Recently Dr. Carlos Galvani joined Arizona Illustrated reporter, Kimberly Craft to discuss his pioneering laparoscopic surgery techniques and how it will impact the future of Bariatric Surgery. Dr. Galvani’s progressive laparoscopic single incision technique enhances the spectrum of Bariatric procedures that can be offered to the patients in the Surgical Weight Loss Program at the University Medical Center. As a result of the single incision technique patients may experience reduced pain and recovery time. Dr. Galvani can be reached at 520.626.2635.

Content courtesy Arizona Public Media © 2011

Contact: Jo Marie Gellerman, (520) 626-7219                                 April 5, 2011

TUCSON, Ariz. – A surgeon at the University of Arizona Department of Surgery performed a new surgical weight-loss procedure at University Medical Centerthat leaves no scar – a first for Southern Arizona. Requiring only one tiny half-inch incision in the navel, single incision laparoscopic weight loss surgery is safer, with shorter recovery time.

Last February, Anna Varela, a Casa Grande, Ariz., mother of five, underwent laparoscopic adjustable gastric banding surgery, performed by Carlos Galvani, MD, UA associate professor of surgery and director of Minimally Invasive, Robotic and Bariatric Surgery. While not recommended, Varela went out dancing five days post op.

Bariatric surgery reduces the size of the stomach of morbidly obese people. Laparoscopic gastric banding was developed in 1993, and approved for use in this country in 2001. The procedure results in four or five small scars in the abdomen. Surgery requires patients to eat a limited, carefully-monitored diet.

The first single-incision surgery was in 2007, Dr. Galvani said, but only a few surgeons have been trained to perform the procedure. A single-incision approach also has been successful with sleeve gastrectomy, another bariatric surgery.

With single-incision laparoscopic banding surgery, Dr. Galvani enters the abdomen through the navel, using three instruments and a camera to guide the way. The procedure lasts 30 to 45 minutes. A band is wrapped around the upper part of the stomach, creating an hour glass shape. When eating, patients get full faster, and the band is adjusted, determining the rate of weight loss.

“Patients appreciate the lack of scars after surgery,’’ Dr. Galvani said. “And there are fewer complications like infection or hernia. Less cutting also means less pain.’’

He said 92 percent of people with this procedure go home the same day.

Surgery Has Mom ‘Feeling Great’

Varela believes the procedure is saving her life. She always was athletic, and ran five miles a day until 2001, when Varela was diagnosed with breast cancer. Radiation, steroids and other drugs were used to battle the cancer, and Varela rapidly gained weight.

“I gained like a whole other person, on top of me,’’ said Varela, 43. “I went from 145 to about 300 pounds.’’

After treatment was complete, Varela started to diet. “But my metabolism was impacted. I tried everything, every program, every pill. I would stick to the program, lose weight, but then the weight would come right back.’’

Varela, who was born with congenital heart disease, was diagnosed with coronary heart failure after radiation impacted her heart. “My doctor told me, ‘If you don’t take care of this, you may not live to see your kids grow up.’ ”

Varela worked with a UMC medical team that stressed that she required a major lifestyle change. Prior to surgery, she got down to 230 pounds.

She appreciates the single incision, which resulted in a quicker recovery and no scars. She is walking for exercise and is starting exercise classes. Her goal is to run again.

“I’m so excited,’’ Varela said. “I dream about running. There’s nothing like it.’’

Varela is losing about 1 ½ pounds a week, and hopes to get under 150 pounds. She eats small portions of carefully selected foods that she cooks herself. “My cardiologist predicts he will lose me as a patient,’’ Varela said. “I’m feeling great!’’

Surgical Weight Loss at University Medical Center

Dr. Galvani joined the UA Department of Surgery as director of Minimally Invasive and Robotic Surgery in 2009, with the goal of starting a bariatric program. Before joining the UA, he performed more than 90 single-incision bariatric surgeries and is one of the most prolific authors of journal articles on bariatric surgery.

Dr. Galvani developed a program that involves the extensive UMC health care team, including psychologists and dieticians. Although other Tucson hospitals perform bariatric surgery, he knows of none that offer the single-incision procedure. And the team at UMC makes the difference.

“Here you have everything you could possibly need – trauma surgeons in the intensive care unit, cardiologists, the gastroenterology department,’’ Dr. Galvani explained.

“Bariatric surgery is different than other procedures,’’ he added. “You need a great deal of support. Many people use food as a way of coping with other issues. You get food out of the picture, but the issues are still there.’’

“It’s potentially life changing,’’ Dr. Galvani said. “But patients need to understand this is just a tool. We don’t make it easy – they must earn it. For insurance to cover the operation, patients must follow a supervised diet for six months prior to surgery.’’

With obesity on the rise, patients are opting for bariatric surgery. In the United States last year:

• 220,000 patients underwent bariatric surgery, 1.5 percent of potential candidates
• 400,000 people died from obesity-related causes

“We are proud of our minimally invasive surgery program at the UA. Dr. Galvani has pioneered many of these techniques that lead to optimum outcomes for our patients,” said Rainer Gruessner, MD, UA Department of Surgery chairman.

To find out more about the Surgical Weight Loss Program at UMC, please call (520) 626-2635.