then installed under the skin. By injecting or removing fluid, the band/balloon can be inflated or deflated, controlling the amount of food the stomach can hold.
  • Sleeve gastrectomy – In this approach, part of the stomach is separated and removed. The remaining section is formed into a tube-like structure; the smaller stomach cannot hold as much food. It also affects the production of hormones that produce hunger.

Why does bariatric surgery appear to be the preferred option over other weight loss options for those considered obese?

It appears to all come down to the success rates of changing old habits. Unfortunately, only slightly more than 5 percent of people are successful in changing their lifestyles on a long-term basis. Health experts claim that the overall risks associated with obesity which include heart disease, high blood pressure, Type 2 diabetes and other life threatening conditions, outweigh the risks and complications of surgery.

Weight-loss surgery isn’t a magic bullet or an easy fix by any means, but research shows it may be the best answer for many people suffering from severe obesity and the deadly health conditions that often accompany it. If you’re considering bariatric surgery in the Las Vegas area, Dr. Tsuda and his expert team are ready to help you find the best treatment for your unique situation.

Doctor measuring obese man waist body fat. Obesity and weight loss.

Benefits of Robotic Surgery

Robotic surgery, or robot-assisted surgery, allows doctors to perform many types of complex procedures with less trauma to the patient than is possible with conventional techniques. Da Vinci robotic surgery enables your surgeon to operate with enhanced vision, precision, and control.

Robotic surgery with the da Vinci Surgical System was approved by the Food and Drug Administration in 2000. The technique has been rapidly adopted by hospitals in the United States and Europe for use in the treatment of a wide range of conditions.

Da Vinci Robotic Surgery is a type of minimally invasive surgery. Minimally invasive is often preferable to operating on patients through large incisions. 

During robotic surgery, miniaturized surgical instruments are inserted through a series davinci1of quarter-inch incisions. The surgeon controls these instruments and a camera from a console located in the operating room. The surgeon operates the special “wristed” robotic arms while looking through a stereoscopic high-definition monitor that allows him or her to see inside the patient, giving a better, more detailed 3-D view of the operating site than the human eye can provide. 

Every movement the doctor makes with the master controls is replicated precisely by the robot. When necessary, the surgeon can even change the scale of the robot’s movements. Because of the console’s design, the surgeon’s eyes and hands are always perfectly aligned with his view of the surgical site, minimizing surgeon fatigue.  

Since procedures can now be performed through very small incisions, patients experience several benefits compared to open surgery, including:

  • Less trauma on the body
  • Minimal scarring
  • Faster recovery time
  • Fewer complications, such as surgical site infection

The da Vinci System represents the latest in surgical and robotics technologies. Your surgeon is 100% in control of the da Vinci System always. Da Vinci technology translates your surgeon’s hand movements into the smaller, precise movements of tiny instruments inside your body. 

At VIPSurg, our doctors specialize 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, using the da Vinci Robotic Surgery System whenever it benefits our patients. Call for an appointment to see how we can help with your surgical needs.

Life After Bariatric Surgery

For many who think weight-loss surgery may be the only way to be healthy and live longer, the fear of how life might be after the procedure keeps them from taking life-saving measures. Be informed so that you can make educated decisions about your health. These facts can help you on the way to knowing what’s best for you and give you a glimpse into what one can usually expect after surgery.

Your recovery will depend on which procedure you choose (gastric sleeve, gastric bypass, lap-band, and duodenal switch surgery). For example:

  • Average Hospital Stay: Ranges from outpatient (return home same-day) to 2-3 days
  • Average Time Until Back to Work: Ranges from 3 days to 2 weeks
  • Average Time to Full Recovery: Ranges from 3 days to 6 weeks
  • Pain: Ranges from mild discomfort to manageable with pain medication
  • Diet: Ranges from a few limited foods to a strict and slow transition from clear liquids to solid foods
  • Back-to-Normal Activity: Ranges from 3 days to 4-6 weeks

Life after weight loss surgery includes (depending on your chosen procedure):

  • Full recovery in 1 to 6 weeks
  • Excess weight loss between 25% and 90+%
  • Many obesity-related health problems cured or improved
  • Significant diet and exercise changes
  • Good and bad changes in how friends, family, and strangers treat you
  • Challenges such as sagging skin, digestion issues, and weight regain

Improvements to your physical health can be as impressive as your rapid weight loss family-eating-at-the-table-619142_1920after bariatric surgery. Conditions such as Type 2 Diabetes, high blood pressure, GERD, and other issues related to metabolic syndrome have been shown to get better or completely go away following gastric sleeve, gastric bypass, lap-band, and duodenal switch surgery.

It is important to emphasize making healthy food and lifestyle choices even before weight-loss surgical procedures. Bariatric surgery is a tool. Use it to make changes for a long, healthy, productive, and happy life.

If you live in the Las Vegas area and are considering bariatric surgery, schedule an appointment at VIPSurg. Our team can help find the perfect treatment for you!

Bariatric Surgery and Adolescents: Weighing the Risks Against the Benefits

The number of adolescents who are overweight or obese has leveled off in recent years, but unfortunately, the number who are severely obese — heavy enough to qualify for bariatric surgery — nearly doubled from 1999 to 2014. As a result, more doctors and parents are facing an extremely difficult dilemma: Should morbidly obese teenagers have bariatric surgery?

While surgery is the only thing that seems to work for these kids, the idea of weight-loss surgery for teens fills many parents and doctors with trepidation because we must weigh the benefits against the potential problems. Which is worse, risks from surgery or the likelihood of serious health risks from remaining obese?

An estimated three to four million adolescents are heavy enough to meet the criteria for bariatric surgery, but only about 1,000 teenagers per year undergo the surgery. Some medical centers will not perform it on teenagers, and many pediatricians never mention it to their heavy patients.

Obesity carries serious health risks in teenagers — including type 2 diabetes, high blood pressure, sleep apnea, acid reflux, fatty liver and high cholesterol levels — that tend to be eased by surgery. Other health problems associated with obesity in teens include asthma, polycystic ovarian syndrome, and skin fungal infections.

Added to that are social and mental health problems, including isolation and depression. Obesity in teens is associated with significant mental and physical challenges.

According to the Surgeon General, overweight adolescents have a 70% chance of becoming overweight or obese adults. The likelihood increases to 80% if one or both parents are overweight or obese.

In the past, teenagers had two options:

  1. Lose weight by changing diet and exercise habits
  2. Live with current and future consequences of obesity

While the first option is ideal, unfortunately it is not effective for as many as 70% of teens who try it. However, as advances in weight loss surgery for adults have reduced complication and mortality rates, more teens – and their doctors – have begun exploring surgery as a valid option.

If you’d like to learn more about bariatric surgery options and if it might be right for you, contact us for a consultation. Visit https://bit.ly/2GePjXn for contact options and information.

Fat Boy, Healthy and lose weight concept

Benefits of Robotic Surgery

Technology is changing the way we do practically everything now, and the medical world isn’t immune. The da Vinci robot is changing the way surgeons are performing operations and is providing benefits to both patients and doctors.

While the surgeon sits at a modified computer console, he/she can control the instruments and camera. Placing their fingers into the master controls, the surgeon operates the arms of the da Vinci robot while simultaneously looking through a stereoscopic high-definition monitor that gives a better, more detailed 3-D view of the operating site than the human eye can provide. Every movement he makes with the master controls is replicated precisely by the robot. The robot’s “hands” have a high degree of dexterity, allowing surgeons the ability to operate in very tight spaces in the body that would otherwise only be accessible through open (long incision) surgery.

Using the da Vinci robot allows surgeons to perform a growing number of surgical procedures. Since these surgeries can be done through very small incisions, patients experience many benefits compared to open surgery, including:

  • Less trauma on the body
  • Shorter hospitalization
  • Reduced pain and discomfort
  • Faster recovery time and return to normal activities
  • Smaller incisions, resulting in reduced risk of infection
  • Reduced blood loss and transfusions
  • Minimal scarring

The surgical team supervises the robot at the patient’s bedside. Unlike traditional surgery where the surgeon stands over the patient sometimes for hours, a surgeon using the da Vinci system is seated, substantially decreasing surgeon fatigue. Add in the greater visualization abilities, enhanced dexterity, and greater precision and there are major advantages for both patients and surgeons using robotic surgery alike.

Dr. Tsuda and Dr. Ryan at VIPSurg are expert robotic surgeons. Call 702-487-6000 to schedule a consultation.

da-vinci-robot-handout_wide-65a56675b7c19da729a83a3378bdd071d7d5cfc6-s1500-c85