What’s your background in medicine and what led you to this area of specialization?
I always knew I wanted to be a doctor. I thought I was going to end up as a family doctor, but I wound up loving surgery at Parkland Hospital in Dallas, Texas. I went to Southwestern Medical School. The Army paid for my medical school training. I wound up in Tacoma, Washington at the Madigan Army Medical Center, where I met a Dr. Eddie Reddick from Nashville, Tennessee. Eddie helped develop laparoscopic general surgery. Eddie and I became friends. When I got out of the military, I came down to Marietta GA to be part of the Advanced Laparoscopic Training Center (ALTC). This was back in 1991. ALTC trained thousands of general surgeons in various laparoscopic procedures and I was on the faculty. That’s when I got interested in advanced laparoscopy: Nissen fundoplication, colectomy, and splenectomy. In November 1991 we were one of the first in the country to perform a successful laparoscopic Nissen fundoplication. Antireflux surgery has always been my favorite surgical procedure even when they were performed open through large incisions. Subsequently I developed some special instruments which made antireflux surgery easier to perform laparoscopically. We developed an esophageal retractor, fundic grasper, and DeBakey graspers. During the same time period we helped develop laparoscopic hand-assisted surgery for colectomies and splenectomies. I’ve been involved with the advanced laparoscopic procedures since the 1991.
What would you say sets your practice apart from other Doctors’?
We were one of the first surgeons in the United States to perform advanced laparoscopic surgical procedures, like the antireflux surgery, splenectomies and colectomies. Initially there was reluctance by the some surgeons to perform advanced laparoscopic procedures. We got a reputation for performing advanced laparoscopic procedures. As our experience grew and we were seeing more and more patients, and the outcomes were good, we continued to do the procedures that the other surgeons were not doing. At present we have on of the largest series of patients having laparoscopic antireflux surgery in the country. Some of the patients that we see, not an insignificant number, are referred by other patients that we’ve already operated on and had a good experience.
How do you see the relationship between you and your patient?
I’ve been in surgical practice in Marietta since 1991. So I’ve had plenty of long term follow-up with my patients. My patients know where I am. If there’s any kind of problem at all, they know I want to know about it. Occasionally people have problems over time. Our relationships with the patients are good. Even before I operate on them, I tell them I’ll never leave them. If they have a problem, we’ll fix it or figure out what it is, because a lot of times, people have symptoms that they think is reflux and it’s a gall bladder or some other things going on. Around the time of surgery, we see them frequently. We see them before surgery, and at one and three weeks after surgery, and as needed afterwards. Most of our patients don’t come back, but if they ever do, I’m happy to see them. Availability, that’s what I offer.
What is the value and place of patient education in your practice?
It’s extremely important because patients need to understand what’s going on as far as the disease process, their symptoms, and what we do to change those symptoms. The patients have to comply with the instructions. After surgery there can be a lot of edema or swelling at the reconstructed valve. It is very important that they understand that they have to eat slowly, chew well, for about 3 weeks after surgery. Women do this very well, men tend to gobble things down. We spend quite a bit of time teaching them about their postoperative diet. I draw pictures of the surgery while I explain the surgical procedure. I try to educate them as much as I can, and if they have any questions we answer them.
Why are you an expert?
Since 1991 I’ve performed over 1,500 successful laparoscopic antireflux procedures. This number includes over 400 redo or revision antireflux surgeries. To date there has been no injuries to the esophagus and no operative deaths. There has been one conversion to open surgery and that was over 20 years ago. I designed some laparoscopic instrument to perform antireflux surgeries. I designed a special mesh to repair complex hiatal hernias. I’ve authored or co-authored three published articles about laparoscopic antireflux surgery. My intense interest, long term experience, surgical publications, instrument and mesh design support my expertise in the field of laparoscopic antireflux surgery.
Copies of Selected Articles
- Laparoscopic Management of Failed Antireflux Surgery
- Parietex Mesh Repair of the Esophagael Hiatus: 10 Year Experience (Submitted for Publication)
- Laparoscopic Posterior Partial Fundoplication: Analysis of 100 Consecutive Cases
- Laparoscopic Nissen Fundoplication: Report of First 15 Cases
- Laparoscopic Anti-Reflux Surgery