Southcoast Center for Weight Loss

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1 Introduction Introducing the Southcoast Center for Weight Loss Left: Tobey Hospital, Wareham Right: Southcoast Health System at Rosebrook Business Park, Wareham The Southcoast Center for Weight Loss is a community-based program at Tobey Hospital, the Wareham site of Southcoast Hospitals Group. The program provides coordinated, safe and comprehensive surgical weight loss services. More than 2,500 patients have benefitted from our program, which includes laparoscopic gastric bypass, adjustable gastric band, gastric sleeve and revision surgical procedures. Outstanding Quality According to national and regional benchmarks The care at the Southcoast Center for Weight Loss far exceeds national quality standards. We have consistently performed significantly better than industry benchmarks, with a major complication rate of approximately one percent. This is a lower rate than some more common procedures, such as gallbladder removal surgery. The Southcoast Center for Weight Loss is designated as a Bariatric Surgery Center of Excellence by the American Society for Metabolic & Bariatric Surgery (ASMBS) for its demonstrated track record of consistent, favorable outcomes in bariatric surgery. Continued on other side. Quality Snapshot Average excess weight loss 70% Average hospital stay Major complications rate 1% Patient follow up after 4 years 1.5 days 75%

2 Introduction Page 2 Proven Results Resolution or improvement of co-morbid conditions When other medically supervised methods have failed, surgery offers the best option of long-term weight control for those with clinically severe obesity. Weight loss surgery has been endorsed by a consensus panel convened by the National Institutes of Health as the only effective means of inducing significant long-term weight loss for the vast majority of patients with morbid obesity. According to the ASMBS, evidence suggests that bariatric surgery is one of the most effective treatments for metabolic diseases and conditions. It can improve or resolve more than 30 obesity-related conditions such as: Type 2 diabetes. High cholesterol. Obstructive sleep apnea. Heart disease. Hypertension. Non-alcoholic fatty liver disease. Osteoarthritis. Typically, patients experience substantial weight loss for years after surgery at the Southcoast Center for Weight Loss. Bariatric Surgery Resolution of co-morbidities after bariatric surgery Source: Ethicon Endo-Surgery

3 Comprehensive Care Comprensive Care By a specially trained team Our program is designed to incorporate a thorough approach to weight loss surgery, utilizing a team of surgeons, nurses, dietitians and psychologists. Our specially trained team is in regular contact with our patients and their referring physicians to maintain a safe and comprehensive surgical weight loss program. We offer a variety of weight loss surgical options and work with each individual to determine the most appropriate course of action to meet their unique needs and circumstances. For more information about the procedures we offer as well as their risks and benefits, visit. Roux-en-Y Gastric Bypass One of the most popular surgical approaches, roux-en-y gastric bypass involves modification of the stomach so that only a small amount of food can be eaten at one time. A portion of intestine and stomach are bypassed so less food is absorbed. Pouch Long Roux-Limb Duodenum Bypassed Portion of the Stomach Bariatric Revisions While the success rate for bariatric surgery is very high, some patients who have undergone surgery may experience weight regain or inadequate weight loss. In these situations, a follow-up bariatric revision procedure may be possible to alter or repair the initial surgery. We offer band-to-bypass or band-tosleeve procedures and welcome patients Laparoscopic Sleeve Gastrectomy A laparoscopic sleeve gastrectomy procedure creates a small, sleeve-shaped who have relocated or are not currently being followed by their primary bariatric program to visit us for a consultation to discuss options that could offer improved success. stomach using a stapling device. Adjustable Gastric Banding During this procedure, an adjustable silicone ring with an inflatable inner surface is inserted surgically usually using laparoscopic techniques and placed like a belt around the upper part of the stomach. Band Stomach

4 Our Success Long-Term Success With proven results Unlike traditional dieting, our weight loss program has proven long-term results that consistently meet national standards. Additionally, our patients have a high rate of follow-up participation four years after surgery, more than 75 percent of our patients are still being followed in our program. Percent Excess Weight Loss Bypass Procedures 2011 Jennifer MacCord of New Bedford *excess weight = initial weight ideal weight Percent Excess Weight Loss Band Procedures 2011 Southcoast Center for Weight Loss data on sleeve procedures not yet available. National data according to ASMBS shows average excess weight loss for sleeve gastrectomy procedures to be 66 percent after three years. *excess weight = initial weight ideal weight Data as of September 2011

5 Our Team Ray Kruger, MD, FACS Director of Bariatric Surgery & Bariatric Surgeon A graduate of Dartmouth Medical School in New Hampshire, Dr. Kruger completed his residency training at the Dartmouth-Hitchcock Medical Center in Hanover, N.H. He is board certified in general surgery and is a Thomas Streeter, MD, FACS Bariatric Surgeon Dr. Streeter is a board-certified surgeon who has practiced as a general surgeon at Tobey Hospital since A graduate of the Bowman Gray School of Medicine in North Carolina, Dr. Streeter completed residencies at the Cleveland Clinic in Donald Colacchio, MD Bariatric Surgeon A graduate of Dartmouth Medical School, Dr. Colacchio completed a residency in general surgery at Millard Filmore Hospital in Buffalo, N.Y., where he served as chief resident. He also did a fellowship in surgical research at Roswell Park Memorial Institute in Buffalo. He has served as a staff surgeon at a number fellow of the American College of Surgeons. He has practiced general surgery at Tobey Hospital since Dr. Kruger is the medical director for the Southcoast Center for Weight Loss and has led the Bariatric Surgery program since Center of Excellence Surgeon Ohio and at Sinai Hospital in Baltimore. He is a fellow of the American College of Surgeons and has received advanced training in bariatric surgery. He has worked with Dr. Kruger to develop the bariatric surgery program at Tobey Hospital. Center of Excellence Surgeon of military hospitals in the Army and most recently was a staff surgeon at Parkland Medical Center in New Hampshire. He has extensive training and expertise in laparoscopic general surgery and is board certified in general surgery. He has practiced at Tobey Hospital since Drs. Kruger and Streeter perfom a gastric bypass surgery in the I-Suite at Tobey Hospital. Clinical Team Our team of professional nurses helps coordinate care and serves as an important resource for patients. Our nursing team includes a bariatric nurse coordinator, nurse practitioners, physician assistants and registered nurses who provide personalized guidance and education on patients weight loss journey, coordinate follow-up care and ensure patients remain on track. Nutrition Team Our team of registered dietitians have specialized training in weight loss and serve as a vital resource before and after surgery. Good nutrition is vital to successful weight loss and long-term health. Our dietitians provide individualized counseling for patients along with monthly support groups. Psychology Team Patients undergo psychological and social challenges as part of weight loss. Our team of social workers and psychologists have extensive experience in helping our patients identify and cope with these issues. For our patients convenience, team members conduct regular support groups in several communities on the South Coast. The program includes a social worker who speaks Portuguese.

6 Support Ongoing, Supportive Programs For continued success Support Groups Group support is vital to a successful surgical result. Research has shown that patients who attend support groups regularly are more successful with their weight loss and mental adjustment than people who do not, especially in the long term. That is why we offer monthly group meetings at locations throughout the region that address education, nutrition and health and provide peer support. Southcoast is the region s leader in weight loss surgery, offering unprecedented support through a full-service program consisting of pre-op education Preoperative Care For optimum successful outcomes Fitness Support In partnership with the YMCA Southcoast and ongoing post-op support to provide support and maximize successful outcomes for our patients. Behavioral workshop. Laboratory and medical screenings. Nutritional support and guidance. Education. Pre-op and post-op bariatric-sensitive/ specific programs. Morning and evening classes. Popular program, with average class attendance of eight to 10 patients. Insurance and Program Costs Most insurance providers have specific requirements that must be met in order to obtain coverage for bariatric surgery. Our team understands the general guidelines for some of the more common providers and helps facilitate this process with all our patients. The Southcoast Center for Weight Loss requires all patients to contact their insurance company directly to inquire about their individual benefit coverage and required medical criteria. It is the patient s responsibility to understand and comply with their insurance company s requirements. Free Support Groups On nutrition, psycho-social and medical topics Well-attended, with monthly average of 120 to 160 patients. Series of small groups (10 to 20 patients per group). Conveniently located in Wareham, Cape Cod, New Bedford and Fall River. Quarterly newsletter for all patients. A program fee includes support group meetings for life for all patients in our program.

7 Referrals Free Seminars Free educational seminars are held monthly on bariatric surgery for morbid obesity. Referral Process 1. Discuss weight loss with your patient. 2. Assess the patient s candidacy for surgery based on NIH and common surgery criteria. This criteria is recognized by most insurance providers. Open the discussion in a delicate and sensitive manner. Use the BMI wheel/chart as a tool in the discussion. Discuss the options for significant weight loss. Body Mass Index (BMI) greater than 40 or BMI greater than 35 with comorbidities (e.g., diabetes, high blood pressure, OSA). Age 18 or older. Failed medically supervised weight loss attempts. Stable psychological condition. Second & Fourth Tuesday of the Month Tobey Hospital Medical Library first floor 43 High Street, Wareham, MA Third Tuesday of the Month Center for Women s Health 300B Faunce Corner Rd. North Dartmouth, MA First Wednesday of the Month The Cape Codder 1225 Iyanough Road, Hyannis, MA Second Wednesday of the Month White s of Westport Colonial Room, 66 State Road Westport, MA Third Wedensday of the Month John Carver Inn 25 Summer Street Plymouth, MA Guide the patient to a free informational seminar with the Southcoast Center for Weight Loss. Call to pre-register your patient for a seminar in their region. Visit for the latest seminar schedule. Fourth Wednesday of the Month Benjamin s Restaurant 698 Bay Street Taunton, MA Call to pre-register your patient for a seminar in their region. Visit for the latest seminar schedule.

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