The success of obesity treatment is decided after the operation
Severe obesity with all the possible secondary diseases such as type 2 diabetes is one of the widespread diseases in the developed industrialised countries and the number of cases is increasing. Not only in the USA, but also in Europe, morbid overweight (obesity) is rampant. Both in Germany and Switzerland, more and more clinics are specialising in the medical and, above all, surgical treatment of heavyweight contemporaries. Accordingly, surgical procedures are performed more frequently in obesity surgery than they were a few decades ago. Stomach reduction, tube stomach or gastric bypass are the keywords for operations related to obesity. While in Germany, according to current surveys, there is an almost complete lack of professional aftercare, in Switzerland, for example, the Centre for Bariatric Surgery (ZfbC) also sets a good example in the aftercare of patients.
Without lifelong follow-up, the success of bariatric surgery is at risk
A stomach reduction, in whatever form, is the only way out of the vicious circle of obesity, secondary diseases, lack of exercise and even more obesity for many obese patients. In Germany, but also in Switzerland, clinics have specialised in surgical interventions for obesity and provide patients with at least short-term hope for change. However, in Germany in particular, this hope remains a mere expectation. Because even more important than the success of the actual surgical intervention is the subsequent aftercare. And in most cases, this will be necessary for a lifetime. Postoperative care for obese patients is by no means limited to the control of small scars or wound healing in the gastrointestinal tract. More importantly, after such an operation, patients have to change their whole life decisively. This starts with a new form of nutrition, continues with controlled nutritional supplementation, for example with vitamins, trace elements and protein, and ends with a new way of learning sensible exercise. Only a corresponding change in lifestyle habits can ensure the success of bariatric surgery in the long term and thus make the lives of overweight patients better.
All experienced medical specialists, nutritionists, physiotherapists and psychotherapists agree on this. However, there is a lack of concrete implementation of such follow-up treatment and further care in Germany. As the Norddeutscher Rundfunk NDR recently revealed in a contribution to the health magazine “Visite”, the concept of follow-up treatment is poorly neglected in Germany and virtually not established at all. One of the reasons for this is that the health insurance companies neither include such a lengthy to lifelong care for patients in their cost catalogue, nor do they seem to be interested in it. Anyone who has managed to get an overweight operation financed by German health insurance funds at all is often left alone and downright to fend for themselves afterwards.
Accordingly, few patients then find their way to nutrition counselling and further care. Until the body again sounds the alarm and all short-term successes of bariatric surgery are acutely endangered. Those who are financially well off will treat themselves to the necessary aftercare if they have sufficient insight and self-discipline. Those who are less well-off or do not even know how important further care is, do not act at all at this point due to ignorance or lack of financial mass and thus endanger not only the success of the overweight operation, but their health in general.
The German health system clearly has a duty here and must find ways to ensure that bariatric surgery does not turn into an odyssey through the clinical pictures of accompanying secondary diseases.
Switzerland sets a good example
It’s different in Switzerland. Here too, medical centres such as Swiss1Chirurgie, together with the Centre for Bariatric Surgery in Bern, have dedicated themselves to surgical interventions for morbid obesity. Unlike its German neighbours, however, the focus here is on the protracted nature of such interventions from the outset. Only patients who are willing to receive lifelong counselling and support are even considered for bariatric surgery. This is already addressed in the initial talks and is also consistently enforced after the interventions. Of course, always with the cooperation of the patients and all the professionals needed for this.
This methodology is also supported in principle by the Swiss health care system. Here it is clear that anyone who has to undergo bariatric surgery will need the support of the relevant specialists such as internists, nutritionists, physiotherapists and psychotherapists for a long time afterwards, if not permanently. This is the only way to ensure the long-term success of obesity surgery, which ultimately not only benefits the health of the patients, but also significantly minimises the follow-up costs due to a lack of follow-up care.such as internists, nutritionists, physiotherapists and psychotherapists.
It remains questionable whether this insight will be reached in Germany in the near future. While the health care system there mainly works on apparent undesirable developments and deficiencies, most obesity patients remain on their own, with or without bariatric surgery.
With a population of around 1.4 billion (as of 2018) and a size of approximately 9.6 million square kilometres, China is the most populous country in the world and approximately 233 times larger than Switzerland. These incredible figures alone show that this is a country with huge potential in all kinds of areas.
Among the less pleasant statistics is the fact that the People’s Republic of China alone accounts for more than half of all oesophageal cancer cases worldwide. In general, this disease is much more widespread in Asia than in Europe, for example.
The unusually high incidence of oesophageal cancer in China was one of the reasons for holding the 2019 OESO World Congress in Beijing for the first time ever, rather than in Europe or the USA. The OESO is a medical society made up of leading surgeons, gastroenterologists, pathologists, radiologists and other professionals in the field of oesophagus and stomach. Prof. Dr. Jörg Zehetner, who offers a specialised range of services for reflux diseases and bariatrics in Switzerland with the Swiss1Chirugie locations in Bern, Brig and Solothurn, is one of these specialists with high recognition worldwide.
Exchange of experience and knowledge every minute
What was particularly interesting about the organisation of the OESO World Congress in Beijing 2019 was that in the main part, technical presentations were each only five minutes long, each followed by a discussion that was also five minutes long. This gave the opportunity to exchange and discuss a lot of expertise within a short time.
This not only encourages the exchange of scientific expertise and opinions. Ideas for new studies are also conceived quite quickly and compactly in this way and can then be further refined later.
Dr Jörg Zehetner was a sought-after expert
In addition to the lectures and opinion pieces of his professional colleagues, Dr. Jörg Zehetner was also a sought-after subject matter expert. His experience from many years of work in the United States and his specialisation in upper GI diseases were just the right profile for a lively exchange with his colleagues.
Topics such as oesophageal cancer, stomach cancer, reflux diseases and diaphragmatic hernias also played an important role in the professional exchange with colleagues. The interactions and complementarities of bariatric and reflux surgery, especially in operations of the oesophagus, stomach and intestine, are a broad field that did not lack a great deal of attention at this year’s OESO Congress.
In a special lecture, Dr Zehetner addressed the topic of the size of the hiatal hernia and the choice of surgical procedure.
The focus was on selecting the most suitable surgical procedure for the individual. Dr Zehetner, who is the only surgeon in Switzerland who is versed in all currently known surgical procedures in this field, emphasised that decision-making must always take place together with the patient if long-term success is to be ensured. Conventional gastric sleeves, partial fundoplication, variants with partial removal of the stomach, LINX reflux management system (magnetic ring), electrical stimulation with Endostim or the new reflux stop system are a selection of methods that must always be chosen well-considered and based on the patient.
Dr. Jörg Zehetner is one of the world’s recognised experts in the field of diaphragmatic hernia and reflux surgery and has published several articles on the subject. Accordingly, the corresponding lecture was listened to with pleasure and followed attentively.
For Dr. Zehetner, it is important in every case to carefully weigh up every intervention and always make a decision in the best interests of the patient. Sometimes, drug treatment may take precedence, as not every patient is suitable for surgery per se. This decision can only be made in discussion with the expert. In the run-up to this, a good counselling interview, a targeted diagnosis and the prognosis for healing are important stages.
Swiss1Chirurgie, with its locations in Bern, Brig and Solothurn, offers such expertise for all patients undergoing bariatric surgery or therapy for reflux disease, abdominal hernias and similar complaints. You can also find out what Swiss1Chirurgie with Dr Jörg Zehetner can do at www.swiss1chirurgie.ch and, of course, always in personal contact with the medical specialists.
With the opening of the Swiss1Chirurgie clinic in Solothurn on 28 November 2019, the medical offering for the entire spectrum of abdominal surgery, but especially obesity surgery and reflux treatment in Switzerland has now taken another step towards improved patient care.
After the existing clinics in Brig and Bern, the Swiss1Chirurgie clinic in Solothurn is now the third location of the specialised medical practitioners. At the doctors’ aperitif on the occasion of the new opening of the Solothurn location, the head of Swiss1Chirurgie, Prof. Dr. med. Jörg Zehetner, emphasised that “in view of the increase in obesity problems and reflux disease, the needs of patients can thus be incorporated into medical practice much better than before”.
Swiss1Chirurgie Solothurn emerged from the visceral surgery clinic of Alejandro Metzger, MD. The expanded clinic in Solothurn and the additional location in Brig cover a large demand of an area that could not previously be served medically in this way.
The main focus of Swiss1Chirurgie at the Bern, Brig and Solothurn sites is on abdominal surgery as a whole, but especially on obesity surgery and the treatment of reflux diseases. While obesity surgery, after thorough individual diagnoses and consultations, often focuses on modern minimally invasive stomach operations in the sense of stomach reductions (tube stomach) or gastric bypass and the subsequent aftercare, reflux surgery deals primarily with the complaints associated with chronic heartburn, acid regurgitation and the subsequent impairment of quality of life. With the LINX Reflux Management System, Dr. Jörg Zehetner is one of the leading Swiss doctors in this field and also enjoys the highest recognition abroad, even in the USA and Saudi Arabia. Dr Alejandro Metzger is a proven specialist in visceral surgery and bariatric surgery.
The Swiss1Chirurgie team includes PD Dr. med. Rudolf Steffen, who as a specialist in visceral surgery covers the entire treatment spectrum of abdominal surgery at the Bern site.
At the opening of the Swiss1Chirurgie clinic in Solothurn, medical specialists and also practising general practitioners met at the doctors’ aperitif to find out in detail about the treatment methods and surgical techniques used by the specialists from Swiss1Chirurgie and the ZfbC (Centre for Bariatric Surgery in Bern). The lively exchange and the great interest show that with Swiss1Chirurgie a network of specialist medical services has been created that meets the needs of existing and potential patients. And it also offers general practitioners in the region a new point of contact, especially for patients with morbid obesity and reflux diseases.
For more information on Swiss1Chirurgie, the centre for bariatric surgery and the specialist doctors and treatment fields involved, please visit www.swiss1chirurgie.ch.
After Dr Jörg Zehetner was able to familiarise a total of five surgeons from Saudi Arabia with the LINX Reflux Management System, a special reflux surgical technique, in the summer of 2019, the next five medical professionals from Saudi Arabia now stood together with the Swiss specialist at the virtual operating table. In a special workshop on the LINX Reflux Management System, the Saudi surgeons were trained in the modern techniques of the procedures. While the summer was spent teaching and training in Saudi Arabia, the November workshop took place in Bern.
Johnson & Johnson had once again selected Dr Zehetner as an expert, who now conducted the workshop lasting several days directly in the Swiss1Chirurgie clinic at Schänzlihalde 1 in Bern. In addition to other special facilities, a meeting room with state-of-the-art presentation and video technology is also available there. In this way, it was possible to clearly and comprehensibly demonstrate and try out how the LINX Reflux Management System is to be applied to patients in need of treatment. Dr. Jörg Zehetner was supported by his colleague Dr. Karl Miller, with whom he has already worked as J&J Faculty at several clinics in Saudi Arabia.
After Dr Jörg Zehetner was able to familiarise a total of five surgeons from Saudi Arabia with the LINX Reflux Management System, a special reflux surgical technique, in the summer of 2019, the next five medical professionals from Saudi Arabia now stood together with the Swiss specialist at the virtual operating table. In a special workshop on the LINX Reflux Management System, the Saudi surgeons were trained in the modern techniques of the procedures. While the summer was spent teaching and training in Saudi Arabia, the November workshop took place in Bern.
Johnson & Johnson had once again selected Dr Zehetner as an expert, who now conducted the workshop lasting several days directly in the Swiss1Chirurgie clinic at Schänzlihalde 1 in Bern. In addition to other special facilities, a meeting room with state-of-the-art presentation and video technology is also available there. In this way, it was possible to clearly and comprehensibly demonstrate and try out how the LINX Reflux Management System is to be applied to patients in need of treatment. Dr. Jörg Zehetner was supported by his colleague Dr. Karl Miller, with whom he has already worked as J&J Faculty at several clinics in Saudi Arabia.
EMEA trainings bring regions together
EMEA is the grouping of Europe, the Middle East and the Americas that Johnson & Johnson has put together specifically to further develop treatments and surgical techniques for reflux disease. At the same time, these are the regions where reflux diseases requiring treatment are becoming more frequent.
As with the training sessions in the two German cities of Speyer and Wiesbaden, the focus of the training sessions was once again on the LINX magnetic ring, which brings decisive advantages for the new treatment technique.
Reflux diseases on the rise
The number of new cases of reflux disease continues to increase in the EMEA regions. Reasons for this include a changed lifestyle with sumptuous food and a corresponding increase in obesity. Even though this is a rather new form of affluent disease in the Middle East, it is still on the rise. Accordingly, it is important to already familiarise the appropriate medical professionals with the current expertise on the LINX Reflux Management System.
Typical signs of chronic reflux disease are frequent acid regurgitation, heartburn and burning in the stomach. The decisive factor here is not the occasional occurrence of such complaints, but a continuous and/or frequent observation of such symptoms with the corresponding sequelae, which can manifest themselves primarily in damage to the oesophagus due to constant contact with stomach acid. Subsequent changes in the mucous membrane of the oesophagus can be the first signs of oesophageal cancer. It is therefore advisable, especially for reflux patients over the age of 50, to have a preventive check-up, which should also be combined with a gastroscopy.
For 20 percent of the Swiss population, this is not an unknown disease, while in the countries of the Middle East, however, similar accumulations can already be predicted now. If you want to learn more about reflux disease, we recommend studying the relevant specialist articles on the Swiss1Chirurgie website or in the Swiss1Chirurgie APP.
More quality in reflux treatment through improved education and training
For Dr. Jörg Zehetner, a faculty member of Johnson & Johnson, it is clear that quality in reflux treatment is primarily a question of the appropriate surgical techniques. Continuing education is also seen as correspondingly important, always focusing on the latest and most successful methods in reflux treatment.
Dr. Jörg Zehetner is one of the most experienced surgeons in this field, both nationally and internationally. Accordingly, it is also the right decision to continue to promote the training and further education of colleagues in Germany, Austria and Switzerland, but also in the USA and in Saudi Arabia, for example, with this professionalism.
Together, J&J and Dr Zehetner are planning about two to three English-language EMEA workshops per year in Bern. In addition, there will be four to five further LINX workshops for German-speaking colleagues, also in Bern. This offer is completed by two to three further training series in Hamburg (at the J&J Institute Norderstedt, the J&J training and development centre) including a masterclass training series. This could at least meet the first major demand for specialised training series on the LINX Reflux Management System.
When the specialists at Swiss1Chirurgie look for the best ways to treat patients, it always has a lot to do with research, scientific work and the publication of the latest findings and methods.
The doctors at Swiss1Chirurgie under Prof. Dr. Jörg Zehetner specialise in obesity surgery as well as medical treatments under the umbrella term UpperGI. This includes, for example, interventions in the areas of reflux, diaphragmatic hernias, oesophageal and stomach cancer. Another field of work of Swiss1Chirurgie is visceral surgery, which is also colloquially referred to as abdominal surgery. In all these specialties, the medical professionals not only work on the patients themselves, but also, and above all, in parallel in the areas of research and further development of methods and techniques.
International prize goes to Swiss1Chirurgie
While Prof. Dr Jörg Zehetner was still attending the OESO Congress in Beijing, Swiss1Chirurgie received a special honour. At the ASMBS Meeting 2019 in November in Las Vegas, USA, Dr Catherine Tsai received the International Award for the best video presentation of a surgical procedure.
Dr Catherine Tsai
Dr Catherine Tsai has been working as a research assistant at Swiss1Chirurgie in Bern for the past two years, and her scientific research work significantly supports further development at the Swiss1Chirurgie sites in Switzerland.
In the video presentation “Laparoscopic Conversion from Gastric Sleeve to RY Gastric Bypass with Remnant Gastrectomy using Fluorescent Angiography” by Dr Tsai, Dr Steffen and Dr Zehetner, you can see the laparoscopic conversion from a sleeve (tubular stomach) to a gastric bypass, whereby here the remaining stomach was completely resected for medical reasons. Fluorescent angiography was used to check the blood flow in the gastric pouch and duodenum, as shown in this video.
Swiss1Chirurgie continues its series of successes
The latest award ceremony for Swiss1Chirurgie and thus also for the Centre for Bariatric Surgery ZfBC continues a series of successes that have long since made the specialists Dr Jörg Zehetner, Dr Catherine Tsai, Dr Steffen and Dr Metzger real experts with an international reputation. We only need to refer to the numerous publications and prizes that were awarded to Swiss1Chirurgie last year.
The medical specialists are less concerned with fame and more with scientific, methodical and ultimately medical progress in the interest of the patients. Various studies are being carried out with the Inselspital Bern as well as in the Swiss1Chirurgie clinics and the Centre for Bariatric Surgery. The results of such studies primarily benefit the patients of Swiss1Chirurgie, underpin the outstanding international reputation of the specialists and, last but not least, form the basis for new developments in the specialist areas of Swiss1Chirurgie.
For the sake of completeness, we summarise here the most important publications, lectures and awards of Swiss1Chirurgie from the past years:
Swiss1Chirurgie accepts international award
When the specialists at Swiss1Chirurgie look for the best ways to treat patients, it always has a lot to do with research, scientific work and the publication of the latest findings and methods.
The doctors at Swiss1Chirurgie under Prof. Dr. Jörg Zehetner specialise in obesity surgery as well as medical treatments under the umbrella term UpperGI. This includes, for example, interventions in the areas of reflux, diaphragmatic hernias, oesophageal and stomach cancer. Another field of work of Swiss1Chirurgie is visceral surgery, which is also colloquially referred to as abdominal surgery. In all these specialties, the medical professionals not only work on the patients themselves, but also, and above all, in parallel in the areas of research and further development of methods and techniques.
International prize goes to Swiss1Chirurgie
While Prof. Dr Jörg Zehetner was still attending the OESO Congress in Beijing, Swiss1Chirurgie received a special honour. At the ASMBS Meeting 2019 in November in Las Vegas, USA, Dr Catherine Tsai received the International Award for the best video presentation of a surgical procedure.
Dr Catherine Tsai
Dr Catherine Tsai has been working as a research assistant at Swiss1Chirurgie in Bern for the past two years, and her scientific research work significantly supports further development at the Swiss1Chirurgie sites in Switzerland.
In the video presentation “Laparoscopic Conversion from Gastric Sleeve to RY Gastric Bypass with Remnant Gastrectomy using Fluorescent Angiography” by Dr Tsai, Dr Steffen and Dr Zehetner, you can see the laparoscopic conversion from a sleeve (tubular stomach) to a gastric bypass, whereby here the remaining stomach was completely resected for medical reasons. Fluorescent angiography was used to check the blood flow in the gastric pouch and duodenum, as shown in this video.
Swiss1Chirurgie continues its series of successes
The latest award ceremony for Swiss1Chirurgie and thus also for the Centre for Bariatric Surgery ZfBC continues a series of successes that have long since made the specialists Dr Jörg Zehetner, Dr Catherine Tsai, Dr Steffen and Dr Metzger real experts with an international reputation. We only need to refer to the numerous publications and prizes that were awarded to Swiss1Chirurgie last year.
The medical specialists are less concerned with fame and more with scientific, methodical and ultimately medical progress in the interest of the patients. Various studies are being carried out with the Inselspital Bern as well as in the Swiss1Chirurgie clinics and the Centre for Bariatric Surgery. The results of such studies primarily benefit the patients of Swiss1Chirurgie, underpin the outstanding international reputation of the specialists and, last but not least, form the basis for new developments in the specialist areas of Swiss1Chirurgie.
For the sake of completeness, we summarise here the most important publications, lectures and awards of Swiss1Chirurgie from the past years:
Swiss1Chirurgie Research Fellowship (2017-2019)
Conferences (number of presentations)
International Federation for the Surgery of Obesity and Metabolic Disorders-European Chapter (IFSO-EC), Athens, Greece, May 2018 (3)
European Association of Endoscopic Surgery (EAES), London, UK,May 2018 (2)
Digestive Disease Week – Society for Surgery of the Alimentary Tract (DDW – SSAT),Washington DC, June 2018 (3)
IFSO, Dubai, UAESeptember 2018, (4)
American College of Surgeons (ACS), Boston, MA, October 2018 (2)
SAGES, April 2019, Baltimore, MD (2)
World Congress on Interventional Therapies for Type 2 Diabetes (WCITD), April 2019, New York, NY (1)
DDW, May 2019, San Diego, CA (1)
Swiss Surgical Society, May 2019, Bern, Switzerland (6)
ASMBS Obesity Week, November 2019, Las Vegas, Nevada (2)
Publications (4)
Tsai C, Steffen R, Kessler U, Merki H, Zehetner J, “Short-term outcomes of endoscopic gastro-jejunal revisions for treatment of dumping syndrome after Roux-En-Y gastric bypass,” Surgical Endoscopy, September 2019
Tsai C, Zeheter J, Beel J, Steffen R, “Long-term outcomes and frequency of revisional bariatric surgeries beyond 15 years after gastric banding: A high band failure rate with safe revisions,” SOARD, February 2019
Tsai C, Kessler U, Steffen R, Merki H, Zehetner J, “Endoscopic Gastrojejunal Revisions Following Gastric Bypass: Lessons Learned In More Than 100 Consecutive Patients,” Journal of Gastrointestinal Surgery, September 2018
Tsai C, Kessler U, Steffen R, Merki H, Zehetner J, “Endoscopic Closure of Gastro-gastric Fistula After Gastric Bypass: a Technically Feasible Procedure but Associated with Low Success Rate,” Obesity Surgery, September 2018
Oral Presentations (16)
Tsai C, Steffen R, Zehetner J, “Magnetic Sphincter Augmentation for Treatment of Gastroesophageal Reflux Disease after Roux-En-Y Gastric Bypass” (Video) ASMBS November 5, 2019
Tsai C, Zehetner J, Steffen R, “Laparoscopic Conversion from Gastric Sleeve to Roux-en-Y Gastric Bypass with Remnant Gastrectomy using Fluorescent Angiography” (Video) ASMBS November 6, 2019
Tsai C, Zehetner J, Bally L, Steffen R, “Impact of roux-en-y gastric bypass alimentary limb length on long-term weight loss, diabetes, and dumping syndrome outcomes,” Swiss Surgical Society Congress, Bern, Switzerland May 17, 2019
Tsai C, Zehetner J, Beel J, Steffen R, “Long-term outcomes and frequency of revisional bariatric surgeries 15 years and beyond after gastric banding: A high band failure rate with safe revisions,” Swiss Surgical Society Congress, Bern, Switzerland May 16, 2019
Tsai C, Steffen R, Kessler U, Lipham J, Zehetner J, “Post-operative dysphagia following magnetic sphincter augmentation for gastroesophageal reflux disease,” Swiss Surgical Society Congress, Bern, Switzerland, May 15, 2019
Tsai C, Steffen R, Kessler U, Zehetner J, “Endoscopic gastro-jejunal revisions for treatment of dumping syndrome after Roux-en-Y gastric bypass,” SAGES, Baltimore, MA April 4, 2019
Tsai C, Zeheter J, “Laparoscopic Hiatal Hernia Repair with Posterior Cruroplasty and Magnetic Sphincter Augmentation in a Patient with GERD and Large Type III Hiatal Hernia,” ACS, Boston, Massachusetts, October 24, 2018 (video)
Tsai C, Kessler U, Merki H, Steffen R, Zehetner J, “Laparoscopic Magnetic Sphincter Augmentation with routine Posterior Cruroplasty: Postoperative Dysphagia and Hiatal Hernia Recurrence,” ACS, Boston, Massachusetts, October 25, 2018 (quickshot)
Tsai C, Zehetner J, Kessler U, Steffen R, “Long-term results of pancreatectomy for post-gastric bypass hypoglycemia,” IFSO, Dubai, UAE, September 27, 2018
Tsai C, Zehetner J, “Conversion of gastric banding to laparoscopic sleeve gastrectomy with perfusion assessment using laser-assisted fluorescence angiography,” IFSO, Dubai, UAE, September 27, 2018 (video)
Tsai C, Zehetner J, “Laparoscopic sleeve gastrectomy with perfusion assessment using laser-assisted fluorescence angiography,” IFSO Dubai, UAE, September 28, 2018 (video)
Tsai C, Kessler U, Merki H, Steffen R, Zehetner J, “Endoscopic gastrojejunal revisions following gastric bypass: lessons learned in more than 100 consecutive procedures,” Digestive Disease Week (SSAT sessions), Washington DC, June 5, 2018
Tsai C, Kessler U, Merki H, Steffen R, Zehetner J, “Endoscopic closure of gastro-gastric fistula after gastric bypass: a technically feasible procedure but associated with low success-rate,” Digestive Disease Week (SSAT sessions), Washington DC, June 4, 2018
Tsai C, Kessler U, Merki H, Steffen R, Zehetner J, “Dumping syndrome after gastric bypass: endoluminal revision of the dilated gastrojejunostomy is a safe and highly effective treatment option,” presented as oral presentation as part of Best Abstracts session at International Federation for the Surgery of Obesity and Metabolic Disorders, European Chapter (IFSO-EC), Athens, Greece, May 19, 2018
Tsai C, Zehetner J, Kessler U, Steffen R, “Outcomes 15 years and beyond following adjustable gastric banding for morbid obesity: high band failure rate with safe revisions,” IFSO-EC, Athens, Greece, May 17, 2018
Tsai C, Steffen R, “Re-sleeve with silastic ring and crurorhaphy in a rare case of severe hyperinsulimic hypoglycemia after sleeve gastrectomy,” IFSO-EC, Athens, Greece, May 18, 2018 (video)
Poster Presentations (10)
Tsai C, Zehetner J, Bally L, Steffen R, “Long-term weight loss, diabetes, and dumping syndrome outcomes after short versus long alimentary limb roux-en-y gastric bypass,” DDW (SSAT sessions), San Diego, CA May 21, 2019
Tsai C, Steffen R, Zehetner J, “Perfusion assessment using laser-assisted fluorescence angiography during conversion of gastric band to laparoscopic sleeve gastrectomy,” Swiss Surgical Society Congress, Bern, Switzerland May 15-17, 2019
Tsai C, Steffen R, Zehetner J, “Laparoscopic hiatal hernia repair with posterior cruroplasty and magnetic sphincter augmentation in patient with refux and large type III hiatal hernia,” Swiss Surgical Society Congress, Bern, Switzerland, May 15-17, 2019
Tsai C, Steffen R, Kessler U, Zehetner J, “Gastroesophageal reflux disease after bariatric surgery: Magnetic sphincter augmentation in patients with normal esophageal motility,” Swiss Surgical Society Congress, Bern, Switzerland, May 15-17, 2019
Tsai C, Herzig D, Zehetner J, Kosinski C, Kunezli C, Stauffer TP, Nett P, Steffen R, Stettler C, Bally L, “Incretin response in patients with postprandial hyperinsulinemic hypoglycemia following gastric bypass surgery with or without extended distal pancreatectomy,” World Congress on Interventional Therapies for Type 2 Diabetes (WCITD), New York, NY, April 8-10, 2019
Tsai C, Steffen R, Kessler U, Lipham J, Zehetner J, “Post-operative Dysphagia Following Magnetic Sphincter Augmentation for Gastroesophageal Reflux Disease,” SAGES, Baltimore, April 3 – 6 2019
Tsai C, Steffen R, Kessler U, Zehetner J, “Gastroesophageal reflux disease after bariatric surgery: magnetic sphincter augmentation in patients with normal esophageal motility,” IFSO, Dubai, UAE, September 26-29, 2018
Tsai C, Kessler U, Merki H, Steffen R, Zehetner J, “Dumping syndrome after gastric bypass: endoluminal revision of the dilated gastrojejunostomy is a safe and highly effective treatment option,” DDW (SSAT sessions), Washington DC on June 5, 2018
Tsai C, Kessler U, Merki H, Steffen R, Zehetner J, “Endoscopic gastrojejunal revisions following gastric bypass: lessons learned in more than 100 consecutive procedures,” European Association of Endoscopic Surgeons (EAES) in London, United Kingdom May 31-June 1 2018
Tsai C, Kessler U, Merki H, Steffen R, Zehetner J, “Endoscopic closure of gastro-gastric fistula after gastric bypass: a technically feasible procedure but associated with low success-rate,” EAES, London, United Kingdom May 31-June 1 2018
Awards
Best Video Presentation International Award, ASMBS Obesity Week, 2019
SSAT Resident and Fellowship session honoree, Digestive Disease Week, 2018
For Christmas 2019, I would like to send you the best greetings and wishes from your Swiss1chirurgie clinic. At the same time, I would like to personally thank you for the trust you have placed in us by choosing Swiss1Chirurgie 2019.
For you, the Christmas season is certainly as special a time as it is for us. Especially when you are thinking about the progress of your recovery or preparing for an upcoming treatment. No matter what stage of recovery you are in, we sincerely wish you all the best. And we will continue to be by your side, accompanying and helping you.
Especially the time around Christmas is a time of peace and contemplation. For many of you it is also a time of introspection. Now new plans are being made for a better and, above all, healthier new year. But now also take the time for your family and friends. These are the most important people in your life and your best allies in regaining your health. So that 2020 can also be a good year.
In this context, I am reminded of a saying that always reminds me of the importance of our health: health is not everything, but without health everything is nothing!
In this spirit, I wish you a relaxed Christmas, many loving moments and, above all, a healthy but also happy 2020.
And if you are already on the road to recovery or have made the decision to live a healthier life, it will certainly be a Christmas that is very different from any other Christmas before it.
At any rate, this is what wishes you
Your Dr Jörg Zehetner
Swiss1Chirurgie
P.S. If you still have some time left between all the presents and temptations of the Christmas season, why not catch up on the news from our clinics on our new Swiss1Chirurgie app and get some inspiration for an even healthier life in 2020.
The new year is now a few days old and for many people everyday life has already returned. Yet 2020 began with many good intentions. Less kilos, more sport and active exercise are the most frequently mentioned good intentions for the new year, along with giving up cigarettes and spending more time with the family.
It is becoming clear that more and more people are taking a more conscious look at their own health and are focusing their plans on fitness, resilience and having more fun with active exercise. Especially when overweight, digestive complaints, stomach problems or reflux are daily companions in life, active exercise or regular sport is the way out of the vicious circle for many Swiss people.
We at Swiss1Chirurgie know that especially in cases of morbid obesity, sporting activity is often difficult to implement and ambition quickly wanes if the pounds do not fall off so clearly and quickly. One quickly falls back into old habits or tries to find other excuses for the supposed failure. In many such cases, bariatric surgery may be the best long-term solution. And even after such an operation, physical activity is one of the most important rules if the excess weight is to be permanently reduced and a healthier lifestyle maintained.
Snowshoeing is a clear recommendation
Especially in the cold season, the choice for recreational sports is somewhat limited. Cycling, classic hiking, jogging or water sports are often ruled out due to the weather. For some, the only option seems to be to go to the gym or the swimming pool. But many overweight people also fail to do this, mainly for psychological reasons. The shame of showing one’s own body openly, the fear of hidden smiles up to open hostility and certainly also fears of failure make the way into the dumbbell gyms and swimming pools even more difficult. Classic winter sports such as cross-country skiing, skiing, snowboarding or ice skating are also rarely possible.
The good variant of relaxed but active hiking in winter is snowshoeing. Even the old mountain farmers at high altitudes in Switzerland used snowshoes to get around in winter when the snow was heavy. Today, that is actually no longer necessary. But snowshoeing has become a popular leisure activity in winter, which is definitely a good choice of means for overweight people and also reflux patients.
The somewhat more difficult running requires, in addition to a certain degree of discipline, above all endurance and attention to one’s own body. Since snowshoeing is also only possible outdoors, it also contributes to a better supply of fresh air for the organism. Another nice thing about snowshoeing is that it can be done alone or in a group. In addition, there are specially prepared and signposted routes for snowshoe hiking, especially in the winter sports regions of Switzerland. Perfect for all those for whom skiing and tobogganing are rather unsuitable and who nevertheless do not want to do without sporting activity even in snowy winters.
We have the right equipment
For those who are now more intensively interested in snowshoeing, we offer an excellent possibility to get the sports equipment for snowshoeing quickly, easily and without additional costs. Together with Suzuki Switzerland, Swiss1Chirurgie is giving away a total of 50 snowshoe sets, each with a pair of snowshoes and matching poles.
However, you have to be quick here. Because only the first 50 entrants can enjoy new snowshoes for free and then start their snowshoeing experience with Suzuki snowshoes.
Click here to go to the competition
But also for everyone else, snowshoeing is a clear recommendation for more activity in winter. This applies to normal weight people as well as to overweight people or those with certain complaints.
Of course, we will be happy to advise you in the Swiss1Chirurgie clinics in Brig, Solothurn and Bern about your very individual options for an active life. This way, you may be able to keep your good resolutions for 2020 a little better and achieve the first results soon. Maybe even with a snowshoe set from Swiss1Chirurgie and Suzuki Switzerland. Have fun and above all wish you a healthy new year Jörg Zehetner and the entire Swiss1Chirurgie team.
The GP Bern has been one of the world’s best-known popular races with international appeal since 1982. The Old Town Run and the Grand Prix Bern are among the ten most beautiful courses in the world and are also visited time and again by international running celebrities.
We want to take part in the run together with employees and patients of the ZfbC and Swiss1Chirurgie as a team on 09 May 2020. The registration period is running. You can find out more about the Grand Prix Bern with Swiss1Chirurgie and ZfbC as well as the possibilities for team participation in the detailed article (LINK).
We look forward to your registration and to a wonderful day in May!
Your
Jörg Zehetner
With Swiss1Chirurgie and the ZfbC to the Grand Prix in Bern
The Grand Prix Bern has been an integral part of Switzerland’s running calendar since 1982. International runners have also long since discovered the challenging 10-mile race for themselves and names such as three-time Olympic champion Kenenisa Bekele from Ethiopia, world champion Martina Strähl from Switzerland or Haile Gebrselassie (Ethiopia) grace the start lists of the Bern Grand Prix alongside national and international athletics celebrities.
The Grand Prix Bern is not only a gathering of the world’s best runners, but also a meeting place for ambitious amateur athletes from all walks of life. Whoever tackles the easy to challenging run on the road between 4.8 and 16.01 kilometres knows they are in the company of the great athletes of our time. More important than that, however, is the certainty that taking part in the Old Town Run (4.8 kilometres) or the Grand Prix (16.01 kilometres) is a challenge for body and psyche and always a good contribution to maintaining and improving health and fitness.
Swiss1Chirurgie and ZfbC invite you to the run
In 2019, Swiss1Chirurgie and the Centre for Bariatric Surgery (ZfbC) have again participated as a team in the GP Bern. And that should be the case again in 2020. Both employees of Swiss1Chirurgie and the ZfbC as well as patients with the appropriate will and physical conditions can participate as team players in the Old Town Run or the Grand Prix.
The doctors and therapists from Swiss1Chirurgie and ZfbC are particularly committed to the patients in advance. Thus, former and current patients can get individual advice from the specialists and also receive sport and health advice in preparation for the GP Bern. After all, the point of participation is not to achieve best values, but to aim for very personal goals, taking into account individual conditions. Ultimately, participation in the Old Town Run or the Grand Prix should be a contribution to the health and fitness of the participants. This is the deeper meaning of such a popular race, as Prof. Dr. Jörg Zehetner also knows from his own experience of participating in many long-distance races.
Application deadline runs
As “Team swiss1chirurgie &zfbc” we want to compete together with staff and patients in the Old Town Run and Grand Prix in Bern on 09 May 2020. Staff and patients can now sign up to participate in the registration list. The deadline for registration is 29 March 2020. The lists of participants are available in our clinics. Participants can also register online via the Swiss1Chirurgie app.
Participation is free of charge for the first 20 registered participants. All registered participants will receive a team shirt for the run on 09 May 2020 in Bern. We are already looking forward to a lively interest. Because last but not least, taking part in the Altstadtlauf or the Grand Prix Bern is a good contribution to keeping healthy and is even more fun as a team.
Even more information about the GP Bern and participation is available at www.gpbern.ch and of course on the Swiss1ChirurgieVictoryAPP (LINK).
The Centre for Bariatric Surgery (ZfbC) and Swiss1Chirurgie specialise, among other things, in patients who are seeking comprehensive medical help with accompanying care due to a serious and morbid obesity problem. Prof. Dr. Jörg Zehetner, as the leading mind behind the ZfbC and Swiss1Chirurgie, knows that the path from severely overweight patients to a happier and fulfilled life is not an easy one. For decades, he has treated and cared for patients who nevertheless take this long journey. Clear progress can be seen just as much as an occasional relapse into old habits and the difficult fight against obesity and the prejudices associated with it.
Sina Gossweiler has embarked on a long journey
Dr Jörg Zehetner has also been able to count Sina Gossweiler among his patients for several years. Many people know the young woman from the show “Deutschland sucht den Superstar” (DSDS), where the Wattenwil native was able to convince with a magnificent voice, and also got into the recall, but not further. The young singer is also known for her fight against obesity, which she finally took up with the professional help of the ZfbC after some back and forth and repeated self-diets.
A gastric bypass operation was finally the right and appropriate way for her to move into a weight-wise and also psychologically lighter future. It was clear from the beginning that this journey does not end with the surgical intervention, but in fact requires follow-up care in a professional environment throughout life. Sina has fought this battle successfully so far and now feels visibly more comfortable in her own skin. In addition to learning healthy eating habits, as well as exercise and sport, she has now reached a healthy weight.
When Sina Lark was also successful in the music business
And in terms of music, too, the signs are pointing to success. Even though the DSDS recall almost exactly a year ago didn’t lead any further, the likeable musician is now standing there with her head held high. With their first single “Everything I Want To Be” they got off to a great start in the charts. As Sina Lark, the self-confident young woman makes her commercial debut in the music business and can already enjoy a great deal of attention.
Not only did her new song run for the first time as Song of the Day on SRF 3 at the beginning of February 2020, but a live performance on 14.02.2020, between 19:00 and 20:00 on the station will also show how consistently and with what passion Sina is looking for the way to the top and has now perhaps even already found it. Then she will present two songs live on the SRF 3 programme “Punkt CH”. Her new single will also be presented as “Hit of the Day” on 14.02.2020.
If you take both the gastric bypass operation and the musical path together, it becomes clear that Sina Gossweiler has already taken the long road very successfully as Sina Lark. This gives the soon to be 21-year-old woman from the canton of Bern even more strength to continue on her path now more than ever. On the one hand, this path leads downwards when it comes to weight. On the other hand, it is also the ascent into a new life that Sina has paved for herself with her musical talent. The fact that both directions always involve a lot of effort, challenges, stamina and also the odd setback is impressively demonstrated by Sina Gossweiler’s still young story.
In the end, it is up to each individual to decide how to deal with his or her own problems. Getting the best help at the right time also proved to be a real stroke of luck in this particular case.
Every year at the beginning of March, there is a day dedicated to the topic of obesity as World Obesity Day. Certainly, this is not a holiday for those affected, but at least it is the day when there is a good reason to think about obesity in general and the stigmatisation associated with it in particular.
This year the focus is “Male Obesity”. This cannot simply be categorised as “gluttony” or “self-indulgence”. Male obesity has as many causes as it has manifestations. It primarily affects men from middle age onwards, who (like women) are undergoing a particular type of metabolic change.
Particularly as we get older, the body strives to store food reserves as fat reserves for developmental reasons, in order to provide for possible shortages. Especially for men who consume fewer calories than they take in due to their occupation or limited exercise, this quickly leads to unwanted excess weight. Organic processes in particular play an important role here, which cannot be “switched off” so easily.
In a special video, I personally addressed the importance of World Obesity Day. This is also due to the fact that obesity is now more common worldwide than malnutrition. The actual problem is mainly to be observed in the western industrialised countries, since it is precisely here that there is an ever-increasing surplus of food – practically at all times.
The obesity rate in the USA, for example, is around 35-40 percent of the population, which is a fact that should not be underestimated. This means an overweight of at least 20 kilograms, or a BMI of 30 or more. This is also the case despite the surgical intervention options, although these methods in particular can now be classified as very safe and successful. Nevertheless, the rate of surgical interventions needed in this particular area is far too low.
World Obesity Day is not simply about informing the public and professional colleagues accordingly. Rather, I see it as important to educate people about the modern treatment options of bariatric surgery. The primary aim is always to help patients according to their individual starting situation.
Information on the topic of obesity
It is important to understand that obesity is always associated with concomitant diseases. Diabetes, high blood pressure, sleep apnoea, high cholesterol – all these manifest themselves in the environment of obesity. But there is also another aspect that has emerged, especially in recent years. The point is that people who are overweight are simply stigmatised. At school, at work and even in private life, overweight people are described as lazy, fat, greedy, careless and lazy about exercise. This puts additional stress on those affected and does not help to tackle the problem in a targeted and conscious way. Significant overweight has been defined as a disease since 2013 at the latest. This puts morbid obesity in the same category as diseases such as diabetes, high blood pressure and many other chronic diseases.
The stigmatisation of obesity is extremely dangerous for patients, as they then withdraw and cannot address their actual problem in a targeted and active way. Professional treatment, counselling and support is the surest way out of obesity.
World Obesity Day can help break down prejudices
Everyone is challenged to exercise some restraint in their contact with morbidly obese people, both in their choice of words and in their behaviour. To this end, World Obesity Day can create better awareness. The problem should not only be addressed on this day of the year. But such a day can help to create more sensitivity for the problems of overweight people instead of leaving them to their fate with stigmatisation and devaluation.
Why specifically “men who are overweight”?
Yes, women also suffer from morbid obesity. But men do it in a special way. There are now “curvy models” for women, but not for men. And men by nature already tend to eat the slightly larger portions, even if that seems to be gradually declining. The world view was and still is such that a belly is always subconsciously associated with prosperity. Also in modern industrial societies. The dangers are usually conscious, but are only realised when they are actually there.
In addition, after a certain stage of life at the latest, men do not have this special view of their appearance that many women have. The actual problem is not recognised, or is recognised only very late, and is then gladly accepted as natural. This means that they don’t have to go to the doctor and the obesity surgeon is an unknown quantity for many of those affected. Therefore, men in particular must be sensitised to actively face this problem. World Obesity Day provides an excellent opportunity to do this.
