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Traumatic Cataract Iridodialysis Mydriasis
The patient had severe blunt trauma with a resultant iridodialysis, mydriasis, and cataract. in the the first surgery we removed the cataract, placed at CTR, placed an IOL, an repaired the iridodialysis. in the second surgery we repaired the mydriasios with a single suture across the area of iridodialysis (to minimize strin here) and to close the pupil in this area of greatest damage.
Ultrasound Training of the Female Reproductive Organs
Roux-en-Y Gastric Bypass "Stomach Stapling"
The Roux-en-Y Gastric Bypass or "Stomach Stapling" remains the gold standard to which other weight loss operations are compared. It is still the most frequently performed weight loss surgery procedure in the United States. The Gastric Bypass takes advantage of both restriction and malabsorption to work. The restrictive part of the procedure is the creation of the small stomach pouch with a very small outlet. The malabsorptive part of the procedure involves re-arranging the small intestine to reduce how much of the intestine is involved in absorbing the small amount of food that is eaten.
The entire procedure is performed laparoscopically. The small stomach pouch is created by stapling. The pouch is created to be small -- about 30cc in size. The remaining stomach is not removed, but simply stapled shut and separated from the stomach pouch. The small intestine is then rearranged - one cut end of the bowel is connected to the pouch, while the other cut end, is reconnected to the small bowel about 100 to 150cm from the pouch. The result is a "Y" shaped re-connection that gives the technique its name. The length of either segment of the intestine can be increased to produce lower or higher levels of malabsorption.
The operation restricts food intake very effectively, particularly during the first year, the time of maximum weight loss. Ultimately a bypass patient will be able to eat about a cup of food per meal three times a day, experiencing prolonged satisfaction and fullness from that amount of food while losing weight. Hunger and cravings are controlled, particularly if the patient is compliant. This is a profound experience for many, being released from a prison of hunger.
The average expected weight loss with the RYGB procedure is around 70% of excess weight. About 50% of the expected weight loss will be lost in the first 6 months after the operation. The remaining half is lost slower over the remaining half to one year. With good compliance an 80% to 90% chance of maintaining the weight loss long-term can be expected, and 80% to 90% of patients have at least improvement or resolution of their medical problems.
Proceeding with weight loss surgery is a very personal and often difficult decision. Educating yourself about weight loss surgery is a very important first step. Although the information presented here may be very helpful, patients have repeatedly told us that attending the weight loss surgery informational seminar helped the most.
For those of you who are not from Kansas, we treat many patients from out-of-state, and from all across the United States. When contacting the office, please inform the staff that you are out-of-state and access our out-of-state link for more information on how we can help you with the preparatory process.
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