Foreword

Research in surgical education has demonstrated the superiority of interactive and experiential educational approaches over traditional didactic educational methods. This has resulted in the development and use of a spectrum of new and innovative educational programs and products that involve multimedia and simulation. The internet offers a special platform for delivery of these educational programs and thus enhances access.

The ACS Multimedia Atlas of Surgery series has been developed by the American College of Surgeons (ACS) Division of Education with Horacio J. Asbun, MD, FACS, as Editor-in-Chief. This multimedia program is especially designed to address the cognitive elements of surgical procedures. Each procedure is presented in a step-wise fashion and the technical steps are described through text, narration, illustrations, and videos. The format of the program permits the learner to progress through the entire procedure or to focus on a specific step. Expert commentaries highlight special nuances, error-prone situations, and actions that should be taken to prevent errors. The content is available online now and a print publication will be offered in the Summer of 2019. The emphasis on the delivery of surgical care of the highest quality and on specific elements to promote patient safety is especially noteworthy. The chapters are authored by internationally renowned experts in the field. The program has proven to be of immense value to practicing surgeons, surgery residents, and members of the surgical team.

Please note that the statements and content expressed in this volume, including the descriptions of surgical techniques, illustrations, and video clips, reflect the opinions of the authors and the consensus of the editors, but not necessarily the opinions or official position of the American College of Surgeons. Certain limitations of the ACS Multimedia Atlas of Surgery are worthy of note. The Atlas is a learning tool and is not recommended for formal, summative evaluation. Although the items and the critiques have been thoroughly reviewed by the authors and editors, the content does not necessarily reflect all relevant material or points of view.

We are delighted to present the ACS Multimedia Atlas of Surgery, which covers the bariatric surgery. Editors of this volume are Horacio J. Asbun, MD, FACS; Daniel B. Jones, MD, FACS; Alfons Pomp, MD, FACS, FRCSC; and Raul Rosenthal, MD, FACS. I would like to extend to them my profound gratitude for their outstanding leadership, commitment, and willingness to share their expertise with others. I am also grateful to Olivier Petinaux, Senior Manager of Distance Education and E-Learning in the ACS Division of Education, for his exceptional support of this superb educational program.

Ajit K. Sachdeva, MD, FACS, FRCSC
Director, Division of Education
American College of Surgeons
Blended Surgical Education and Training for Life^®

In Dedication

This publication is dedicated to George L. Blackburn, MD, PhD, FACS, for his compassion as a doctor, his contributions as a researcher, and his dedication as a mentor. His significant impact on this field will always be remembered.

Table of Contents

1. Metabolic Syndrome and the Obesity Disease: Weight Loss or Metabolic Surgery?
George L. Blackburn, MD, PhD, FACS; Bruce M. Wolfe, MD, FACS

2. Value of Accreditation
Dan E. Azagury, MD; John M. Morton, MD, MPH, FACS, FASMBS

3. Anatomic Considerations for Weight-Loss and Metabolic Surgery
Eric J. DeMaria, MD; Omar Bellorin, MD; Alfons Pomp, MD, FACS, FRCSC

4. Operating Room Setup
Daniel M. Herron, MD, FACS, FASMBS; Darshak Shah, MD

5. Preoperative Evaluation
Manish Parikh, MD, FACS; Collin Creange, MD

6. Laparoscopic Adjustable Gastric Banding
Christine Ren Fielding, MD, FACS, FASMBS; George Fielding, MD, FRCS, FASMBS

7. Band Erosion: Removal and Treatment
David M. Williams, MD; Marina Kurian, MD, FACS, FASMBS

8. Revision of Band for Port and Tubing Complications and Prolapse
Emma Patterson, MD, FRCSC, FACS

9. Laparoscopic Sleeve Gastrectomy Overview
Emanuele Lo Menzo, MD, PhD, FACS, FASMBS; Samuel Szomstein, MD, FACS, FASMBS; Raul Rosenthal, MD, FACS, FASMBS

10. Laparoscopic Sleeve Gastrectomy Technique
Michel Gagner, MD, FRCSC, FACS, FASMBS

11. Laparoscopic Sleeve Gastrectomy: Management of Complications - Leak
Emanuele Lo Menzo, MD, PhD, FACS; Samuel Szomstein, MD, FACS; Raul Rosenthal, MD, FACS

12. Laparoscopic Sleeve Gastrectomy: Laparoscopic Management of Complications - Sleeve Stenosis
Julietta Chang, MD; Matthew Kroh, MD, FACS

13. Laparoscopic Sleeve Gastrectomy: Management of Complications - GERD
Italo Braghetto, MD, FACS; Owen Korn, MD, FACS; Héctor Valladares, MD

14. Roux-en-Y Gastric Bypass: Open Technique
Bruce Schirmer, MD, FACS

15. Roux-en-Y Gastric Bypass: Basic Laparoscopic Technique
Enrique F. Elli, MD, FACS; Kristin D. Patton, MD

16. Roux-en-Y Gastric Bypass: Single Incision Technique
Alan A. Saber, MD, FACS

17. Hand-sewn Gastrojejunostomy: Anastomosis
Kelvin Higa, MD, FACS; Subhash Reddy, MD

18. Constructing the Gastrojejunostomy: Transgastric Stapled End-to-End Anastomosis
Jaisa Olasky, MD; Daniel B. Jones, MD, FACS

19. Constructing the Gastrojejunostomy: Linear Stapled Technique
Tammy Fouse, DO; Philip Schauer, MD, FACS

20. Constructing the Gastrojejunostomy: Transoral Circular Stapler
Alan Wittgrove, MD, FACS

21. Constructing the Jejunostomy
Aurora Dawn Pryor, MD; Dana Telem, MD; Vamsi Alli, MD

22. Closing Mesenteric Defects
Robert E. Brolin, MD, FACS

23. Banded Gastric Bypass
Mathias Fobi, MD, FACS, FICS, FACN, FASMBS; Muffazal Lakdawala, MD

24. Management of Complications of Roux-en-Y Gastric Bypass: Short-Term Postoperative Complications
Pedro Paulo Caravatto, MD; Ricardo Cohen, MD

25. Management of Long-Term Complications After RYGB: Internal Hernias, Ulcers, Nutrition, Dumping, and Others
Robert B. Lim, MD, FACS, FASMBS; Steve Bowers, MD, FACS, FASMBS

26. Management of Complications of RYGB: Gastrogastric Fistulas (GGFs)
Kelly Haisley, MD; Laura E. Fischer, MD, MS; Gene Bakis, MD; Samer G. Mattar, MD

27. Management of Complications of Roux-en-Y Gastric Bypass: Abdominal Pain
Michel Suter, MD, FACS

28. Management of Complications of Roux-en-Y Gastric Bypass: Endoscopy Complications
Manoel Galvão Neto, MD; Lyz Bezerra Silva, MD; Josemberg Marins Campos, MD, PhD

29. Management of Complications: Nutritional Complications
Liz Goldenberg, MPH, RD, CDN

30. Biliopancreatic Diversion - Scopinaro Procedure
Luigi Angrisani, MD; Ariola Hasani, MD; Marco Raffaelli, MD

31. The Duodenal Switch by Laparoscopy: Technique
Jacques Himpens, MD, PhD

32. Unusual Surgical Approaches: Gastrostomy/Jejunostomy
David A. Provost, MD, FACS, FASMBS

33. Gallstones and Bile Duct Pathology After Weight-Loss Surgery
J. Paul Sanders, MD, FACS; Pornthep Prathanvanich, MD, FACS; Bipan Chand, MD, FACS; Daniel B. Jones, MD, MS, FACS

34. Conversion of Gastric Bypass for Inadequate Weight Loss or Weight Regain
Alfons Pomp, MD, FACS, FRCSC

35. Conversions: Band to Roux-en-Y Gastric Bypass
Cheguevara Afaneh, MD; Gregory Dakin, MD, FACS; Alfons Pomp, MD, FACS, FRCSC

36. Laparoscopic Adjustable Gastric Band Removal with Conversion to a Laparoscopic Sleeve Gastrectomy
Leonardo Claros, MD, FACS, FASMBS; Maher El Chaar, MD, FACS, FASMBS

37. Conversions: Laparoscopic Sleeve Gastrectomy to Roux-en-Y Gastric Bypass
Amir Aryaie, MD; Tomasz Rogula, MD, PhD; Philip Schauer, MD

38. Conversions: Conversion of Vertical Banded Gastroplasty to Roux-en-Y Gastric Bypass
Emanuele Lo Menzo, MD, PhD, FACS, FASMBS; Samuel Szomstein, MD, FACS, FASMBS; Raul Rosenthal, MD, FACS, FSAMBS

39. Conversions: Laparoscopic Sleeve Gastrectomy to Roux-en-Y Gastric Bypass
Amir Aryaie, MD; Tomasz Rogula, MD, PhD; Philip Schauer, MD

40. Robotics: Setup and Overview
O. Yusef Kudsi, MD, MBA, FACS; J. Stephen Scott, MD, FACS

41. Robotic Roux-en-Y Gastric Bypass
Keith C. Kim, MD, FACS; Michele L. Young, PA-C

42. Single Dock Robotically-Assisted Biliopancreatic Diversion With Duodenal Switch
Ranjan Sudan, MD, FACS; Shaina R. Eckhouse, MD

43. Laparoscopic Gastric Plication
Michael J. Mulcahy, MD; Stacy A. Brethauer, MD, FACS

44. Conversion of Vertical Sleeve Gastrectomy to Stomach Intestinal Pylorus-Sparing (SIPS) Surgery—Single-Anastomosis Duodenoileal Bypass (SADI)
Mitchell S. Roslin, MD; Andrew R. Brownlee, MD

45. Reversible Vagal Nerve Blocking (vBloc) for the Treatment of Morbid Obesity and Related Comorbid Conditions
Scott A. Shikora, MD, FACS, FASMBS

46. Endoluminal Surgery: Suturing
Shinil K. Shah, DO; Erik B. Wilson, MD, FACS, FASMBS; Natan Zundel, MD, FACS, FASMBS

47. Intragastric Balloon
Jeff W. Allen, MD FACS; John M. Morton, MD, MPH, FACS, FASMBS

48.  Laparoscopic One-Anastomosis Gastric Bypass (Mini Gastric Bypass/ One-Anastomosis Gastric Bypass)
Jean-Marc Chevallier, MD, PhD; Matthieu Bruzzi, MD; Richard Douard, MD, PhD