How long have you been a bariatric surgeon?
- I have been practicing bariatric and metabolic surgery for over 15 years.
How many surgeries have you performed?
- Over the past decade, I have performed over 5,000 bariatric procedures, including gastric sleeve surgery, rny gastric bypass, and lap band.
I’ve read studies showing that smaller bougie sizes (28F-32F) are associated with high leak rates, strictures, and GERD. Sizes above 34F-36F seem to be tolerated better with the same amount of weight loss. Therefore, I’m wondering what size bougie you use?
- Dr. Jacqueline Osuna uses 34 fr bougie in all patients.
What is your goal for the final stomach capacity in ounces?
- The final goal Is between 3 and 4 ounces
Do you oversew the staple line?
- Yes, we do with a prolene string.
How many sleeves have you performed? Have you had any complications? Leaks? Deaths?
- Around 2700 and we had 4 wound infections that require curations, we had no leaks, we transfuse blood to 2 patients but no require reoperation. No deaths at this time.
I hear it is common for the sleeve to swell after surgery which may lead to nausea and vomiting. Can anything be done prophylactically to prevent this?
- Yes, we use 2 medicines to avoid nausea and sometimes we use steroids very useful in those patients.
Do you place patients on blood thinners to prevent pulmonary embolisms?
- Just in BMI up to 50.
I tend to scar very easily and so I am wondering how you close the incisions. Do you use subcuticular suturing that eventually dissolves with Dermabond/glue over the incisions?
- Yes, we use subcuticular absorbable sutures.
I’ve never had surgery before but I am worried about post-surgery nausea and vomiting. I have a very low threshold for nausea and easily get nauseated. If possible, can an anti-emetic be given before surgery or even during surgery via IV to prevent nausea after the surgery?
- Of course, we will give you 2 medicines to avoid nausea.
How many leak tests are done?
- Two leak tests. One operative room and the second one the next day after surgery.