Dr. Ferzli's Procedures
Specializing in Minimally-Invasive Surgery
What is obesity?
Obesity is a serious disease that can lead to other severe health problems and may even lead to early death. Obesity is now considered an epidemic in the US. It is associated with a wide range of medical problems (or comorbidities) including hypertension, heart disease, diabetes, obstructive sleep apnea, arthritis, gastroesophageal reflux disease and high cholesterol among others. Obesity is measured by the Body Mass Index or BMI. This is a calculation using weight and height to characterize the severity of a person's obesity. BMI = weight (kg) / height (m2).
How is a person's weight characterized according to BMI?
|Category of weight||BMI|
|Super Obesity||> 45|
What is Bariatric Surgery?
Bariatric surgery is surgery that is performed on the gastrointestinal tract of the morbidly obese patient with the goal of achieving long-term weight loss. Bariatric surgery has been clearly shown to effectively reduce weight in the morbidly obese and to achieve significant improvement and even cure of many of the obesity related comorbidities. Recent studies have even shown that bariatric surgery increases life span in the morbidly obese.
Patients that have a BMI of 35 and one or more comorbidities, or patients with a BMI of 40 or more, are eligible for bariatric surgery.
There are a variety of surgical techniques for bariatric surgery. The most common and accepted techniques are the laparoscopic roux-en-y gastric bypass, and the laparoscopic band.
Lap-band Surgery is a minimally invasive weight loss procedure that is indicated for the morbidly obese patient or the obese patient that has certain associated, or comorbid, medical problems. The surgery involves placing a plastic band around the upper stomach to restrict the amount of food and calories a patient can take in. It has been found to be an effective way to achieve long-term weight loss. Patients find this surgery appealing because the band can be removed if necessary. The surgery is performed laparoscopically through about five small incisions. Most patients who undergo a lap-band will go home the day after surgery.
For more, read the section on morbid obesity and bariatric surgery.
Roux-en-Y Gastric Bypass
Laparoscopic roux-en-Y-gastric bypass (RYGB) is considered the gold standard for minimally invasive weight loss surgery. It is indicated for the morbidly obese patient or the obese patient that has certain associated, or comorbid, medical problems. The surgery involves making about five small incisions in the abdominal wall and placing a camera and small instruments into the abdominal cavity to redirect the flow of food through the gastrointestinal tract. This 'bypasses' the food to a lower segment of bowel so that the body absorbs less food and fewer calories. The surgery also reconstructs the stomach, creating a small stomach 'pouch'. The creation of a small gastric pouch, limits the amount of food a person can take in at a given time.
Laparoscopic RYGB allows for a safe and effective surgery for long term weight loss, with a much faster recovery time compared with open surgery. Laparoscopic RYGB has been shown in numerous academic studies to be in an extremely effective way of treating morbid obesity and its associated comorbidities. Most patients start taking in liquids the day after surgery and most patients return home a day after that.
Laparoscopic Sleeve Gastrectomy
Laparoscopic sleeve gastrectomy is a minimally invasive operation to achieve weight loss. It is categorized as a "restrictive" bariatric procedure. In this procedure a portion of the stomach is removed. This decreases or "restricts" the amount of food that a person can take in at a given time. Patients are not only restricted in how much they can eat, but they actually feel less hungry. Many people feel this operation is a good alternative to the laparoscopic gastric band because there is no introduction of foreign material into the body.
Many surgeons feel this procedure is a good procedure for the super obese patient to transition more safely to a laparoscopic roux-en-Y bypass later.
Liposculpture is an out patient cosmetic surgery used to remove areas of excess fat on the body. It is a less invasive form of liposuction that does not require general anesthesia. Many patients undergo this procedure after bariatric surgery to remodel their tissue after weight loss. Recovery is usually only 2 or 3 days.
For further information, you can ask Dr. Ferzli.
Corneliu T. Vulpe, MD
Dr. Vulpe is an active Assistant Clinical Professor at SUNY Health Science Center at Brooklyn. He is currently an attending surgeon at Lutheran Medical Center and Staten Island University Hospital as well as Dr. Ferzli's associate. Dr. Vulpe is fluent in English, Spanish, French, Romanian and Italian.
Karen Sander, RN Bariatric Coordinator
Ms. Sander is a graduate of St.Vincent's Medical Center School of Nursing and the College of Staten Island. Employed at Lenox Hill Hospital, Ms. Sander continued her specialty training in Medical-Surgical, Critical Care, Open Heart Surgery, Emergency Medicine and Trauma. She held a position in Critical Care discipline at Lenox Hill Hospital and was the recipient of the Rose Award for outstanding nursing and compassion.
Ms. Sander entered into the Administrative-Supervisory area of Nursing specialized in Long-Term Care and Bariatrics. She is certified in BCLS, ACLS, Child Abuse and Infectious Disease. She is now the Bariatric Program Coordinator for Dr. George Ferzli.
Andrea D'Oria - Cameron, MS, RD, CDN
Brooklyn born and raised, she attended Brooklyn College and received a Bachelor of Science Degree in Biology. Later, she graduated with a Master's Degree in Clinical Nutrition from NYU. Ms. D'Oria-Cameron is also certified in adult weight management and has experience as a personal trainer.
Ms. D'Oria-Cameron has over 10 years experience working as a clinical dietitian at SUNY Downstate and research dietitian for Fred Hutchinson Cancer Research Center in Seattle, WA. Her most recent position was as a retail dietitian. In June 2014, Ms. D'Oria joined the team of Dr. George Ferzli.
For further information, you can ask Dr. Ferzli.