Dr. Ryan Tyner is used to achieving near-miraculous results when he performs minimally invasive gastric sleeve or gastric bypass bariatric surgery on severely obese patients.
“Some diabetic patients come in with insulin pumps,” Tyner says matter-of-factly. “I’ve had those patients leave the hospital with no medications and normal blood sugar in two days.”
While bariatric procedures are often pursued for the cosmetic benefits that accompany drastic weight loss, Tyner explains they’re actually a very effective form of life-saving metabolic surgery. People dealing with extreme obesity often suffer from serious conditions like diabetes, sleep apnea, hypertension and high cholesterol.
“It helps them reduce or get rid of these life-threatening medical problems,” Tyner says. A board-certified general surgeon with ABQ Health Partners, Tyner recently joined with UNM Sandoval Regional Medical Center and its physicians in a collaboration aimed at making the hospital the state’s premier bariatric surgery destination. The collaboration comes as UNM Hospital – under the direction of General Surgery Chief Dr. Chip Bellows – develops its own bariatric clinic, with surgeries to be performed at SRMC.
The American College of Surgeons recently awarded provisional accreditation to SRMC’s in-patient bariatric surgery center, which will undergo an independent, voluntary and rigorous peer evaluation in accordance with nationally recognized bariatric surgical standards. Full accreditation is pending a full site review by the American College of Surgeons.
“Bariatric surgery accreditation not only promotes uniform standard benchmarks, but also supports continuous quality improvement,” said Jen Ogden, bariatric program manager at SRMC.
ABQ Health Partners wanted to develop a comprehensive bariatric program to better serve patients in its health system, Tyner says. “We needed a facility to create an American College of Surgeons-accredited center of excellence,” he says, and to win that recognition, a hospital must consistently demonstrate excellent results.
When Tyner first met with SRMC’s leadership, he discovered they were on the same page. “They said explicitly, ‘We’re not interested in doing bariatric surgery unless we become a center of excellence,’” Tyner recalls. “We’re a very good fit and match.”
The key to the collaboration is the state-of-the-art 72-bed hospital, which opened in Rio Rancho in 2012. The building features extra-wide doors throughout, heavy-duty commodes that can support overweight patients and showers designed for people who are recovering from surgery.
Beds, stretchers, operating room tables – even the CT scanner – were meant to accommodate larger-than-average individuals. “They have facilities that outperform most of the other facilities in New Mexico,” Tyner says. “Sandoval was designed very well for that from its inception.”
ABQ Health Partners bariatric surgeons will share SRMC facilities with UNM bariatric surgeons, Tyner says. “What we envision is that the hospital is a center of excellence where there are two parallel programs where we help each other out,” he says.
Because the nursing staff will serve both programs, Tyner would like to develop a standardized post-operative care protocol that both can share. “I think that makes a huge difference in terms of making sure every patient gets great care,” he says.
Tyner also credits Dr. Tony Ogburn, SRMC’s chief medical officer, with making the UNM-ABQ Health Partners collaboration run so smoothly. “Dr. Ogburn and I are very much on the same page,” he says.
Ogburn says the bariatric partnership underscores SRMC’s multiple missions. “It’s a community hospital with the expertise of the university behind it,” he says.
With top-of-the-line facilities and both UNM and ABQ Health Partners surgeons on site, “We want to be the hospital of choice for bariatric surgery,” Ogburn says. He and Tyner think SRMC could handle 600 to 650 bariatric cases a year when the program is fully operational.
Most patients who come in for gastric sleeve or gastric bypass surgery can count on spending two nights in the hospital, Tyner says. They are put on liquids for two weeks following surgery, followed by two more weeks of a soft-food diet.
Patients often lose 40 to 45 pounds within the first month – and up to 200 pounds long-term – but they start to see metabolic improvements right away. About three-quarters percent of patients are diabetic, yet two-thirds leave the hospital no longer needing medication.
While the surgical outcomes are clearly life-changing, Tyner wants his patients to think of their bariatric procedure as merely a tool, albeit one with the potential to increase their lifespan and improve their quality of life.
Twenty-five percent of their success will depend on the surgeon, he tells them, and another 25 percent depends on diet and lifestyle changes. “Fifty percent is hard work for the rest of your life,” he says.