MGB Animation	The Mini-Gastric Bypass		MGB Patient "Buck Rogers"
	More Effective than the LapBand / Safer than the RNY Gastric Bypass


	West: Las Vegas, Nevada Dr. Rutledge Email: DrR@clos.net or Call Dr. Rutledge Now at: 702-215-9550	East: Orlando, Florida Dr. Peraglie Email: DrP@clos.net or Call Dr. Peraglie Now at: 407-922-3424

The New "Out-Patient" Mini-Gastric Bypass


Information as of 2/7/2008 We are pleased to announce that Dr Rutledge and St Rose Dominican Hospital in Las Vegas have agreed to begin offering a new program in Outpatient Mini-Gastric Bypass. The plan for the start up should be ready with details for those that are interested in the next two weeks (2/20/2008) The new Outpatient Mini-Gastric Bypass program is also being considered by Dr Peraglie and Heart of Florida Regional Medical Center in Florida. Over the past 6 months Dr Rutledge has been working with the staff and anesthesiologists at St. Rose Hospital to craft a newer and safer form of the MGB. Nursing input, patient surveys, administrative staff and our anesthesiologists have all participated in creating this new program and each and every one of us agrees whole heartedly that this is a new successful and safe addition to the services of CLOS West. Exciting new research shows that perioperative subanaesthetic doses of ketamine reduce the need for pain medicine and the pain intensity, or both. Quantitative analysis showed that treatment with ketamine reduced 24 hour PCA morphine consumption and postoperative nausea or vomiting (PONV). Adverse effects were mild or absent. Even more exciting are new studies of Anesthesia Care With a Combination of Ketamine and Dexmedetomidine (Precedex) which show remarkable safety, especially for obese patients.
Our Recovery Room Nurses have commented that the new "Opiod Sparing" anesthesia technique has improved recovery tremendously. It decreases pain and nausea. Our floor nurses agree that patient recovery has improved markedly as well. The need for pain medicine has decreased along with the need for nausea medications. Less narcotic pain medication makes the surgery much safer. Every nurse that sees our patients has been canvassed and contacted to ask their opinion about the new technique. We have uniform agreement that the program is resulting in patients that are doing better have more stable vital signs and can safely be discharged the same day of their surgery. The patients have improved levels of respirations and oxygen saturation. They are sedated and comfortable but without respiratory depression. This is particularly important for obese patients with restrictive lung disease. The advantage of this new approach is that hospital resources are tremendously costly and by eliminating the overnight stay we hope cut the costs of the operation significantly, possibly in half. We should know more about hospital pricing at St Rose in the next two weeks. We are enthusiastic about the potential to offer this lifesaving procedure with Dr Rutledge at our NV center on an outpatient basis to those qualifying candidates seeking a proven weight loss surgery and better quality of life. For the first six months to a year we plan to offer outpatient Mini-Gastric Bypass to only a select group of patients. While this list of criteria is still undergoing review it should follow these guidelines: For patients to be considered for out patient MGB Patients will go through all the usual steps in the CLOS packet process NO TENTATIVE SURGERY DATES! The entire packet must be completely reviewed by Dr Rutledge PRIOR to offering the patient even a hint of a date!!! Height: 5'2" to 6" Weight Requirement: Less than 300 lbs (Weight under 250 lbs for the first 10 patients) Age requirement: Over 18 and under 40 years of age Health: NO major health issues such as COPD, cardiac issues, severe HT, etc. Surgical HX: As with all of our patients, NO major abdominal surgeries, etc. Mental status: no current medications

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Contact Information: -Telephones: *** CLOS West: 702-456-4643; Trish Lanman 702-376-3446, Sandy Brubaker 702-376-3647; Jennifer Brubaker 702-376-9339, Dr. Rutledge 702-215-9550; 989-450-8081 Kim Hazen 989-450-8081 *** CLOS Florida: Flo Ballengee 863-899-3463 Wayne Robbins 704-682-1549 Elizabeth Robbins 704-928-6693 Dr. Cesare Peraglie 407-922-3424

Email Us Anytime for Help: Email: Dr. Rutledge DrR@clos.net, *** CLOS West: Trish Lanman Trish@clos.net, Sandy Brubaker SandyB@clos.net Dr. Rutledge DrR@clos.net, Kim Hazen khazen@clos.net *** CLOS Florida: Flo Ballengee flo@clos.net, Wayne Robbins wr@clos.net Elizabeth Robbins epr@clos.net Dr. Peraglie drp@clos.net

Addresses: Address: *** CLOS West Office: Dr Robert Rutledge / CELOS, 98 E Lake Mead Parkway Suite 302, Henderson NV 89015, Office 702-456-4643, Office fax: 702-456-1173, Contacts: Trish Lanman 702-376-3446 Trish@clos.net, Sandy Brubaker 702-376-3647 SandyB@clos.net, Jennifer Brubaker 702-376-9339 Jen@clos.net, Dr. Rutledge 702-215-9550 Drr@clos.net Kim Hazen 989-450-8081 khazen@clos.net *** CLOS Florida: 40124 Highway 27, Suite 203, Davenport, FL 33837, Wayne Robbins 704-682-1549, wr@clos.net, Elizabeth Robbins 704-928-6693 epr@clos.net, Dr. Peraglie 407-922-3424 drp@clos.net

Warning: Gastric Bypass Surgery is a MAJOR surgical procedure. It can be associated with significant risks and complications, up to and including death. Weight loss surgery is a rapidly developing area of medicine. Bariatric surgery is filled with controversy. It is very important to take a careful and deliberate approach to considering surgery for the treatment of obesity.

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-It is imperative that you consult your own physician regarding the applicability of any opinions or recommendations with respect to your symptoms or medical condition.
-Contact with this web site or Dr. Rutledge over the web site does not constitute a doctor patient relationship and for good quality medical care you must obtain advice and consultation form your own local physician.
-This site is intended as a resource for references on the treatment of obesity for health care professionals and educated consumers.
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This information is not medical advice or diagnosis, nor is it to be construed as medical advice, medical information, medical diagnosis, or medical prescription for curing, removing, or preventing any disease, or related symptoms. You must seek the direct assistance, advice and evaluation of your own personal physician before acting on any information found herein. These statements have not been evaluated by the Food and Drug Administration.
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Copyright © 1998 The Center for Laparoscopic Obesity Surgery