I am a 69 year old gastrointestinal surgeon, originally trained in general and thoracic surgery but now my practice consists of 90% bariatric surgery.
I finished my medical school and internship in 1964 at Paraná University Medical School and the University Hospital (Faculdade de Medicina da Universidade do Parana e Hospital de Clinicas) in Curitiba, State of Parana, Brazil. From 1965 to 1968 I was a Resident in Surgery at the University and in 1967 I passed the examination of the Educational Council for Foreign Medical Graduates, when I obtained the equivalence of my medical degree to U.S. doctors.
In 1968 I went to Philadelphia, Pennsylvania for my Surgical Residency at the Graduate Hospital of the University of Pennsylvania. From 1970 to 1971, I served as Chief Resident at this Hospital. In June 1971 I went to England for my Thoracic Surgical Residency (Registrar in Thoracic Surgery) at Hawkmoore Chest Hospital in Devon.
During my stay in England I went to Cambridge and at the Lakenheat Airbase I took my written part of the American Board of Surgery examination. I returned to US and in 1972, in Nashville, Tennessee, I took the oral part of the Board examination. In 1973 I became a Diplomate of the American Board of Surgery qualified for the practice of Surgery in the United States of America. In 1975 I became a Fellow of the American College of Surgeons.
I am a member of the faculty at the Department of Surgery of the University Hospital and the Medical School (Universidade Federal do Paraná). I started as Instructor of Surgery, and then was promoted to Assistant Professor of Surgery and after that to Associate Professor of Surgery. Now I hold the position of Senior Professor of Surgery at the Post Graduate Course in Clinical Surgery.
I received on December 2007 the great honor to become an Emeritus Professor of Surgery of the Universidade Federal do Parana, Brazil. I have also earned an MS and PhD degrees from the Universidade do Paraná. I have edited four books and have more than 200 papers published and have presented innumerable lectures and conferences at medical meetings and congresses. I was Vice President and then President of the Brazilian Society of Bariatric Surgery. I was also Editor-in-Chief of Bariatrica&Metabolica, this Society Journal (Sociedade Brasileira de Cirurgia Bariátrica).
After many years in the practice of General Surgery and Gastrointestinal Surgery, I became interested with Bariatric Surgery about 17 years ago. My total experience with these procedures passed 3000 patients in January, 2010 including Vertical Banded Gastroplasties, Laparoscopic Vertical Sleeve Gastrectomies, Laparoscopic and open Roux-en-Y gastric bypasses,Laparoscopic adjustable gastric bandings, Laparoscopic and Open Biliopancreatic diversions with distal gastrectomies (Scopinaro operation) and with duodenal switch (Hess & Marceau).
I have performed more than 700 DS procedures up to now. Out of these 3000 surgical procedures I have had 6 immediate postoperative deaths (within 30 days from the operation and operation related). One patient died after a stapling disruption after a Laparoscopic RNY procedure, the second one after a conversion of a VBG to RNY due to an anastomotic leakage, the third patient of a pulmonary thromboembolism 28 days after a RNY operation.
I have had three deaths after DS. One patient died after a massive haemorrhage from an abnormal vascular malformation at a secondary bronchus of the left upper lobe of the lung. The second one died after discharge, while walking in the street from a cardiac arrhythmia secondary to an aortic stenosis and myocardial hypertrophy. I had one third death from a leakage of the Roux-en-Y entero-anastomosis, the intestinal part of the DS. As major complications with DS I had 11 cases of leakage of the gastric stapling line that cured after reoperation and three extended hospital stays, one case of postoperative acute pancreatitis, which had good evolution with clinical treatment, four cases of intestinal obstruction related to the surgical procedure which required surgical correction elsewhere, two cases of perforated duodenal ulcers and several cases of wound seromas that drained after the operation. Incisional hernia occurred in 14% of the cases operated open. The long term results after DS procedure has been good, but for 34 cases of Protein malnutrition, from where 14 required revisions. I have also experience with revisional bariatric operations.
I have performed 74 such procedures.
