Dr. Luis V. Gorospe answers common questions about the benefits and risks of bariatric surgery. Dr. Gorospe is one of
the country's leading experts in bariatric surgery, having completed more than 3,000 procedures.
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Dr. Luis V. Gorospe attended Medical School at Manila Central University. He finished his residency of Family Practice at
the Singian Clinic and was in Private Practice in Manila, Phillippines. His Surgical Internship was at Hillcrest Medical
Center. He served as General Medical Officer at the Claremore Indian Hospital. He was in U. S. Public Health Service at
Galveston, Texas. He finished his General Surgery Residency at Oklahoma University, Tulsa Medical College and has been
in Private Practice in Tulsa, Oklahoma. Dr. Gorospe has held academic positions as Clinical Assistant Professor of General
Surgery at Oklahoma University - Tulsa Medical School and Oklahoma State University College of Osteopathic Medicine.
He is affiliated with Muskogee Community Hospital and Hillcrest Medical Center. He has held the positions of Chief Of
Staff, Chief of Surgery and Chairman of Quality Assurance Surgery at Doctors' Hospital, been a Member of Quality
Assurance Committee at Hillcrest Medical Center and St. John's Medical Center. He also had membership in numerous
Surgical Societies and other committees.
Among his many accomplishments, Dr. Gorospe has been: the first to perform Laparoscopic Colon Resection in Tulsa; the
first to perform Laparoscopic Extra-Peritoneal Balloon Hernia Repair in Oklahoma; the first to perform hand assisted
Laparoscopic Colon Resection in Tulsa; the first to perform Laparoscopic Roux-En-Y Gastric Bypass in Oklahoma; certified
to perform ABBI and Mammotome Breast Biopsy; performed a large number of Laparoscopic Fundoplications (Toupet and
Nissen) for control of Gastroesophogeal Reflux Disease; experienced in Intra Abdominal Adhesions (take down of scar
tissue inside of the abdominal cavity using Laparoscopic Technique); the first Doctor from Oklahoma to be a member of
the American Society of Bariatric Surgeons; an alternate delegate to American Medical Association.
His hobbies include: Judo and Ju-jitsu. He is the Head Instructor of Judo and Jujitsu at Southside Judo and Ju-jitsu School
in Tulsa. He was recognized as Outstanding Masters Judo Coach in 1998 and 2000 by the Oklahoma Judo Association and
was inducted to the United States Martial Arts Hall of Fame as Master Coach in 2000. He is married to Margo, and they
have three children: Anthony, Andrew and Allison.
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What are the routine tests before surgery?
Certain basic tests are done prior to surgery: a Complete Blood Count (CBC), Urinalysis, and a Chemistry Panel, which
gives a readout of about 20 blood chemistry values. Often a Glucose Tolerance Test is done to evaluate for diabetes,
which is very common in overweight persons. All patients but the very young get a chest X-ray and an electrocardiogram.
Women may have a vaginal ultrasound to look for abnormalities of the ovaries or uterus. Many surgeons ask for a
gallbladder ultrasound to look for gallstones. Other tests, such as pulmonary function testing, echocardiogram, sleep
studies, GI evaluation, cardiology evaluation, or psychiatric evaluation, may be requested when indicated.
What is the purpose of all these tests?
An accurate assessment of your health is needed before surgery. The best way to avoid complications is to never have
them in the first place. It is important to know if your thyroid function is adequate since hypothyroidism can lead to
sudden death post-operatively. If you are diabetic, special steps must be taken to control your blood sugar. Because
surgery increases cardiac stress, your heart will be thoroughly evaluated. These tests will determine if you have liver
malfunction, breathing difficulties, excess fluid in the tissues, abnormalities of the salts or minerals in body fluids, or
abnormal blood fat levels.
Why do I have to have a GI Evaluation?
Patients who have significant gastrointestinal symptoms such as upper abdominal pain, heartburn, belching sour fluid,
etc., may have underlying problems such as a hiatal hernia, gastroesophageal reflux or peptic ulcer. For example, many
patients have symptoms of reflux. Up to 15% of these patients may show early changes in the lining of the esophagus,
which could predispose them to cancer of the esophagus. It is important to identify these changes so a suitable
surveillance or treatment program can be planned.
Why do I have to have a Sleep Study?
The sleep study detects a tendency for abnormal stopping of breathing, usually associated with airway blockage when the
muscles relax during sleep. This condition is associated with a high mortality rate. After surgery, you will be sedated and
will receive narcotics for pain, which further depress normal breathing and reflexes. Airway blockage becomes more
dangerous at this time. It is important to have a clear picture of what to expect and how to handle it.
Why do I have to have a Psychiatric Evaluation?
The most common reason a psychiatric evaluation is ordered is that your insurance company may require it. Most
psychiatrists will evaluate your understanding and knowledge of the risks and complications associated with weight loss
surgery and your ability to follow the basic recovery plan.
What impact do my medical problems have on the decision for surgery, and how do the medical problems
affect risk?
Medical problems, such as serious heart or lung problems, can increase the risk of any surgery. On the other hand, if they
are problems that are related to the patient's weight, they also increase the need for surgery. Severe medical problems
may not dissuade the surgeon from recommending gastric bypass surgery if it is otherwise appropriate, but those
conditions will make a patient's risk higher than average.
If I want to undergo a gastric bypass, how long do I have to wait?
We offer a free monthly informational seminar that is mandatory attendance for those interested in scheduling for
surgery.Call the office to make a reservation as seating is limited. After the seminar if you still wish to pursue surgery,
call the office to schedule an Intake Visit with our Physician Assistant and staff. Generally you are able to get an Intake
Appointment within a month of calling.
The intake visit will accomplish 2 steps in the process.
1. We will find out if you meet the criteria for weight loss surgery and let you know what your insurance requires you to
do. Some insurance companies have steps for you to do before approving you. Some we know because we deal with
them frequently and sometimes insurance companies change their requirements, so we are not aware of changes. The
insurances that have upfront requirements need to be done before we send the letter of medical necessity. These
requirements are placed by the insurance companies to see if you are a compliant person, if you will be compliant after
surgery. Unfortunately most patients think they will not be required by their insurance to complete those steps. That is
not the case. If we have told you upfront you have hoops to jump through with your insurance company, it is because
your insurance company has told us the requirements for approving weight loss surgery. If you try to circumvent the
insurance requirements, it will take you longer to get approved than if you just met the requirements.
2. We will generate a letter of medical necessity to the insurance company.
After the letter goes out it is just a waiting game with your insurance company. Approval can take anywhere from 3
weeks to several months.
What can I do before the appointment to speed up the process of getting ready for surgery?
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Select a primary care physician if you don't already have one, and establish a relationship with him or her.
Work with your physician to ensure that your routine health maintenance testing is current. For example, women may
have a pap smear, and if over 40 years of age, a breast exam. And for men, this may include a prostate specific
antigen test (PSA).
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Make a list of all the diets you have tried (a diet history) and bring it to your doctor.
Bring any pertinent medical data to your appointment with the surgeon - this would include reports of special
tests (echocardiogram, sleep study, etc.) or hospital discharge summary if you have been in the hospital.
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Bring a list of your medications with dose and schedule.
Stop smoking. Surgical patients who use tobacco products are at a higher surgical risk.
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Laparoscopic Roux en Y
Laparoscopic Roux en Y is the most time proven weightloss surgery. A small stomach pouch is created and attached
directly to the proximal small bowel. Food intake is decreased due to the small stomach. Some hormonal changes occur
when the proximal small bowel is bypassed. The majority of the patients lose their appetite. The surgery discourages the
patients from eating large amounts of carbohydrates since they can develop uncomfortable symptoms of dumping
syndrome.
Laparoscopic Adjustable Banding
Laparoscopic Adjustable Banding is a surgical procedure wherein a band is placed around the upper stomach. The
band is tightened to restrict the passage of food from the upper stomach to the lower stomach. A port is placed under the
skin. Saline is injected into the port that is connected to the band. This will make the band thicker thus making the food
stay longer at the upper part of the stomach.
Laparoscopic Gastric Sleeve
Laparoscopic Gastric Sleeve is a surgical procedure that removes 70% - 80% of the stomach. This will restrict the
amount of food a patient can eat during meals.There is also a decrease in the amount of hormone that is secreted by the
stomach that makes us hungry.
Conversion Surgery - There are some cases when the Lap Adjustable Banding surgery does not result in the desired
weight loss and has to be converted to Lap Roux en Y Gastric Bypass or Lap Gastric Sleeve. This is done by removing the
band and performing the desired weight loss surgery. This surgery is more complex because of the presence of scar
tissue which can weaken the stomach wall. There is a slight increase in the complication rate with conversion surgery.
Revision Surgery is a procedure done to revise the surgery to either help in losing more weight or to correct any
problem pertaining to the weight loss surgery.
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Patient Stories
Brandee Vazquez Preop weight 240 lbs.
Postop weight 120 lbs.
Comments About Dr. Gorospe:
I had Laparascopic Gastric Bypass on October 15, 2003. I am 5'2" and on the day of surgery I weighed 240 lbs. I was
taking two different medications for blood pressure and was borderline diabetic. I tried every diet known to man and even
sought out a Doctor that prescribed several different medicines to help in the aid of losing weight. I never had problems
losing the weight. My issue was keeping the weight off by sticking with the life style changes. During July of 2003 I went
to see my regular Doctor to discuss my options for weight. I cried my eyes out while I pouring out my heart and soul to
her. She then asked me if I had ever thought about Gastric Bypass. To which I replied," Yes." She gave me the telephone
number of Dr. Gorospe's office and I immediately went home and made an appointment. I was approved about a month
later through my husbands insurance for surgery.
Dr. Gorospe is extremely knowledgeable in the field of Bariatric surgery. He is so kind and caring. He made me feel like I
was his only patient. His office staff is also wonderful and extremely professional.
I had no complications from surgery. I have now lost a total of 120 lbs. I am literally half the size I used to be. I went
from a size 22 to a size 2. I am no longer taking any medications for my blood pressure and the problems with blood
sugar went away.
My life has changed dramatically. I have so much energy now and I exercise faithfully 5 days a week. I love going to the
gym. I don't even sweat while working out. I used to be completely out of breath walking up and down the stairs in my
home and avoided them at all cost. Taking the stairs now is no longer an issue for me. I think one of the funniest and
most surprising aspects since having this surgery for me is that my husband has been accused of cheating on me a few
times. The only thing is the woman he has been accused of cheating on me with.... is me! My body and appearance have
changed so much. Life is good and I know I will be around for a long time to enjoy it with my husband and three children.
Pamela (Pammy) Graham
PreOp Weight 285
Current Weight 220 (and still losing)
Comments About Dr. Gorospe:
From the first time I set foot in the office, I knew this was it for me, and this Dr and the staff to get me and my family
through this experience. I could not have asked for a more knowledgeable and experienced surgeon as well as staff
(knowing some of the staff has undergone the experience at the hands of Dr G was a great comfort as well.) Dr Gorospe
showed great expertise and was willing to answer any question posed regardless of how rudimentary.... THANK YOU!
David Morgan
Pre Op Weight 364
Post Op Weight 194
Comments About Dr. Gorospe:
Words can not express the appreciation and admiration I have Dr. Gorospe. The level of care I have received from him,
and the staff, is just out of this world. The day of my consultation I left knowing I had picked the right place for my
surgery. Finally, I had found a doctor and a staff that understood the physical pain and mental anguish I was going
through. Today I am healthy, happy and alive! Thank you so much!
Robert Kubica
Tulsa, OK
Comments About Dr. Gorospe:
He seemed quite friendly and straightforward. His staff is very helpful and friendly on the phone. I have seen a few other
Doctors and when I mention his name, I get really great opinions of him. He is the most peer respected doctor I have
ever dealt with.