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Bariatric Surgery

Welcome to Bariatric Solutions and the Division of Minimal Access & Bariatric Surgery, a part of Greenville Health System – Department of Surgery. Our medical professionals are dedicated to providing all aspects of safe, effective weight loss. We are the most experienced group offering weight loss surgery in the area, and our bariatric surgery expertise draws patients from Greenville, Asheville, Columbia, and throughout the Southeast. From comprehensive pre-op medical evaluations to life-long follow-up care, our bariatric surgery program features everything a patient will need to be successful before AND after surgery.


Our mission is to relieve suffering from morbid obesity using all available modern resources to provide safe, effective, long-term results. We strive to exceed the expectations of our patients, their families and their primary care doctors, and we set the standard for high-quality, comprehensive weight loss services in the region.

To achieve safe, effective, long-term results, patients don’t need a surgeon alone; they need a comprehensive team approach. Our weight loss surgery program includes extensive nutritional counseling, psychological counseling, and group support along with exercise, encouragement and long-term follow-up care. Surgery is only one piece of the puzzle. The most important piece of the puzzle is YOU

Want to know more?  Plan to attend our information session. Click Here


ASMBS Bariatric Surgery Center of Excellence

Bariatric Solutions and Hillcrest Memorial Hospital have achieved the prestigious designation of being a Center of Excellence of the American Society for Metabolic and Bariatric Surgery (ASMBS). As a result, referring physicians can rest assured their patients receive safe, comprehensive care that considers the “whole person,” including physiological and psychological needs.
 


Meet our Physicians

Bariatric Solutions, founded and led by fellowship-trained surgeons Eric Bour, MD, FACS, FASMBS and John Scott, MD, FACS, FASMBS employs a full-time psychologist and two dietitians – all specializing in bariatric care. Even among other Centers of Excellence in the nation, this degree of staffing and bariatric surgery specialization is intense, and the high-level of care draws weight loss surgery patients from Greenville, Spartanburg, Anderson, Asheville, Columbia, and throughout the region.

Eric S. Bour, M.D.

Specialty:   Bariatric Surgery
Practice:    GHS Division of Bariatric and Minimal Access Surgery

2104 Woodruff Road
Greenville, SC 29607
Phone: (864) 676-1072  


John D. Scott, M.D.

Specialty:   Bariatric Surgery
Practice:    GHS Division of Bariatric and Minimal Access Surgery

2104 Woodruff Road
Greenville, SC 29607
Phone:    (864) 676-1072

Dr. John Scott is featured on the August 2011 cover of American College of Surgeons Surgery News. Click here to see the cover.


Patricia L. Eichhorn, M.D.

Specialty:   Bariatric Surgery
Practice:    GHS Division of Bariatric and Minimal Access

2104 Woodruff Road
Greenville, SC 29607
Phone: (864) 676-1072 

Edward J. Rapp II, M.D., FACS

Specialty:   Bariatric Surgery
Practice:    Premier Surgical Services, PA
Tower Pointe Medical Center
107 Vine Crest Court
Greenwood, SC 29646
Phone: (864) 227-8932 


Luciano Fiszer, M.D.

Specialty:   Bariatric Surgery
Practice:    Premier Surgical Services, PA
Tower Pointe Medical Center
107 Vine Crest Court
Greenwood, SC 29646
Phone: (864) 227-8932 

Kristine Koop, P.A.

Specialty:   Bariatric Surgery
Practice:    GHS Division of Bariatric and Minimal Access

2104 Woodruff Road
Greenville, SC 29607
Phone: (864) 676-1072 

 

A 360° Approach to Care

Our Bariatric Solutions surgeons perform three surgical procedures for weight loss. 

  • Laparoscopic Divided Roux-en-Y Gastric Bypass
  • Laparoscopic Sleeve Gastrectomy
  • Laparoscopic Adjustable Gastric Banding (REALIZE™ Band)
As our commitment to complete, comprehensive surgical care, all of our patients received:
  • Comprehensive pre-surgical evaluations
  • Complete nutritional assessment and unlimited pre-surgery and post-surgery nutritional support from our two experienced registered dietitians
  • Complete pre-surgery psychological evaluation and post-surgery psychological support
  • Weekly pre-surgery and post-surgery group support sessions run by the psychologist, a surgeon or a dietitian
  • A dedicated office staff experienced in the needs of bariatric patients

The Bariatric Solutions office adjoins Nutrition Solutions, LLC, an independent business that includes supervised weight loss programs, nutrition counseling, healthy cooking classes and other educational opportunities. Nutrition Solutions’ retail store sells vitamins, supplements and healthy prepared meals. It recently launched an online system that allows patients to order from the healthy meal menu, which is planned by a certified bariatric chef, from the convenience of their homes or offices.
 



Beyond professional counseling, our practice has an emphasis on providing patients with a strong peer support network to help them get through the critical pre- and postoperative phases of bariatric surgery. It’s common to see a full parking lot Tuesday and Thursday evenings when we host support groups and educational sessions at our office off Woodruff Road. Demand has been so great – paralleling the surge in the practice’s patient base, which grows by about 300 patients annually – that we recently added a weight loss surgery support group that meets during the day on Tuesday.

WEIGHT LOSS SURGERY PROCEDURES

Roux-en-Y Divided Gastric Bypass

What is a Gastric Bypass and how does it work?

This operation converts the stomach into a very small pouch that holds less than an ounce of food. It also rearranges the intestinal tract to cause malabsorption of fats, limiting the amount of food that can be eaten (leaving the patient feeling full and satisfied on very little food), and further acts to reduce absorbed calories.

The Roux-en-Y gastric bypass has been performed for over 40 years. Published studies demonstrate the safety and efficacy of this operation after 20 years of follow-up. It is the most common bariatric operation performed in the U.S. and is endorsed by the American College of Surgeons (ACS), American Society for Metabolic and Bariatric Surgery (ASMBS), Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), National Institutes of Health (NIH) and many others. Well over 175,000 Roux-en-Y gastric bypasses are performed annually in the U.S.
 
The procedure has become so common because it works. More than 90 percent of patients maintain significant, long-term weight loss with minor or no complications. Many studies have shown this operation to lessen or eliminate co-morbid medical problems and significantly reduce an obese person’s chance of death. In a recent study, the overall death rate after five years in obese individuals who had gastric bypass surgery was 90 percent less than in similar individuals who did not have gastric bypass (Ann Surg. 2004 Sep;240(3):416-23).

The gastric bypass works three ways:
  • First, it reduces the amount of food you can eat at once (usually no more than four to five ounces).
  • Second, it diverts or “bypasses” the food past the stomach and first section of intestine, resulting in delayed digestion of food. Then, bile and pancreatic juices are added (the Roux-en-Y part) to allow for digestion and absorption of nutrients.
  • Third, the operation produces “dumping syndrome” if unhealthy foods are eaten. This syndrome may result in abdominal pain, cramps, nausea, vomiting or diarrhea. Needless to say, most patients learn to avoid unhealthy foods.

Results after Gastric Bypass

The result is that patients must eat proper amounts of proper foods at proper intervals and at the proper speed. In combination with exercise, psychological support and nutritional counseling, the results can be amazing. It is not unusual for severely obese patients to lose 75-85% of their excess weight in the first year following surgery.


 Normal Anatomy

Normal anatomy               

 Anatomy after Gastric Bypass Surgery
Anatomy after gastric bypass

LAPAROSCOPIC Vertical Sleeve Gastrectomy

What is a Vertical Sleeve Gastrectomy and how does it work?

The obese individual's normal stomach has the ability to hold great amounts of food, about 2000-3000 milliliters (2-3 quarts) in capacity. This allows a higher caloric intake than can be expended in energy each day. The extra calories not burned by the body are stored as fat. Vertical sleeve gastrectomy surgery was developed to counteract this process. This operation divides the stomach to create a “sleeve” along the inner curve of the stomach that holds approximately 60 milliliters (two to three ounces). This limits the amount of food that can be eaten (leaving the patient feeling full and satisfied on very little food). In addition, the part of the stomach that is removed is where the hormone that causes hunger (Ghrelin) is produced. Consequently, the caloric intake and the feeling of hunger are reduced, and weight loss will usually follow. On average, patients will lose about two thirds of their excess weight in one year. Weight loss will continue during the second year at a slower rate.

The vertical sleeve gastrectomy procedure consists of separating the stomach into two sections using parallel rows of titanium staples. The larger portion of the stomach is removed and discarded. The remaining portion of the stomach (the “sleeve”) is long and narrow and holds about 3 ounces. The staples remain fixed and do not migrate. The sleeve is made so small because it will eventually stretch somewhat. By making it very small at first, the final size will still be quite restrictive.

Results after Sleeve Gastrectomy

The result is that patients must eat proper amounts of proper foods at proper intervals and at the proper speed. In combination with exercise, psychological support and nutritional counseling, the results can be amazing. It is not unusual for severely obese patients to lose 65-75% of their excess weight in the first year following surgery.

 Vertical Sleeve Gastrectomy Picture 1

The VERTICAL SLEEVE GASTRECTOMY

 Vertical Sleeve Gastrectomy Picture 2

The VERTICAL SLEEVE GASTRECTOMY


Laparoscopic Adjustable Gastric Band

What is an Adjustable Gastric Band and how does it work?

The AGB is an adjustable band placed around the upper stomach to create a small 15 ml (half ounce) pouch with a narrowed outlet. Outlet size can be adjusted by injecting saline into a small reservoir (port) connected to the band and placed under the skin at the time of surgery.

The band induces weight loss by restricting food consumption. The pouch fills quickly with solid food and empties slowly to relieve hunger and produce a feeling of fullness.

What are potential advantages of the AGB?
  • No cutting or stapling of the stomach is required
  • Outlet size can be adjusted by injecting saline into the band to loosen or tighten the opening
  • AGB surgery is less invasive than gastric bypass surgery

Results after AGB

The result is that patients must eat proper amounts of proper foods at proper intervals and at the proper speed. In combination with exercise, psychological support and nutritional counseling, patients lose an average of 45-50% of their excess weight in the first year following surgery.

 Realize Weight Loss Surgery Band

The REALIZE Band

 Realize Band for Bariatric Surgery

The REALIZE Band around the stomach

 

COMPLICATIONS OF WEIGHT LOSS SURGERY

First and foremost, weight loss surgery performed by experienced surgeons in a comprehensive program is very safe. However, as with any surgical procedure, weight loss surgery does have associated complications. These complications vary with the different surgical procedures, and will be discussed in much more detail during your visits to the office.

Overall, Bariatric Solutions has a complication rate lower than the national average for weight loss surgery procedures. In addition, the program has a mortality rate that is less than half of the national average for these types of procedures.

Successful Outcomes: Weight Loss and More

Bariatric Solutions’ comprehensive approach to care has led to impressive improvement and resolution of weight-related medical comorbidities.

Type 2 Diabetes resolves in over 85% of patients who undergo gastric bypass; the results are slightly less with sleeve gastrectomy (75%), and gastric banding (40%). Similar improvement and resolution in hypertension, obstructive sleep apena, and elevated lipids/cholesterol after each procedure.


Expanding Services, Innovative Techniques

As a Center of Excellence, Bariatric Solutions often is invited to be an early implementer of the latest bariatric technologies and materials. In 2008, we were among the first in the nation to use the new REALIZE™ Adjustable Gastric Band from Ethicon Endo-Surgery Inc. In fact, Bariatric Solutions is recognized as a best practice site in Ethicon’s “Victory Division,” which means that bariatric specialists across the Carolinas, Tennessee, Virginia, Washington, D.C., Maryland and parts of Georgia are encouraged to visit Bariatric Solutions to see the latest weight loss surgery techniques and technologies in action.
 


Dr. Bour and Dr. Scott are exploring the possibility of adding “scarless surgery” to the practice’s portfolio. This innovative weight loss surgery approach involves accessing and operating on the gastric area with tiny endoscopic surgery tools inserted through the mouth.

Bariatric Solutions has recently developed the PRO-Teens program offering treatment of adolescent patients who suffer from morbid obesity (www.goproteens.com).

Our practice is also enrolling patients desiring surgery as treatment of Type 2 diabetes, even in the absence of morbid obesity. This type of procedure is know as “metabolic surgery”, and shows promise as the first known surgical therapy for this devastating disease.



Bariatric Solutions is proud to be a leader in providing comprehensive weight loss surgery services. Our bariatric surgery expertise draws patients from Greenville, Spartanburg, Anderson, Asheville, Columbia, and throughout the Southeast. For more information, or to refer a patient, please call (864) 676-1072 or visit our practice website at www.ghsbariatricsolutions.com.