New Services Being Offered at Wittgrove Bariatric Center:

Endoscopic Placation Methods

As many of you know, our center has been at the forefront in new technology and techniques.  For most of our bariatric patients “routine” is a good thing since our surgical techniques and programmatic assistance has been proven to be a significant tool to fight the disease of Morbid Obesity.  For some of our patients and some from other programs who have not attained the level of success they would have liked to achieve, we offer new hope and assistance.  Now it is true you may have seen other similar statements made by other programs but in this section we will outline some of the things to think about within this arena.

First off it is important to be evaluated by a program (and specific surgeon) that has been doing bariatric surgery AND patient follow-up, for many years.  It takes years to know and understand the variations that can be seen since this disease is such a multi-factorial disease.  It is important for the surgeon to have a lot of “hands on” follow-up so that they truly know by first hand experience what influences work in which situations.  Along with this follow-up experience it is very important to know the surgeon’s operative experience both with primary bariatric cases as well as with various types of revision operations. 

Next, we feel it is important for the program to have an algorithm or pathway to follow in their evaluation.  This means that the program needs to have a multitude of methods to treat various types of “poorer outcomes”.  We have seen some programs that have never performed a revision operation now jump on the band wagon of the new “endoscopic” procedures.  If a program has no real experience in evaluating the reasons patients fail to have the best results, and they have not performed revisions for various types of anatomic complications or failures then they are by definition too closed minded on their approach to the solution to the problem.  The old saying “if all you have is a hammer, all the world looks like a nail” is true.  Not all problems in bariatric surgery can (nor should they) be treated by endoscopic procedures.  And certainly not all endoscopic procedures are the same!  We at Wittgrove Bariatric Center are happy to announce we have teamed up with the USGI Corporation in offering the endoscopic “Rose” procedure.  This procedure is not for everyone.  But for the selected patient, this procedure offers better results, over a longer time of study than some of the other endoscopic techniques.

And finally, many patients don’t need surgery at all.  They may need proper instruction on using the tools they already have in their toolbox.  They may need Psychological support or the assistance of a general support group.  Some patients never received the best advice when it comes to dietary choices or the best supplements to be taking.

For more insight on how we approach the evaluation of patients who might need further assistance, view the section under revisions in the drop-down on surgeries.  This outlines our algorithm or approach to the subject and this approach is based on over 20 years of bariatric surgery with thousands of patients followed and literally hundreds of revisional surgical procedures.  We have evaluated patients from programs all over the country.

Gastric Bypass being offered to Type 2 DM whose BMI is less than 35

Wittgrove Bariatric Center is very proud to announce that we are one of only a handful of programs thought the country who can offer Gastric Bypass for patients who suffer with Type 2 Diabetes Mellitus.  That is right the primary indication for the operation is not morbid obesity in this group of patient but rather the indication for surgery is Diabetes alone.  We have obtained an IRB from Scripps Memorial Hospital to perform Laparoscopic Gastric Bypass operations on Diabetic patients with BMI from 27 to 35.  Historically Gastric Bypass operations have been offered to patients with BMI over 35 and some of these individuals may also have Diabetes.  We are currently investigating the effect of Gastric Bypass on Diabetes in more normal weighted individuals.  The importance of an IRB can not be overstated.  An IRB is an institutional board which helps insure the rights of the patients while studies are being done.  The board is made up of doctors and lay persons and their job is to insure the study has enough merit to believe the patients will receive a benefit and there is an adequate safely ratio is present to protect the patient. 

What does this mean if you have type 2 Diabetes and you are not Morbidly Obese?  All indications are that the metabolic effects we see on DM after Gastric Bypass surgery on the Morbidly Obese are also seen in the obese or overweight patient.  That is, in a Diabetic who has a Gastric Bypass for Morbid Obesity, the chance are over 80% that they will be off all their diabetic medications and have normal blood sugar levels within 3 days after the operation.  It sounds too good to be true but IT IS TRUE!  We see it every day.  And the indications are that the same effect will be seen in the overweight Diabetic as well.  This surgery will probably offer the best sugar control for type 2 DM without the need for medications and that is what we will be studying. 

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Vertical Banded Gastroplasty

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Biliopancreatic Diversion (BPD)

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Biliopancreatic Diversion with "Duodenal Switch"

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Dr. Wittgrove's Favored Technique and Approach

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