Losing to Win — Weight-loss Surgery at Crouse Hospital

By Valerie Lauer
Tuesday, August 23, 2016

By focusing on proven surgical techniques, lifestyle changes and long-term supportive care, Crouse Hospital’s Weight-loss Surgery Program has created an environment where obese patients gain in life and well-being while they lose on the scale.

The bariatrics team at Crouse Hospital

Recognizing the medical expertise and surgical support available at Crouse Hospital, Kenneth Cooper, DO, and Jeffrey DeSimone, MD, bariatric surgeons with Central New York Surgical Physicians PC, began discussing the possibility of creating a dedicated team to treat overweight patients in need of surgical solutions.

“Dr. DeSimone and I had performed surgery for patients at Crouse Hospital for many years, so we were familiar with the resources available there,” Dr. Cooper says. “When it was time for us to establish a bariatrics program, we knew Crouse was where we wanted it to be.”

In 2011, Crouse Hospital’s Weight-loss Surgery Program launched, establishing a community resource that would not only help patients successfully lose weight and maintain healthy lifestyles, but also provide an extensive network of postoperative support patients can rely on for the rest of their lives.

Assembling an Expert Team

As board-certified diplomates of the American Board of Surgery who underwent specialty training in minimally invasive bariatric techniques, Drs. Cooper and DeSimone knew the challenges morbidly obese patients face and the necessity for lifelong postoperative support. They knew they had to create a team of experts to meet the needs of patients who undergo bariatric surgery.

“Our patient success stories are inspirational. From running races to hiking and being able to play on the floor with their grandchildren, the individuals who have bariatric surgery and successfully stick with the program are doing things they could only dream of before intervention. Their health problems improve. Their self-esteem rises. They have a fresh start.”
— Jeffrey DeSimone, MD, Bariatric Program Medical Director

Jeffrey DeSimone, MD

“Assembling the right team and support staff is essential to success for weight-loss surgery patients,” says Dr. DeSimone, who is also the bariatric program’s Medical Director. “Dr. Cooper and I have dedicated our careers to treating obesity and obesity-related issues, and we’ve put together a team with comparable expertise. Our group includes a licensed psychologist, two nurse practitioners, a registered dietitian and support staff who are passionate about helping patients successfully lose weight and live healthy lifestyles. Our team is a game changer.”

Weight management is not always the easiest topic for patients to discuss or feel comfortable addressing. All team members at the Crouse Hospital Weight-loss Surgery Program were hand-selected for their skills and trained in sensitivity to make the patient experience as comfortable as possible.

Focus on Proven Solutions

According to research, approximately 35 percent of adults are obese and one in 20 people is considered extremely obese with a body mass index (BMI) of 40 or greater. These statistics represent a medical epidemic with far-reaching consequences.

“Bariatric surgery and particularly gastric bypass surgery are extremely effective at resolving Type 2 diabetes. I have seen patient after patient come off of medication, have their blood sugar stabilize and go on to live life without this disease following successful weight-loss surgery. Type 2 diabetes and other such comorbidities drain patients physically and financially and can shorten their lives. What we do changes that.”
— Kenneth Cooper, DO, Bariatric Surgeon

Kenneth Cooper, DO

According to the National Institutes of Health, extreme obesity and its related comorbidities can shorten an individual’s life by 14 years. Such conditions also negatively affect quality of life and increase the likelihood of an individual needing medication or other healthcare services.

For many individuals, diet and exercise alone are not enough to stop and reverse harmful weight gain. Weight-loss surgery is a well-documented option with a high success rate. On average, most patients who undergo bariatric surgery lose at least 50 percent of their excess weight. Those numbers are higher for the two procedures offered at Crouse Hospital. Patients who undergo gastric bypass surgery typically lose 70 percent of excess weight, while those who have sleeve gastrectomy procedures typically lose 60 percent of excess weight.

“Of all the types of bariatric procedures that are currently available, gastric bypass and sleeve gastrectomy are the two with the most consistent track records of safety and patient success,” Dr. Cooper says. “Focusing our practice on these two options positively impacts our patient outcomes and creates a high rate of success among those we treat.”

Pastor Jack Keating lost 175 pounds and praises the support he’s received through Crouse’s Weight-loss Surgery Program: “The Crouse team has been with me from the very beginning, which started six months before my surgery all the way up to today.”

Schoolteacher Jacqueline Goettel-Strecansky: “Before my surgery, my life was very isolated.”

Roux-en-Y gastric bypass is considered the gold standard in weight-loss surgery. During the procedure, Drs. DeSimone and Cooper meticulously refashion the stomach into a smaller pouch and connect it to the small intestine. Reducing the size of the stomach pouch restricts the amount of food that can be ingested comfortably in a single sitting, reduces the amount of fat absorbed during digestion and alters the hormonal balance of the digestive tract. Patients feel reduced hunger, and a number of comorbidities, such as Type 2 diabetes and sleep apnea, may be cured.

Drs. DeSimone and Cooper also perform laparoscopic sleeve gastrectomy, a minimally invasive, image-guided technique for reshaping the stomach into a smaller, banana-shaped organ. The procedure does not alter the digestive tract as gastric bypass surgery does, but it does reduce the size of the stomach, helping patients feel fuller, faster. The excised portion of the stomach contains much of the anatomy that produces ghrelin, a hormone that causes people to feel hungry.

Each procedure addresses specific aspects of a patient’s condition. For example, patients who have had Type 2 diabetes for less than 10 years may be cured by gastric bypass. Patients who don’t have as much weight to lose may benefit more from sleeve gastrectomy.

“Bariatric surgery is not one size fits all,” Dr. DeSimone says. “We go through a rigorous patient evaluation and education process to help identify which option is best before making a recommendation for a specific type of weight-loss procedure.”

As a true comprehensive bariatric and metabolic center, Crouse Hospital’s Weight-loss Surgery Program also offers revision surgery for patients who have had weight-loss surgery in the past, perhaps with a less effective approach, and who require additional assistance.

Preparation for Success

Educating patients about weight-loss surgery is an integral part of a carefully structured screening and preparation process all bariatric candidates must complete before being approved for a procedure.

“I like to tell patients that it’s possible to get them ready physically for weight-loss surgery in a week or two, but that preparing them mentally and emotionally does far more to ensure their success,” Dr. DeSimone says. “That’s why we have such a rigorous system in place. Research shows that patients who are qualified for surgery mentally as well as physically do better in the long run. That goes hand-in-hand with the type of sustainable, permanent lifestyle changes we want our patients to make.”

“Our support group meets once a month on the second floor. It is amazing to see patients start out taking the elevator and progress to being able to walk the stairs as the weight comes off. I see their expressions change and their mood lift. Weight-loss surgery does more than change the number on the scale. It gives patients a second chance at life.”
— Cindy Cusson, RN, MSN, Bariatric Program Administrator

Syracuse radio personality Ted Long from 93Q was Crouse’s first bariatric surgery patient and has since been an avid supporter of the program.

Corrine Reid lost 80 pounds and found her sense of adventure.

Crouse Hospital weight-loss specialists work closely with patients to resolve medical issues that might increase the risk of surgery, introduce them to the hospital’s support system, and ensure they are emotionally ready to transform their eating and exercise habits. Weight-loss surgery is a tool patients can use to reshape their lives to be healthier and more fulfilling. Following an operation, the onus is on the patient to adhere to the postsurgical weight-loss plan.

Specialists at Crouse Hospital follow their patients closely after surgery, providing encouragement and medical support.

Long-term Care Makes All the Difference

One of the most important elements of the Weight-loss Surgery Program at Crouse Hospital is the highly structured long-term care plan in which every patient participates.

“Follow-up care is essential to our patients’ success,” says Cindy Cusson, RN, MSN, Program Administrator of the Weight-loss Surgery Program at Crouse Hospital. “We pride ourselves on a regimented long-term care protocol. It helps keep patients accountable and allows us to identify any concerns as soon as possible so we can intervene.”

Postoperative follow-ups are scheduled for 10 days, six weeks, 12 weeks, six months, nine months and 12 months. After the first year, patients are seen every six months for one additional year and then transitioned to annual visits.

During these visits, patients’ progress is monitored, blood work is used to look for any potential nutritional deficiencies, and the program’s specialized weight-loss physicians are able to assess patients for any physical or mental concerns related to the procedure.

“Because we are so highly specialized and focus solely on weight-loss surgery patients, we are able to identify potential issues more readily than a primary care physician may be able to,” Dr. Cooper says. “We like to be involved at every phase of the treatment process and post-surgical follow-ups are a large part of that for our patients. Our job does not end when patients leave the table. Patients are with us for life.”

Patients have access to continued nutritional and psychological support services. There is also a vibrant support group that meets the second Wednesday of each month where weight-loss patients can connect with others who are going through similar experiences.

“We are invested in the long-term success of our patients both professionally and personally,” Dr. DeSimone says. “Helping them achieve greater health and live longer, more fulfilling lives is our passion and I believe our program and our outcomes reflect that.”

To learn more about Crouse Hospital’s Weight-loss Surgery Program, visit crouse.org/weightloss.