Of Louisiana

Affiliated with

504-244-5483 / 1-800-581-2570
A Surgical approach to long-term weight loss and control

E-mail us

Renew® is a multi-disciplinary program focused on significant weight reduction in morbidly obese patients, particularly those who have failed to lose weight by conventional methods. This approach utilizes gastric stapling with bypass. Renew® is a pioneering surgical weight loss program introduced to New Orleans in 1995 (formerly SurgiLite). It offers an integrated approach to the morbidly obese patient population. Appropriate consultations with the primary care physician, nutritionists, endocrinologists, cardiologists and social workers are part of the patient's management. Monthly post - surgical follow-up meetings of the “ Renew® Society,” under the guidance of a therapist, serve to reinforce the patient's behavioral and nutritional education. All patients accepted for the procedure must be in compliance with National Institutes of Health Guidelines.

The Program's Success
 

Morbid obesity is defined as weight greater than 75-100 lbs. over ideal body weight or Body Mass Index (BMI) greater than 35-40. It is a multifaceted disorder that affects individuals physically, emotionally and socially. About fifty million Americans are obese, twelve million are morbidly obese. There is a direct relationship between the amount of excess weight and the incidence of morbidity and mortality from hypertension, cardiac disease, diabetes mellitus, stroke, sleep apnea, biliary disease, osteoarthritis and other associated medical problems. The high cost of treatment for obesity and its complications has led to aggressive attempts to control what is becoming a significant public health problem. The care and control of the morbidly obese remains generally unsatisfactory in most medical practices. Pharmacological approaches also can be risky, expensive and unsuccessful. Surgical management of the extremely obese patient has developed due to: 1- Poor results obtained with standard approaches like diet, behavioral modification and other methods. 2- The need to control the high risks associated with the obese state. A surgical approach leading to significant long-term weight loss and improvement in associated conditions, is the most viable alternative for these patients. Several operative procedures have been developed and studied in the past including: intestinal bypass, total gastric wrapping, gastric balloon, vertical banded gastroplasty, gastric banding and bilio-pancreatic bypass . Some of these procedures have been associated with a high complication rate and/or ineffective long-term weight loss. Currently, the generally accepted surgical operations are: vertical banded gastroplasty, gastric banding and Gastric stapling with bypass. We have chosen the gastric stapling with bypass operation due to its recorded long-term effectiveness and low complication rate. It is considered the gold standard in weight reduction surgery.
Criteria for operation
 

We exclusively utilize the Roux-en-y Gastric Bypass procedure: Transverse stapling with 4 rows of titanium staples creating a small (1 1/2 fluid ounce) gastric pouch constitutes the major part of the procedure. A segment of small intestine is brought up to that pouch. This procedure with some minor variations is considered to be the standard for treatment of morbid obesity and associated weight loss. An abdominal incision is made above the umbilicus. The incision is approximately four to five inches in length. The procedure can also be performed laparoscopically.

After the abdominal cavity is entered, the jejunum (first part of the intestine) is divided. The stomach is stapled at its very upper end, creating a very small pouch.

One jejunal end is connected to the small intestines distal to (beyond) the transection site. The other jejunal end is attached to the small stomach pouch, achieving the bypass. Additional procedures may be done only if necessary, this includes: cholecystectomy (removal of the gall bladder) if it contains stones; spleenectomy (removal of the spleen) if injured during the procedure; gastrostomy (insertion of a tube in the excluded stomach) if needed in special circumstances; and hernia will be repaired if found.

          1.Vomiting after surgery: This may be as a result of overeating and putting more food in the small pouch than it can hold.

          2.Vitamin and mineral deficiencies: Vitamin B12, Iron and Calcium. Anemia is not common.
          3.Wound infections: Because of the thickness of the abdominal wall and poor healing quality of fat.
          4.Splenic injury: We may have to remove the spleen if injured because of its close proximity to the
            stomach.
          5.Anastomosis leak: In any operation involving the intestinal tract, leakage may occur at the suture lines.
          6.Pneumonia: In the immediate period after surgery, deep breathing and coughing can be painful,
            pneumonia may develop.
          7.General complications: As with any other surgical procedure, there is the possibility of bleeding, obstruction and infection etc..
          8.Mortality: Most patients do very well post-operativly; however a small percentage (1%) may develop major complications that can lead to death.

Ruary O`Connell, M.D., FACS. Surgeon and Medical Director. Certified by the American Board of Surgery. Fellow of the American College of Surgeons, and the American Society for Bariatric Surgery. Dr. Ruary O`Connell completed his surgical training and Fellowship at Harvard Medical School, Peter Bent Brigham Hospital, in Boston, Massachusetts, and Tulane Medical School in New Orleans, Louisiana. CREDENTIALS: Dr. O`Connell is certified by the American Board of Surgery, Fellow of the American College of Surgeons and a member of the American Society For Bariatric Surgery , He is a Clinical Associate Professor of Surgery and Adjunct Associate Professor in the Nutrition section at Tulane School of Public Health. EXPERIENCE: Dr. O`Connell developed an interest in nutrition, metabolism and the care of the obese patient early in his surgical training. He has published and spoken extensively on the subject and has successfully performed hundreds of Gastric Bypass procedures during his career. Office and clinic address: 6600 Plaza Drive. Suite 206. New Orleans, LA 70127 / 3800 Houma Blvd., Suite 110. Metairie, LA 70006

Wagih Mando, M.D., FACS. Surgeon and Assistant Medical Director. Certified by the American Board of Surgery. Fellow of the American College of Surgeons. Member of the American Society for Bariatric Surgery (ASBS). Dr. Wagih Mando finished his surgical training at New York Medical College, Mount Vernon Hospital in New York. He completed a four-year Vascular, Thoracic and Cardiac Surgery fellowship at Baylor College of Medicine and at Texas Heart Institute in Houston, Texas. CREDENTIALS: Dr. Mando is certified by the American Board of Surgery, Fellow of the American College of Surgeons, Fellow of the Gulf Coast Vascular Society. Member of the American Society for Bariatric Surgery (ASBS) and the International Federation for Surgery of Obesity (IFSO). Member of Kenner Medical Society. EXPERIENCE: Dr. Mando's experience is diverse reflecting his training and educational background. He has interest in all vascular as well as general surgical procedures including Laparoscopic surgery. Dr. Mando is the surgeon and Renew® Assistant Medical Director and he is involved with obesity surgery since 1995. Office and clinic address: 200 W. Esplanade. Suite 410, Kenner, LA 70065. Tel (504) 464-8619. / 3800 Houma Blvd., Suite 110. Metairie, LA 70006. Tel. (504) 464-8619. For more information

Heather Surcouf, APRN, MSN, Certified Family Nurse Practitioner: Ms. Surcouf is the Nurse Manager of Renew®, assisting patients with their needs both before and after surgery including the insurance approval process, patient education, counseling and follow up. Ms. Surcouf received a Bachelor of Science degree in Nursing from William Carey College in Hattiesburg, Mississippi. She received her Masters in Nursing, Family Practice, from the University of South Alabama in Mobile, Alabama.  She has been directly involved in the care of the gastric bypass patient for the last six years. She is a member of the Louisiana Association of Nurse Practitioners, American Academy of Nurse Practitioners, and the American Society for Bariatric Surgery.

Stephanie Barrocas, LDN, RD: Ms. Barrocas is a Licensed, Registered Dietitian. She is responsible for the patient's pre- and post-operative education. She supervises the patients during each phase of their "re-introduction" to food in the post-operative period, helps them to adopt healthy eating habits and monitors their weight loss progress. Ms. Barrocas is a graduate of University of Central Arkansas in Conway, Arkansas and completed her Internship at Touro Infirmary in New Orleans.

Wendy Guichard, BCSWI, ACSW : Ms. Guichard is the Clinical Social Worker for the Renew® program. She provides individual counseling and group support to Renew® patients during the weight loss process. Ms. Guichard received her Bachelor's Degree in  Social Work from Southeastern University in Hammond, Louisiana, and her Master's Degree in Social Work from Louisiana State University in Baton Rouge. She is board certified and licensed by the National Association of Social Workers.

Leslie Mathews : Ms. Mathews is the Renew® Representative. She is the first to receive the patients' calls, answer their questions and supply them with information regarding the procedure. Ms. Mathews works diligently to verify insurance benefits and schedule each patient's initial visit with the surgeons. She keeps in contact with the patients to ensure smooth office operation.

Beth Loker, Scheduling Coordinator: Beth is responsible for the process of scheduling the patients for testing, education, meetings, and surgery. She is the link between the surgeons and the patients.

        -- How do I know if this procedure is suitable for me? By reading the NIH Guidelines or calling Renew®
        directly at 1-800-581-2570.

        -- What is Body Mass Index (BMI)? A standardized method for comparing patients of different
        heights/weights and scoring them. It is a figure expressing the relationship of the body weight to the height.
        The normal BMI is 25-27.

        -- What is the surgical procedure that is used? Transverse Gastric Stapling with Bypass. A small stomach
        pouch is created, causing early satiety with a very small amount of food, slow emptying and no diarrhea.

        -- Is the operation an Intestinal bypass procedure? No, this is a gastric stapling procedure. The Intestinal
        bypass is an outdated surgical procedure that is used only in very special circumstances. Transverse Gastric
        Stapling is considered the gold standard in weight reduction surgery.

        -- Is the operation reversible? The operation can be reversed functionally, but not anatomically, only in
        extreme circumstances.

        -- Are there any risks and complications from the procedure? Yes, all surgical procedures carry risks.
        However the percentage is small and in our experience, comparable, if not better, than the national average.
        The benefit of this operation for the morbidly obese may outweigh the risks and the complications of their
        present disease state (see complications of surgery in this page).

        -- Are the surgeons who perform the surgery qualified? Yes, the two surgeons who are performing the
        procedure are American Board Certified, Fellows of the American College of Surgeons and Members of the
        American Society of Bariatric Surgery. They have additional qualifications and experience in Vascular and
        Bariatric Surgeries. Both surgeons are always present together in all cases, and in combination have successfully perfored over sixteen hundred gastric bypass procedures (see Renew® team in this page).

        -- Will my insurance pay for the surgery? A letter of medical necessity will be submitted to your insurance
        carrier. If you fit the NIH criteria, your insurance will most likely approve and cover the cost.

        -- How do I start? You can call the Renew® office at 504-244-LITE (5483). 1-800-581-2570. You can also send us
        an e-mail with your questions.

Pendleton Memorial Methodist Hospital is a modern health care facility and affiliate of the Methodist Health System. It is located in a health complex in New Orleans East. Its location is easily accessible from New Orleans, Slidell, Mississippi, Alabama and the other areas in Texas and Louisiana. The hospital is well equipped with up to date equipment and qualified staff. Renew® clinic is located on the 6th floor in the office building adjoining the hospital, suite 670. The hospital is located on 5620 Read Blvd. New Orleans, Louisiana 70127. Exit Read Blvd., South from Interstate 10.
 
 
 
 
 

- Read current Renew® Newsletter "Horizons"
- American Society for Bariatric Surgery
- Obesity and treatment
- American College of Surgeons
- Methodist Hospital
- Obesity Help Site
 
 

Back to top

Current News letter