SeeMel3

I am new here but need to share what I have learned that may hopefully help others. I did my research and knew that the Gastric Sleeve procedure was what I would have, fortunately my insurer recently approved the procedure so I was eligible. What I didn't know at the time is that my surgeon was one of 2 in the nation that would be utilizing a new technology to perform the surgery. There is a company named TransEnterix that has engineered a new and innovative instrument "Spider" to allow a single incision that will receive multiple instruments. It was pretty amazing to awake from surgery and learn that I was the second patient in the entire US to have a sleeve with this method. I was out on a family outing on my 5th post op day. I returned to work from home (email, conference calls, etc) on day 7. The umbilical incision is very small and soon will be unnoticeable. The surgery has given me the freedom to return to my former active life style. I have absolutely no regrets and would encourage anyone that is considering a bariatric procedure to consider a single incision spider sleeve. My Dr. is Dr. Robert Marema US Bariatrics and Flagler Hospital in St Augustine, Fl. I can tell you from experience that it was also worth traveling a distance to see a surgeon with such technical expertise. Dr Marema is also a bariatric patient and has assembled a team of skilled professionals that will assist you through your entire weight loss journey. Due to other health conditions I have had the opportunity to travel to some very large and influential medical centers such as Mayo, Vanderbilt, etc. I can honestly say that receiving care at Flagler Hospital pre- and post- procedure has been the best medical experience I have had. The clinical care is literally second to none, they are a Center of Excellence for Bariatric Surgery and one piece of advice "in network" does NOT mean "in your zip code". I have learned the HARD way to seek out the best of the best for any type of surgical intervention. If you would like details on how I arrived at that knowledge I will be happy to share my miracle survival story with you...email me at seemel150@gmail.com. As soon as I can download some pics I will be happy to post my before and after....and show you my little single abdominal scar! Best of Luck to all of you who are beginning this journey. I am happy to say that I am finally off the roller coaster and at a little over 3 months I am only about 15 lbs from my goal...YAY!

Hi, I got your message and understand if you are upset with my comments. I did state that there are 2 surgeons in the country doing the surgery, Dr. Marema is on the East Coast. There will be more surgeons moving to it and providing the newest options to their patients. Not every surgeon wants to do this type of surgery, the procedure takes longer than a typical laparascopic bariatric surgery. There was a news feed about my surgery in the press and I will happily send you the link. Yes I did mis-state that multiple instruments were used and I will be happy to correct that comment. I was certainly no guinea pig. My surgeon has been doing laparascopic surgery and he personally has more than 8000 procedures. That comment from you was quite rude and perhaps you should do some research before stating something so derogatory. The most important thing to me was for me to share was who my surgeon was, that he is doing something new and different. This is a forum to share and I of course encourage everyone to do their research. I was pleased to have only one incision and one scar to deal with as I have had multiple scars from at least 7 other surgery experiences. It was very exciting to watch my scar disappear into my belly button. I certainly do not understand your hostility and the tone of your comments. My research is not "totally flawed" I found an excellent surgeon and a hospital where quality health care takes place. If you had bothered to read the rest of my comments you would understand that I am quite passionate about that. I will definitely post the link to the article written about my surgery in July of 2010 below. (I-Newswire) , July 21, 2010 - SAINT AUGUSTINE, FL (July 21, 2010) – Dr. Robert Marema, one of the nation’s most recognized experts on surgical weight loss, is now the first surgeon in Florida and second in the world to perform a single–incision vertical sleeve gastrectomy using the SPIDER® Surgical System. Vertical sleeve gastrectomy is the latest and fastest growing type of surgical weight loss procedure, which dramatically minimizes the size of a patient’s stomach. Without using SPIDER, surgeons typically rely on conventional laparoscopic equipment that requires five separate small incisions in a patient’s abdomen – rather than just one. “The SPIDER minimizes physical stress on patients while also providing cosmetic benefits,” commented Marema. “I simply make one small incision that’s hidden in the patient’s belly button and insert the SPIDER. I then expand the internal portion of the device, similar to expanding an umbrella. This allows me to clearly see the anatomy and accurately perform the operation. When I’m finished, I close the system and remove it through the small incision, leaving almost no visible scar.” This marks the first time the SPIDER Surgical System has been used to perform this procedure in Florida. Released on a limited basis beginning in March, SPIDER has been used by surgeons to perform other procedures including colon re–sections, kidney and gallbladder removals, and gastric banding. SPIDER’s proprietary expansion technology is unique – it is not available in any other surgical device today. In addition, SPIDER contains four working channels through which the surgeon inserts a camera and instruments. Two of the channels are flexible, providing surgeons with true left and true right instrumentation, a marked contrast to other single–port instruments that force a surgeon to cross his hands to operate. “As an individual who has been involved with the evolution of bariatric surgery since its earliest beginnings, I am continuously seeking new ways to improve the experience and outcomes for my patients,” added Marema. “The SPIDER definitely provides several advantages that I am happy to offer as part of our program.” Marema is the medical director at the Flagler Hospital Bariatric Surgery Center – a Center of Excellence facility located in St. Augustine, Florida. He has performed more than 12,000 bariatric procedures, is a long–standing member of the American Society for Metabolic and Bariatric Surgery, Fellow of the American College of Surgery, Diplomat of the American Board of Surgery and a member of the American Medical Association. TransEnterix, a fast–growing medical device company, created the SPIDER Surgical System. TransEnterix partners with leading medical thought-leaders to rapidly develop pioneering technologies that advance minimally invasive surgery. For more information, visit www.TransEnterix.com. About Flagler Hospital Flagler Hospital is a 316-bed acute care hospital that is consistently recognized nationally for overall clinical excellence. HealthGrades has ranked Flagler Hospital among the top 5% of all hospitals in the nation for the past 6 consecutive years. They also named Flagler Hospital as the #1 hospital in the state of Florida for general surgery outcomes in 2009 and 2010. Most recently, the hospital earned accreditation from the Society of Chest Pain Centers. It also has the Gold Seal of Approval™ from The Joint Commission for Primary Stroke Care Centers and Center of Excellence Designation for its Bariatric Surgery Center. For more information about Flagler Hospital, please visit us at www.flaglerhospital.org. ###

Congratulations to you! I couldn't be happier that I chose to have the sleeve. I had seen a lot of pictures on the web of people with scars on the belly and I was surprised when from a distance you cannot tell my belly button was cut. You have to share if you used anything special for prevention of scars, or maybe they all just fade naturally? I am really happy to hear that as my sister n law wanted a sleeve but ended up with a bypass and couldn't have that with one incision she is concerned about the scars. Happy New Year!

I am a Registered Nurse, I have done a lot of research on the hospital and surgeon. Unfortunately due to much illness over the past 4 years, I have been immersed in doing research on rare health conditions, technical procedures, etc. I also spent the past 8 years working in the medical device industry and a primary role for me was training other nurses (Injection and Infusion products) on the device use in hospitals. I am sorry if I sound so corporate, I guess that part of me turns on when writing as I have been writing that way for so long. I am on this site for support and joined a similar board on Obesity help prior to surgery to research the procedure and surgeons. I was very excited to be able to have only one incision and wanted to share that with the rest of the community. When I researched the lap procedures I understood I would have at least 3 and up to 6 abdominal incisions. In 2006, I had a biopsy procedure done, I had multiple incisions, it was supposed to be an outpatient procedure...I woke up in ICU with a lot of equipment attached to me. I spent 37 days in the hospital recovering from a surgical site infection, this incident almost took my life. I thank God that he has restored me to health. My family has been affected by poor health care- my mother also acquired an infection in the hospital and as a very poorly controlled diabetic was unable to fight the infection. My sister had a simple operation (appendectomy) in 2008. She woke up with a pretty severe burn on her face and a permanent scar. She has schizophrenia, and I was quite disgusted when the hospital staff tried to convince her that she had a cold sore. I was furious. I couldn't believe they could just lie to her. She didn't have the "cold sore" before surgery I took her picture in the ER bed on my cell phone. (Now she has an attorney and a pretty solid law suit) I do feel a passion for helping others and that I am supposed to use this pretty tragic experience to guide others to find good health care. I had 2 months of home nursing care and it took another 5 months to even begin feeling like myself again. I learned a lot from this experience and when I find clinical excellence in health care and new and innovative ways to protect patients from incidents like this I do get excited. I have posted my story about this experience on boards about health care acquired infections, have become kind of an activist in a way - I want everyone to know they have to be a true advocate for themselves. They have to know that this can happen and minimally invasive like a single incision surgery can minimize the opportunity for infection. I can assure you I am for real. I have fought weight issues my entire life. It started in the 3rd grade up and down...I am so happy to have found my way to the smallest size I have ever been. The other day my husband lost me in the grocery store. When I asked him where he had been he stated he couldn't find me..."I just don't recognize you from behind anymore" WOW!

I understand that at the moment there are only 2 surgeons in the country that utilize the spider technology to perform the sleeve. My surgeon Dr. Robert Marema and is at Flagler hospital in St Augustine, Fl. They have a hospital concierge (Angel Gulick) that will help you coordinate if you choose to travel for surgery and an awesome support network. I spent a week there in St Augustine, only 2 nights in the hospital. I know that some insurance companies even reimburse you for mileage, hotel, and meals if you are traveling more than 100 miles for your care. I was first going to have my surgery at Mayo in Jacksonville...then I discovered that they were out of network with my insurance (which they failed to notify me of) they wanted to limit me to only a band procedure, I wasn't given a choice, and they were not a Center of Excellence for Bariatric Surgery...so I started to do my homework and I actually moved once I found Dr. Marema. The staff was incredibly helpful in guiding me to obtain the right paperwork and records as well as scheduling me for visits and follow up on my schedule. I do hope that you find the right place and surgeon and wish you well on your journey. If I can answer any more questions for you I am happy to.

It is pretty amazing, it seems life gets a little easier every day. The weight continues to come off and I am already nearing my goal which has been so challenging my entire life. This past week I took out old pictures of myself and discovered that I have literally been riding a roller coaster since the 3rd grade. I don't have a lot of memories from those years but I have the pictures that show a normal looking happy child and from that point the next picture is a tremendous change in size and my face was so round and chubby. I remember always feeling that I was the largest-roundest kid in the class. I remember having to wear shorts when I would wear a dress because my thighs would rub together and I would really suffer. I remember not liking to go to P.E. class and was so embarrassed by my size that I would beg my mother to write a note so that I wouldn't have to participate. Incredible that although my parents tried to help me, they really didn't know how. My Mother was obese most of my life she also struggled with her weight and unfortunately there were several diets and exercise programs attempted but to no major success for either of us. I watched as my Mother diagnosed with type 2 diabetes at 42 suffered developing severe neurologic pain in her feet and hands, watched as the woman I knew drifted away into a narcotic induced flatness trying to cope with the pain, her health spiraled down and within 15 years she was gone. I knew that I didn't want to follow her. In 2006, illness became a part of my daily life and I started to suffer with my own very challenging illness. This required a tremendous amount of medication, pain management Doctors and finally 2 brain surgeries. Through all of it I gained weight thanks to my bedridden status and the effects of all of the steroids and other meds. Little did I know this was only the beginning of my experience of illness and I often would feel incredibly guilty thinking I was being punished for some horrible transgression I had committed and prayed to God that if I was ever unkind to someone suffering intractable pain that I would receive his forgiveness. I know that was not the case but when stricken with something like this you begin to doubt who you are as a person, question every belief every action, I know now that sometimes God allows you to experience things as lessons in life and so that you can take those and help others. So much good has come from this experience that I do not regret the experience, I have been able to council others who suffer from Trigeminal Neuralgia (the suicide disease) often so challenging to diagnose that many cannot cope with the pain and end their lives. I am on the other side of this now. A survivor. Through my story and experiences I have been able to help others who are coping with this illness and guide them to get care. Often just navigating the health care system is such a challenge as DR's do not always have the time to listen, nor are they inclined to actually HEAR what you are saying to them. That is why when I found my surgeon, Dr. Marema and found out that he was a bariatric surgery patient himself with more than 12,000 procedures performed that I would have him do my surgery. This has been a life changing experience. Every day I thank God for these blessings and for the favor he has shown me. I do hope that others on this journey to wellness are given an opportunity to regain a sense of self, the final recovery, access to quality health care and that you all will be treated with respect, compassion, and empathy. I know that I have to share the miracles in my life or I may not receive more. I hope this in some way helps someone out there, today. Sharing this was not the easiest thing I have ever done but I will tell you that "scars remind me how far I have come" Shakira, is the absolute truth. Today I am grateful for my journey.

Hi RK - I do wish you well. I think you will have a similar experience. The procedure was a little longer but I didn't mind because I was asleep. The pain is well controlled after, I had a pca and then by the second day on oral medication. The most challenging part initially was getting all of the recommended fluids in and remembering all of the post op instructions. But it does get easier every day, Best of luck to you!!!