Weight Loss Surgery Forums

OH: Tell me about your practice and what is important to you and your staff?

Dr. Buchin: My practice offers complete bariatric services. I perform laparoscopic gastric bypass, laparoscopic sleeve gastrectomy, the laparoscopic band, as well as the duodenal switch. Since every patient is unique, I feel that a complete bariatric practice offering all techniques is the best approach. Certain patients do well with one procedure where another patient's outcome will be better with a different procedure. In our practice, we review the patient's medical history and ultimately make an educated decision with the patient as to which procedure would be best for that patient.

I was always interested in the technical aspects of all laparoscopic procedures. I attended one of the top bariatric programs in the country where I learned to perform all of the bariatric surgical procedures. I chose bariatric surgery as a specialty because it is extremely rewarding to see all of the positive changes we are able to make in the patients' lives. The transformations are life changing, and I feel very fortunate to play a role in that transformation.

OH: How many bariatric procedures have you performed so far and what percentage of your practice is dedicated to bariatric surgery?

Dr. Buchin: I have performed over a thousand procedures since 2005, and about 80 percent of my practice is dedicated to bariatric surgery. Gastric bypass has been the most popular procedure in my practice for the past four years, and this year, in particular, the sleeve gastrectomy has become more popular than any other procedure. I have been performing the sleeve gastrectomy procedure since 2006. I think it is an effective procedure with great outcomes. This sleeve is almost as easy to perform as the gastric band; however, it will produce similar weight loss results as the gastric bypass.

OH: How did you become interested in the surgery grant?

Dr. Buchin: Bariatric surgery is an extremely effective approach to weight loss. For someone who does not have insurance and who is suffering with multiple co-morbidities and multiple medical problems, they should be given the opportunity to improve their health. I feel a great way to achieve that healthier lifestyle is through bariatric surgery. In the past, I had donated my services to a gentleman who did not have insurance coverage and was an extremely unhealthy individual. He had all the co-morbidities including hypertension, sleep apnea, and high cholesterol, in addition to coronary artery bypass. He was very sick and bariatric surgery was the only way to get him healthy. Since the surgery he has lost over 100 pounds, resolved most of his co-morbidities, and is doing very well.

OH: What steps did you have to take to materialize this grant proposal?

Dr. Buchin: I discussed the grant with Huntington Hospital, who were happy to donate their resources, as well as the other physicians who will be donating their services.

Dr. Balveen Singh will be donating her cardiology services; Jalil Anwar, MD, MRCP will be donating his pulmonary services; Rachael Lebowitz, LMSW, will be performing the psychological evaluation; Joy Licata, RD, will be donating nutrition education and North American Partners in Anesthesia will also donate their services.

OH: What criteria do you consider for the patient to qualify for the surgery grant?

Dr. Buchin: The patient must qualify for bariatric surgery, which means they have to follow the NIH guidelines for bariatric surgery. They have to have a BMI of 35 or greater with two co-morbidities, or a BMI of 40 or greater. They do not have insurance coverage or they do not have weight loss surgery benefits under their current insurance plan. They must be healthy enough to undergo bariatric surgery. The patient must be a non-smoker because complication rates tend to be much higher for smokers. They simply do not heal as well as non-smokers.

OH: What specific procedures will you consider for the surgery grant? Will it be performed laparoscopically?

Dr. Buchin: I perform all procedures laparoscopically. The two procedures I am considering for this surgery grant are either the gastric band or the sleeve gastrectomy.

OH: Do you perform revisional procedures as well?

Dr. Buchin: Yes, I do perform a lot of revisional surgeries. I revise gastric bypasses, duodenal switches, and convert bands to gastric sleeves or gastric bypasses. Patients have come to me for revisional bariatric surgery when they do not achieve the expected rate of weight loss or they are experiencing problems with their original procedure. Revisional surgery is complex bariatric surgery and should be performed by an experienced surgeon.

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