In The News
Rare Surgery at
Pasco Regional
Medical Center
Offers Hope for
Weight-Loss
Patients
By Kit Ingalls - Pasco News 
printed Thursday, July 21 2005

 

Testimonials

Before LapBand I was so depressed and disgusted with myself. I vowed I was going to just "eat myself to death". No diet worked for me. My LapBand has allowed me to eat like a "normal" person. I can no longer over eat, therefore, I am losing excess weight. I am very happy to have my LapBand, and Dr. Grossbard!

 

Barbara

Highest Weight 240

Date of Surgery

Current Weight 186

Ian DesVignes, 34, had a gastric bypass six years ago at UCLA Medical Center. After surgery, he had lost 200 pounds. But then, he hit a plateau. Eighteen months ago, he began gaining the weight back. He was able to eat more and he did. His weight began yo-yoing again, as it had before surgery.

“That brought the fear of gaining weight back,” DesVignes says. “You don’t want to go back down that path.” A father of five, he feared that he would not be there to see his children graduate. So, after long discussions with his wife Terri, who had the LAP-BAND® procedure last November, he decided to have surgery once again.

pictured left to right: Mr. Ian DesVignes, patient,
Dr. Lee Grossbard, M.D., Dr. Richard DiCicco, M.D.,
and Dr. Pandurangan Krishnaraj, M.D.

DesVignes did not seek to become a landmark patient. He just sought help.  In doing so, he became the first patient in the state of Florida to have “LAP-BAND over open gastric bypass” surgery.

Lead surgeon Dr. Lee Grossbard, assisted by two of his colleagues from Florida Obesity Surgical Associates, P.A., Drs. Pandurangan Krishnaraj and Richard DiCicco, performed the procedure at Pasco Regional Medical Center in Dade City on July 1. The surgery is rare; there have been fewer than 30 of these procedures in United States and fewer than 100 worldwide.

The first surgery had left DesVignes with a small pouch, separated from the rest of his stomach, which could hold only about 1/2 cup of food. The size of the pouch limited the amount he could eat at any one time. Over the years, his pouch had tripled in size. He had also learned how to eat foods that could “go down” more easily. After regaining 50 pounds, DesVignes opted for a LAP-BAND® over his bypass.

The surgeons operated laparoscopically, that is with long tools through small incisions no larger than 1-1/4 inches. To DesVignes, whose open gastric bypass had left him with a scar running from his breastbone to his navel, 1-1/4 inches incisions sounded good. The difficulty of the operation lay in getting through the scar tissue created by the prior surgery. “Once that was down, it was a pretty simple operation,” says Dr. Grossbard.

In LAP-BAND surgery, a hollow silicone band is placed around the upper stomach, creating a small pouch. A kink-resistant tube connects the band with an access port positioned just under the skin. The doctors can govern the amount of food that the patient can eat comfortably by adding or removing salt water and, thus, controlling the size of the opening between the pouch and the remainder of the stomach. For DesVignes, the laparoscopic procedure took just under 2-1/2 hours, five times as long as it takes the surgeons to install a LAP-BAND without the complications of scar tissue and distorted anatomy from prior surgery.

DesVignes had the procedure on Friday, went home the next day and back to work the following Tuesday. He contrasts this with his previous surgery, which had required five days’ hospitalization and six weeks off work. He will have mandatory follow-up visits monthly for the first year and periodically in succeeding years. He also participates in a number of support groups.

Support groups were not a common feature of weight-loss surgery when DesVignes had his bypass six years ago. He considers them key to his success this time around. “When you’re in that community and you have that support from other people, and you socialize with them, even outside the sessions, it’s good because everybody understands,” he says.

“Even doing something simple like going to a restaurant – you go to a restaurant with your normal friends who haven’t had surgery and everybody’s looking for you to eat, because they remember the old you. And you get looks from the waiters like something’s wrong or the food is bad. So they continually come and ask you, ‘Is something wrong? Is there a problem?’ You’re like, ‘No, I’m just trying to lose weight. I’m sorry for being fat, okay?’ But they don’t understand.”

Dr. Grossbard is a member of the same support groups – not as a doctor, but as a patient. One of the first surgeons trained to do the LAP-BAND procedure in the United States, he chose the surgery for himself in October 2002 and has since lost 100 pounds. He cites three major advantages of the LAP-BAND -- “It is reversible; it is the safest and easiest to do laparoscopically, and it is adjustable.”

To be eligible for weight-loss surgery in the United States, patients must be morbidly obese, with a Body Mass Index (BMI) of 40 or more – generally 100 pounds or more overweight. Severely obese patients, those with a BMI of 35 or more – generally 65 to 75 pounds overweight – are eligible if they also have another condition impairing their health, such as diabetes, hypertension, heart disease, arthritis, or gastro esophageal reflux disease (GERD). All patients must have a psychological evaluation.

The surgeons at Pasco Regional Medical Center have performed more than 600 LAP-BAND surgeries, more than have been performed at any other hospital in Florida. And they have operated on patients with BMIs as high as 82.
The surgeons see great hope for patients who are no longer benefiting from their weight-loss procedures. “We already have two patients with prior gastric procedures getting ready to have LAP-BANDS put over what they have,” says Dr. Grossbard, who believes that the trend in weight-loss surgery is toward the LAP-BAND.

Terri DesVignes agrees. She has lost 62 pounds insisted that Dr. Grossbard perform her husband’s surgery. “I went to Orlando with the kids,” she says. “I walked 15 miles. I actually went on roller coasters with them. I would have never done that before. After a couple of hours, we would have had to go back to the motel.  It’s much easier on the kids now.”

The children were a major factor in Ian’s decision. “You want to be able to get out there and really coach them and teach them and really show them things – not just sports, but anything. You want to have that energy level.” DesVignes says he feels good after surgery.  Losing more weight has alleviated his back pain.

“And you stopped snoring,” adds his wife.

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