WLS Surgical Associates
Dr. Joe Kuhn and Dr. Greg Barnes 

March 2011 
 Greetings!

Things are constantly Changing.  New Procedures.  New techniques.  This month, we will highlight some of the research we have been doing for the past year.  Also, see the Minutes from the Support Group Below.

Sincerely,  Joseph A. Kuhn, MD
Recent Bariatric Presentations at the American College of Surgeons Meeting held in Dallas, Texas in February

    


Dr. Kuhn and Dr. Barnes were authors of several unique bariatric presentations last month.  We work with Premed students (one was Dr. Kuhn's daughter, Kristin), surgical residents and research nurses who help with all aspects of the research. 



Band to Bypass Revisions:  

This is the largest reported series of Band to Bypass revisions in the   US.  The results look excellent.  The abstract is included below.
Band Revision Abstract

Surgical Repair of Gastro-Gastric Fistulas

This is also the largest series of laparoscopic repairs of this complex problem, which is a connection of the upper stomach to the lower stomach (often due to smoking or aspirin compounds)
Gastro-Gastric Fistula Abstract

New and Safer Technique for Sleeve Gastrectomy

This novel technique offers a virtually Bloodless way to perform sleeves.  It also prevents heat injury to the upper stomach, which is crucial for avoiding leaks.
Sleeve Gastrectomy Technique

Sphincter of Oddi Dysfunction

This is the largest experience with a rare problem that occurs in the pancreas duct following gastric bypass.  Symptoms include pain and nausea.  An elevated amylase, lipase, or alkphos is key.
Sphincter of Oddi Abstract


Dr. Kuhn also presented research on the following topics:

Microwave Ablation of Liver Tumors
Oxaliplatin vs Mitomycin C for Intraperitoneal Chemotherapy
Novel Vaccine for Colon Cancer
Granulomatous Mastitis
Safety Technique for Intraperitoneal Chemotherapy

 

The Research Project I am most proud of . . .


Lateral Ballottement for Inserting Trocars: A new Standard.

 

This is a safety technique that was inspired by one of our patients who miraculously survived an incredibly rare injury due to the insertion of the laparoscopic trocar (tube) that is used during surgery.  Air was passed into her vascular system, causing cardiac arrest, and leading to chest compressions, CPR, and clamping of her aorta.  Dr. Kuhn asserts that a verbal prayer during the case led to her recovery, motivating him to change the insertion technique across the country.

This new technique is already sweeping through the residency training program as a simple safety maneuver to reduce internal injury with nearly all laparoscopic procedures.

  
Actual Poster with Images
MARCH SUPPORT MEETING: 

For the First Time:  Minutes about What happened !!!!  See Below

    Mar 14 (2nd Mon)Medical City Dallas
           47777 Forest Lane, Building A
            Conf A/B, Childrens tower,
            across from Cafeteria
              7:00-8:30              
    Mar 10 (2nd Thurs) Baylor Park Lane
            9101 N Central Expwy
            2nd floor conference room
            6:30 to 7:30

    Mar 17 (3rd Thurs)Baylor Southwest
             Fort Worth
             2nd floor conference room
             6:00 to 8:00 pm
     
   



 MCDH Bariatric Support Group Meeting Minutes


March 14, 2011

The meeting was called to order by Dr. Barzune at 7:00pm.  He welcomed everyone and gave the floor to Dr. Louis Fox, the moderating physician for the evening.  Dr. Fox introduced the first speaker, Ryan Eason from Medical City Heart.

Ryan creates programs for the community.  He runs Medical City's Restaurant Partner Program, its Physician Speaking Program, and its Kids Teaching Kids Program.  All of these programs are aimed at helping those in the communities around Medical City to lead healthier lives.

The Restaurant Partner Program is a cooperative program between Medical City Dallas and area restaurants.  Medical City has a dietician who works with Ryan who goes to the restaurant partners and analyzes their menu items.  She determines which items meet the American Heart Association guidelines for heart healthy meals and those menu items get to have a Medical City logo placed next to them on the menus indicating that they are heart healthy.  These restaurants are also advertised in Medical City Heart's quarterly publication so that the community knows where they can go to eat out healthfully.

The Kids Teaching Kids Program is really exciting!  Medical City partners with the Greater Dallas Restaurant Association for this one.  Area high schools in the counties in and around Dallas who purchase the Texas Pro Start Program for its culinary arts students are eligible to participate.  For those high schools chosen, such as those in Frisco ISD, Richardson ISD, and Wylie ISD, among others, Medical City sends out Ryan and the dietician to teach classes about nutrition, reading and understanding food labels, and the importance of learning to eat healthfully as a child.  Ryan also takes a chef who is a member of the Dallas Chefs Association to the high schools to give a class in culinary skills and to demonstrate how to prepare a healthy fruit snack and a veggie snack.  The high school's culinary arts students are then given the challenge to create a healthy snack that a fourth grader would eat.  It must meet the following criteria:

�     200 calories or less
�     Less than 7 grams of fat
�     Less than 2 grams of saturated fat
�     Less than 15 grams of sugar
�     Aim for 2 grams of fiber

The preparation of the snacks also cannot require the use of sharp knives, utensils or the stove or oven.  They have to be able to be prepared safely by a fourth grader.  The winning snacks are published in a pamphlet which is designed by the high school's journalism students and the photos of the snacks are taken by the high school's photography students.  In this way, many of the high school students are taught about healthy eating.  The pamphlets are paid for by different restaurants which are given the opportunity to advertise in them.  The pamphlets are then distributed to the district's fourth graders via their PTA's.  This is a great way to help curtail the steady increase in childhood obesity. Ryan left copies of the most recently published pamphlets for the group to take home.

Dr. Fox then introduced Julie Shaw, RD, LD, Medical City Dallas' Bariatric Dietician.  Julie had set the tables in the room as dining tables and had an interactive presentation that taught us all about correct portion sizes and healthy food choices.  We learned that a tennis ball sized orange or apple is the correct serving size of fruit, whereas a larger apple or orange is two servings.  A deck of cards is the correct serving size of already cooked meat and two dice equals an ounce of cheese which is the correct serving size of cheese.  Julie gave other examples as well.  She also had 3 minute egg timers on the table and told the group that they should have about three minutes between bites.

Julie talked about the importance of being a mindful eater.  She explained that we should not eat on the couch in front of the TV.  We should eat at the table where we can pay attention to what we are eating so that we can tell when we are full and stop eating.

Julie finished her talk by doing a fun demonstration of how to calculate the amount of protein, in grams, that you eat in a day.  She asked for a volunteer and one woman volunteered to tell the group everything she had eaten for the day.  Julie wrote it on an easel pad and used a chart she had given out to total the amount of protein the volunteer had eaten in the day.  The total was 68 grams of protein!

Dr. Barzune and Dr. Fox then answered questions from the floor.  Afterwards the meeting was adjourned around 8:40pm.


 

 
New Referrals

 
 
 
For new referrals, we will mail a DVD to a potential person who is considering their options or who simply wants to learn more about bariatric surgery.
 
You can Email our new patient coordinator to assist with mailings:
 
 
COE emblem
 
 

Sincerely,


Joseph Kuhn, MD, Medical Director

Gregory Barnes, MD

WLS Surgical Associates
New Study Opportunity NOW OPEN for recruitment

Dr. Kuhn and one of the pre-eminent Gastroenterologists in the country (Dr. Fordtran) have opened a great study to determine the amount of absorption in the intestines after two slightly different gastric bypass procedures. 
Eligibility:  BMI over 50, having a gastric bypass in the next 6 months.
 
Please contact Dr. Kuhn if you are interested.




  


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