Baylor Scott & White Surgical Group of North Texas

The transoral incisionless fundoplication procedure is an effective solution for chronic acid reflux. It is a minimally invasive treatment for gastroesophageal reflux disease (GERD) that is performed in the outpatient setting. Nathan Emerson, MD, has specialized training in endoscopic reflux surgery to help treat acid reflux.

What causes GERD?

GERD is a complex process but is ultimately a disorder of a failing gastroesophageal junction. The tissue of the gastroesophageal junction becomes stretched and thinned until it is no longer able to hold back the pressure created by the muscular stomach.

If my medications for GERD aren’t working well, what else can I do?

Lifestyle changes can help to reduce GERD symptoms in many patients. These include decreasing meal size and eating earlier in the day. Patients with GERD symptoms also have some success sleeping in a more upright position. However, in many cases, these lifestyle measures aren’t enough even in combination with medications. These patients should at least consider surgery for GERD, including endoscopic and/or laparoscopic robotic procedures.

If medications are working to control my GERD, then why consider surgery at all?

Every medication has side effects, including those that control stomach acid. Your physician can discuss these with you in detail during an office visit. Furthermore, a lifetime of anti-GERD medications can be quite expensive. Some insurance companies are resistant to paying for the medication that may be most effective for you.

What are my surgical options for acid reflux treatment?

The surgeons here offer the full array of anti-reflux procedures, including the transoral incisionless fundoplication, robotic hiatal hernia repair and a traditional Nissen procedure. We would be happy to discuss all of your options in detail during your visit to our surgery clinic in Grapevine.

TIF procedure

The TIF (transoral incisionless fundoplication) procedure is an effective solution for chronic acid reflux. It is a minimally invasive treatment for gastroesophageal reflux disease (GERD) that is performed in the outpatient setting. The TIF procedure is performed from inside the patient’s stomach without incisions and delivers patient outcomes similar to those provided by conventional ARS procedures. However, the TIF procedure is less invasive, has fewer adverse effects and does not limit future treatment options for acid reflux.

Sina Matin, MD, and Julio Rivera, MD, are surgeons specializing in weight-loss. Have you committed to diet and exercise, and the weight won’t come off, or it just keeps coming back? If so, weight loss surgery may be an option for you

Baylor Scott & White Surgical Group of North Texas performs four different types of weight loss surgery for appropriate candidates:

• Sleeve gastrectomy
• Roux-en-Y gastric bypass
• Duodenal switch
• Gastric band

Sleeve gastrectomy

Currently, the sleeve gastrectomy is the most commonly performed weight loss procedure, not only in the US but globally. It is a restrictive weight loss surgery to permanently remove about 80% of the stomach. It holds the equivalent of about 3-7 ounces of liquid. This surgery is also a metabolic operation that not only severely restricts the amount and quantity of food that you can eat, but it also has some hormonal metabolic effects as well.

Expected weight loss:

• When accompanied by healthy lifestyle changes, after the sleeve gastrectomy operation, patients can expect 70-80% of excess weight loss.

Sleeve gastrectomy risks:

• Bleeding and leaking
• As with any surgery or procedure, there are risks, albeit small, for severe complications, like allergic reactions, infections, heart attacks, pneumonia and rarely death

Roux-en-Y gastric bypass

The Roux-en-Y gastric bypass weight loss surgery works by re-routing, re-connecting or re-wiring your intestines, so that your new stomach is only about the size of a golf ball and holds only 1 to 2 tablespoons of food.

Expected weight loss:

• Following Roux-en-Y gastric bypass surgery, you can expect your maximum weight loss to be achieved in about 18 months. When accompanied by appropriate lifestyle changes,  you can expect to lose approximately 75-85% of your excess weight.

Roux-en-Y gastric bypass surgery risks and complications:

• Leaking (0.5%)
• Ulcers—avoid NSAIDs (5-7%)
• Strictures (5-7%)
• Dumping syndrome—Very unpleasant sensation of a rapid heart rate, nausea, vomiting, abdominal pain and sometimes diarrhea resulting from eating foods high in sugar
• As with any surgery or procedure, there are risks, albeit small, for severe complications, like allergic reactions, infections, heart attacks, pneumonia and rarely death

Duodenal switch

The duodenal switch, or “switch,” is a weight loss operation that combines the qualities of both the sleeve gastrectomy and the gastric bypass. The duodenal switch weight loss surgery is performed in two steps. First, we perform a sleeve gastrectomy removing around 70-80% of the stomach and converting the stomach into a slender tube. We then divide the small bowel that normally connects to the stomach (called the duodenum) to create the bypass portion of the surgery. After food enters the “sleeved” stomach, it goes into the initial part of the small intestine, but then it is re-routed or ‘switched’ to the lower part of the small intestine (the ileum).

Expected weight loss:

• Of the four operations that we offer, this is the most drastic, and as a result, it creates the most weight loss. With the “switch,” patients can expect to lose between 90-100% of their excess body weight.

Duodenal switch surgery risks:

• Protein calorie malnutrition
• Mineral and vitamin deficiencies
• Internal hernias (<2%)
• Gallstones
• Temporary hair loss
• Sangría
• Developing incisional hernia

Gastric band

Adjustable gastric banding is a less-invasive but restrictive weight loss operation. The Lap-Band is a small device that goes around the top part of the stomach. It contains a balloon that is slowly inflated over time resulting in a “tightening” of the band around the stomach. This, in turn, leads to greater restriction and ultimately more weight loss.

Expected weight loss:

• With the gastric banding, patients can expect to lose about 40–50% of their excess body weight.

Gastric band risks:

• Difficulty swallowing due to band slippage
• Lack of feeling full due to pouch enlargements
• Erosions (1/300 cases)

Breast cancer treatment in Grapevine

Dealing with breast cancer can be a trying situation for the strongest of women. Ed Clifford, MD, and Baylor Scott & White Surgical Group of North Texas strive to provide the latest treatments for breast cancer, including the SAVI^® applicator five-day breast cancer treatment. Dr. Clifford and Baylor Scott & White Surgical Group of North Texas focus on providing quality, compassionate care for you or your loved ones.

We take a tailored approach in working with each of our breast cancer patients. Once you reach out to us, we strive to ensure your initial appointment is made timely. After an initial meeting, Dr. Clifford will design a unique treatment plan that provides effective results while allowing you to live as normal a life as possible. 

Dr. Clifford specializes in oncologic surgery, primarily focusing on breast cancer treatment and surgery. Dr. Clifford believes in using a team approach to treatment, including meeting with your medical oncologist, radiation oncologist and plastic surgeon (if needed) to create a breast cancer treatment plan best suited for you.

Genetic testing for breast cancer

Baylor Scott & White Surgical Group of North Texas takes a personal interest in your welfare. That is why your treatment will be based upon breast cancer genetic testing. Genetic testing enables us to proactively monitor high-risk populations using genetic screening.

Variants in your DNA may present genetic abnormalities that increase your risk of breast cancer. Using the latest software models, a 25-gene panel assessment and compiling an extensive family history profile, we can provide an individualized risk assessment, a preventative medical program and, as required, a personalized breast cancer treatment plan.

If you have any questions regarding genetic mutations or the breast cancer screening we can provide, please feel free to contact us.

Breast cancer risk factor quiz

With the latest advances in cancer research, a number of organizations have published calculators and tools for individuals to help assess their risk of a breast cancer diagnosis. While they do not replace a consultation with your doctor, they do empower individuals with information to prompt a productive discussion at your next appointment.

Breast cancer risk evaluation tool—An interactive tool that estimates the likelihood of a woman developing breast cancer within 10 years and over the course of her lifetime. The tool was designed by scientists at the Wolfson Institute of Preventive Medicine, Queen Mary University of London.

Laparoscopic hernia repair is a technique to fix tears in the abdominal wall (muscle) using small incisions, telescopes and a patch (mesh). 

Hernia surgery options: 

Open repair surgery is done through an incision in the abdominal wall or from the outside through a three- to four-inch incision in the groin or the area of the hernia. It may go through part or all of a previous incision, skin or an underlying fatty layer to get to the level of the issue. The hernia surgeon in Grapevine may choose to sew your natural tissue back together, but frequently it requires the placement of mesh (screen) in or on the abdominal wall for a sound closure. This technique can be done with a local anesthetic and sedation using a spinal anesthetic or a general anesthetic.

Hernia surgery risks and complications:

• Bleeding, infection and damage to surrounding structures, such as nerves, arteries, veins, intestines, bladder, etc. can occur but are rare. Inguinodynia–chronic groin pain. (7% risk) 

Laparoscopic hernia repair is a technique to fix tears in the abdominal wall (muscle) using small incisions, telescopes and a patch (mesh). If may offer a quicker return to work and normal activities with a decreased pain for some patients.

• Ventral hernia–laparoscopic
• Inguinal hernia–laparoscopic

Laparoscopic hernia surgery risks and complications: Bleeding, infection and damage to surrounding structures, such as nerves, arteries, veins, intestines, bladder, etc. can occur but are rare. Inguinodynia–chronic groin pain. (7% risk)

Thanks to advancements in technology, we have an effective alternative to traditional open surgery and laparoscopy. The da Vinci^® Surgical System enables the surgeons here in Grapevine to perform delicate and complex operations through a few small incisions.

Robotic surgery may be used to improve on the methods used in minimally invasive surgery. By means of robotic surgery, invasiveness is further minimized. When the surgeons here use robotic surgery, they can achieve greater levels of precision and visualization when operating on a patient. Robotic surgery allows us to see your organs in three dimensions. Mechanical arms, controlled precisely by specially designed computer software, replace hand movements. Robotic surgery in Grapevine provides for greater precision, smaller incisions and improved recovery times post-surgery.

Robotic surgery benefits

In simplest terms, robotic surgery is a very elaborate tool designed to allow surgeons to accomplish the complex surgical tasks and motions that they are used to doing through large open incisions with multiple tiny, 5-8 mm-sized incisions. This combination of dexterity and minimally invasive techniques combine to a result of accomplishing more tasks for the patient with less pain and quicker recovery.

Is robotic surgery safe?

The robot is a tool that we use. It is 100% controlled by your surgeon at all times. It has many safeguards to make sure that the surgeon is in control continuously. So the salient question is, do I trust my surgeon? We do everything in our power to earn your trust, and we feel that robotic surgery aids us in that pursuit.

Will I pay more?

Typically, no. There is no added billing attached to use of the robot by either your surgeon or your OR. In fact, in many cases, the shortened hospital stay, recovery and lessened pain leads to lower overall cost. While this can’t be guaranteed in every case, we can state that there is no up-charge related to having robotic surgery in Grapevine.