Texas Bariatric Specialists: Local Expertise for Bariatric and Heartburn Surgery

By: Michael Ferguson
Wednesday, January 1, 2014

Austin residents now have local access to the full gamut of surgical and nonsurgical weight-loss and heartburn treatment options from providers who emphasize procedural expertise and long-term patient support.

Nilesh A. Patel, MD, FACS, leader of Texas Bariatric Specialists and the Heartburn Center of South Texas, helms a multidisciplinary team made up of a surgeon, a psychologist, a dietician and an insurance concierge team. Their primary goal: to support patients throughout the continuum of bariatric or heartburn care.

Dr. Patel, who has performed more than 3,000 bariatric surgeries, specializes in the three major weight-loss procedures performed in the United States — Roux-en-Y gastric bypass, laparoscopic sleeve gastrectomy and the gastric band. His true area of expertise is revisional surgery for patients with failed weight loss or with ongoing issues. This year, he expects to operate on more than 600 patients.

“We most commonly perform laparoscopic Roux-en-Y gastric bypass surgery and laparoscopic sleeve gastrectomy — probably at about a 60 percent to 40 percent ratio,” Dr. Patel says. “The sleeve procedure has gained popularity because it is less involved than gastric bypass but yields comparable results. We also specialize in revision surgeries for patients who have undergone unsuccessful LAP-BAND procedures and other antiquated procedures.”

While these modalities allow patients to shed much of their excess weight and can help address many obesity-related comorbidities, including heart disease, high blood pressure and Type 2 diabetes, long-term success depends upon the availability of a solid support structure to address nutritional and psychological issues that may arise following a major life change.

“Morbid obesity is a true epidemic in our country and has even greater implications in our region because the Hispanic population is at higher risk for diabetes. We need to organize ourselves as physicians within the state of Texas to drive home the message that we have solutions to obesity. We need to be the champions in the fight against obesity and not simply accept it as a way of life in the United States. Working together to construct an aggressive approach to fight this disease can make a difference.”
— Nilesh A. Patel, MD, FACS, founder of Texas Bariatric Specialists and the Heartburn Center of South Texas

Teaming Up for Life

The critical first step in weight-loss surgery is helping patients embrace their roles in the process, so Dr. Patel’s preliminary objective is providing the education needed to empower patients in their struggle with any lifestyle challenges they may face following surgery. Each patient receives a binder packed with information, personal considerations and tips for receiving the greatest benefits from his or her procedure.

There is a growing demand for bariatric surgery. Dr. Patel, who is also Medical Director of Bariatrics at Southwest General Hospital in San Antonio, has expanded Texas Bariatric Specialists into a network of locations across South Texas. Working in concert with primary care physicians, Dr. Patel’s team supports patients through the entire treatment process, from preoperative education through vigilant, lifelong follow-up and support.

“In bariatric surgery, outcomes depend upon a team approach,” Dr. Patel says. “There can’t be competing fiddles in the band. Each member must know what the other is doing. The teams at Southwest General and Texas Bariatric Specialists are committed to the best long-term outcomes, so we fully engage our patients in preoperative education and work with referring physicians to provide support.”

Bariatric procedures require lifelong monitoring to ensure proper physiological and nutritional function, so Texas Bariatric Specialists have made patient follow-up easy by establishing offices in Austin and throughout South Texas, allowing quick access to medical support.

Dr. Patel’s medical expertise, in conjunction with nutritional and psychological counseling, forms the foundation of postoperative care. A comprehensive menu of social support options — including online support groups, Facebook and Twitter groups, electronic voice and email messaging systems, Android- and iPhone-supported apps, and local support groups in which patients receive encouragement from others on similar journeys — encourages postoperative success.

Revolutionizing Reflux Management

Further serving the needs of the Austin area, Dr. Patel has opened the Heartburn Center of South Texas office in the same location as Texas Bariatric Specialists. Patients suffering from acid reflux, chronic heartburn or gastroesophageal reflux disease (GERD) benefit from the comprehensive surgical and nonsurgical treatment options Dr. Patel provides.

Obesity is a major contributing factor in GERD. Because the condition results from malfunction of the lower esophageal sphincter (LES), allowing stomach contents to reflux back to the esophagus, patients commonly experience heartburn and dysphagia as a result of GERD. Physicians can often diagnose the condition based on the presence of these symptoms.

Over-the-counter and prescription antacids are commonly used to stave off the painful effects of GERD, but these medications don’t resolve reflux and provide only fleeting relief for many patients. For patients for whom medical therapy for GERD fails, Dr. Patel offers a comprehensive array of minimally invasive options. He uses minimally invasive surgical techniques that effectively stop symptoms in the majority of patients.

The Gold Standard

Dr. Patel performs laparoscopic Nissen fundoplication (Nissen) through five quarter- to half-inch incisions in the patient’s abdomen. A laparoscopic camera supplies a high-resolution, monitor-displayed image that Dr. Patel uses as a map to guide him to the LES. In less than two hours, Dr. Patel wraps part of the stomach around the lower esophagus, reconstructing a functional LES.

Because the laparoscopic approach requires less cutting, patients experience reduced postoperative pain and risk for infection. They can get back to their normal lives quickly, usually spending one night in the hospital and returning to nonstrenuous activities within
one week.

The Leading Edge

Using laparoscopic surgical methods similar to those used in Nissen surgeries, Dr. Patel performs a novel, less complex procedure to treat GERD in fewer than 30 minutes. The LINX Reflux Management System consists of a small ring of magnetic beads placed around the damaged LES. Essentially, the magnetic bracelet helps the LES function normally, opening to allow food to pass and closing to prevent reflux.

A “Safety and Effectiveness Analysis” published by the Society of American Gastrointestinal and Endoscopic Surgeons highlights the LINX procedure’s ease of performance compared with Nissen and asserts that the procedure enables patients to return to a solid diet more quickly. Dr. Patel reports that patients spend the night in the hospital and then return home, able to resume their normal diets and usual day-to-day activities right away. Safety data presented within the report indicates no mortality and very few serious adverse events associated with the procedure.

Ensuring Excellent Experiences

Nilesh A. Patel, MD, FACSPatients seeking the care of the Heartburn Center of South Texas have easy access to the practice’s network of care and support. A specially trained coordinator manages patients from initial referral to the completion of their follow-up appointments and return to referring physicians. Dr. Patel is an exclusive provider for South Texas and in Austin.

“All of us are committed to long-term support,” he says.

In Dr. Patel’s practices, patients and referring physicians gain a lifelong champion for better health. At both Texas Bariatric Specialists and the Heartburn Center of South Texas, patients who have suffered from uncomfortable, chronic medical conditions receive medical care from specialists with compassionate hands — and now, they don’t have to travel for these benefits.

For more information about Texas Bariatric Specialists, please visit www.TexasBariatricSpecialists.com. For more information about the Heartburn Center of South Texas, please visit www.heartburnMD.com.