Click to view this email in a browser

Dear Friends and Family of LapSF and the Surgical Weight Loss Center of Hawaii

We hope this newsletter finds you off to a health and happy start for 2008! We have moved our San Francisco office downstairs to suite 110. We are also doing our first informational seminar and support group in Kauai. Due to the super patient participation in the Oahu and Kona groups, we hope Kauai will also be successful.

Other exciting news: We have hired a full-time psychologist. She will be starting on January 28th. LapSF and the Surgical Weight Loss Center of Hawaii are very happy to add another valuable resource to the patients. We will let her introduce herself in the next newsletter.

Petaluma Support Group Directions

There has been some confusion about our support group. The exit off of 101 is: Highway 116 East (not west). It is on the East side of 101 and South of 116. You can't miss it from the freeway. This road is also called "the Lakeville Highway". The meeting is in the Heron room on the lobby level.

Support Group Calendar

Attention Kauai Patients!

ImageWe are having our very first seminar and support group!

When: January 31st from 7pm-9pm
Where: Hilton Hilton Kauai Beach Resort,
4331 Kauai Beach Drive, Lihue, HI 96766.
Details: The first hour will be an informational seminar for pre-op patients, the second hour dedicated to post-op patients. Free parking.

Please email Nicole at for group ideas, suggestions, guest speakers, relevant meeting topics, etc.

Seminar and Support Group Schedule

Our San Francisco Office has Moved!

We have upgraded to a much more spacious and nicer office suite. We are still in the 2100 Webster Street building, now in suite 110. Stop by and check it out!

All office locations and addresses

Image Nutrition News by Jeannette Tejano

Eating out with some friends this weekend? Don’t know what to order? This can be challenging at times after having weight loss surgery, but here are some key items to look for on the menu and the food item description:
-Grilled -Baked
-Broiled -Steamed
-Boiled -Tomato/Broth based soups

Here are some appetizer items from some common neighborhood restaurants that are good choices:

Teriyaki Steak N’ Shrimp Skewers (Applebee’s)
Cajun Lime Tilapia (Applebee’s)
Wings Over Buffalo (Chili’s)
Chili and Side Salad (Chili’s)
Guiltless Grill Salmon (Chili’s)

Here are some common descriptions of foods to avoid when choosing an appetizer or entrée:
-Crispy -Creamy
-Breaded -Cheesy
-Fried - Breaded

Please feel free to email me at any time if you have any food questions:

Helpful links to look up nutrition facts on your favorite foods

Image Vertical Sleeve Gastrectomy update

The International Consensus Summit for Sleeve(Vertical) Gastrectomy on October 26th, 2007 was a meeting attended by surgeons from all over the world. Approximately 15 surgeons from different countries presented their experience. Many surgeons had only been doing the operation for 2-3 years and had less than 200 patients to report. The largest experience was right here in San Francisco at LapSF (Dr. Jossart and Dr. Cirangle) at over 900 patients since 2002. The next largest experience was from Belgium with 450 patients.

It was clear from the various presentations that the technique, pouch size, complications and results were quite different from surgeon to surgeon. Major complications ranged from less than 1% to more than 5%. Most surgeons were making the pouch too large and were offering it to higher weight(high BMI) patients only. Weight loss results were moslty limited to 1 year.

Our experience with over 900 sleeve gastrectomy plus 500 duodenal switch patients over 10 years has produced some very clear data and also the limitations of the procedure. The following points can be made:

1. A pouch less than 2 ounces(32 French bougie) is necessary for optimal weight loss. This has been our routine technique since 2002.
2. Five year weight loss results are still not available because so few patients have achieved that point. Our three year results show that weight loss is similar to the gastric bypass and the duodenal switch for patients with BMI under 55. It is unclear if any procedure is optimal for patients with a BMI over 55.
3. The cure rates for Diabetes, high blood pressure, high cholesterol, sleep apnea and other weight related problems are the same as the gastric bypass and duodenal switch. One only needs to attend one of our support groups or go online to verify all the diabetics that have been cured by this operation. Our diabetic cure rate is over 90%!
4. Insurance companies are still resistant to approving the procedure because of the lack of 5 year results and higher complication rates among less experienced surgeons. Please be sure to follow up and report your annual weight loss result so we can continue to publish our results and convince the insurance companies to approve this procedure!

In summary, the vertical sleeve gastrectomy will become more common as more results are published and the insurance companies update their policies. For additional questions surrounding this procedure please attend one of our support groups or call the office and ask to speak to one of our new patient coordinators or one of the doctors.

Learn more about the Vertical Sleeve Gastrectomy


Dr. Gregg Jossart ~ Dr. Paul Cirangle
Laparoscopic Associates of San Francisco
2100 Webster Street, Suite 110
San Francisco, CA 94115
(415) 561-1310/(415) 561-1713 fax

If you no longer wish to receive these emails, please reply to this message with "Unsubscribe" in the subject line or simply click on the following link: Unsubscribe
Laparoscopic Associates
2100 Webster Street, Suite 110
San Francisco, California 94115

Read the VerticalResponse marketing policy.