Apc a-00112-blaming the victim

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Apc a-00112-blaming the victim

  1. 1. a-00112 Dr. Robert RUTLEDGE Title of Paper: BLAMING THE VICTIM; NEED FOR AMULTIDISCIPLINARY TEAM FOR BARIATRIC SURGERY, MINI- GASTRIC BYPASS Nationality: United States of America Position: Director Department: Surgery Organization: Center For Laparoscopic Obesity Surgery Tel: +1-702 714 0011 E-mail: drr@clos.net
  2. 2. BLAMING THE VICTIM; NO NEED FOR AMULTIDISCIPLINARY TEAM FOR BARIATRIC SURGERY, MINI- GASTRIC BYPASS Robert RUTLEDGE11Director, Surgery, Center For Laparoscopic Obesity Surgery, United States of America
  3. 3. Gallbladder Disease• Gall stones Cholecystitis• Cholecystectomy• Cure• No need for Multidisciplinary Team• No need for psychologist, dietitian, physical therapist, support group, multiple follow ups etc….
  4. 4. Introduction• The results of numerous bariatric procedures is marked by failure.• Patients weight regain or Failure to lose weight is often attributed to Patients failures,• “A good operation sabotaged by a poor patient”• Many Believe that these failures can be ameliorated by non-surgical support by the use of Multi-Disciplinary Team (MDT).
  5. 5. Introduction• The hypothesis of this study was that the critical success factor for weight loss following bariatric surgery is the operative procedure and• NOT patient motivation, education or use of a multidisciplinary team (MDT).
  6. 6. Corollaries• Corollaries to the Primary hypothesis:• The WORSE the Bariatric Procedure;• The MORE Need for a Multi-Disciplinary Team• Combination of an POOR procedure with• Excellent multidisciplinary team will still• Lead to POOR patient outcomes
  7. 7. Methods:• Four surgeons offering the Mini-Gastric Bypass WITHOUT an MDT were queried as part of the• First International Consensus Conference on the Mini-Bypass / One Anastomosis Bypass, Paris 2012 October 18-19.• Patient results were assessed in these 7150 patients treated without MDT.
  8. 8. Results• The results in patients with no MDT were excellent.• Lost More than 50% of EW (%) in 83%.• Weight Loss "Failure" (%) 1.7%• Excess Weight Loss (%) was 79%.• Mean length of follow up was 5.4 years.
  9. 9. Results• The rate of long term revision was 2.6%.• Bowel obstruction rate was 0.3%.• Postop GE Reflux rate (%) 5.8%,• Marginal Ulcer rate was 2.4%.
  10. 10. Conclusions:• The critical factor in excellent outcomes following bariatric surgery is likely• NOT the presence or absence of patient motivation or a Multidisciplinary Team.• The critical success factor in the outcome of the surgical treatment of obesity and metabolic diseases is• An excellent, effective, low risk operative procedure.
  11. 11. MDT and Cholecystectomy• No MDT is Needed post Cholecystectomy• Why?• Because the Operation Cures the Disease
  12. 12. For Discussion• Imagine:• Excellent Bariatric Procedure with• Complete/Near Complete Resolution of• Obesity and Associated Co-Morbities

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