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McGill University Health Centre
What is the McGill University Health Center (MUHC)? Located in Montreal, the MUHC is a merger of five teaching hospitals affiliated with McGill University—The Montreal Children's Hospital, The Montreal General Hospital, The Royal Victoria Hospital (shown above), and The Montreal Neurological Hospital, as well as The Montreal Chest Institute. Building on the tradition of medical leadership of the founding hospitals, our goal is to provide patient care based on the most advanced knowledge in the health care field, and to contribute to the development of new knowledge. We are proud of our reputation for excellence with our clinical programs, research and teaching. Which Operations are done at the MUHC?The MUHC is a tertiary care institution able to treat patients with complicated diseases and complications because of a state of the art intensive care unit, dialysis capability etc. For this reason we reserve the limited number of beds and operating room time available to us for the most high risk bariatric surgery patients. The decision to accept patients for treatment at the MUHC is based on the BMI, sex and obesity associated diseases that afflict our patients. We use the Case History Form that is filled out by our patients to determine a Points Score to help us prioritize their position on the waiting list. More details are presented in the “Let's Get Started Together” section. History of Bariatric Surgery at the MUHC The first weight loss surgery was performed at the Royal Victoria Hospital in 1963 by Dr. H. Shibata and Dr. R. Long. Dr. Shibata and Dr. Lloyd D MacLean started performing the Jejunoileal bypass in 1967. This procedure was discontinues in 1980 when Dr. McLean and others reported significant complications after long-term follow-up, including malnutrition, liver failure, severe diarrhea, and electrolyte imbalance. Dr. MacLean, Dr. R. Armour Forse, and Dr. Peter McLean switched to vertical banded gastroplasty until 1989 when Dr. MacLean showed much better weight loss and reduced complications when vertical gastroplasty was compared to the vertically based gastric pouch Roux-en-Y gastric bypass (RYGBP) Since 1989 Drs. MacLean, Forse, Nohr, McLean and Christou offered the open RYGBP at the RVH site of the MUHC and Dr. Brown the loop gastrojejunostomy gastric bypass (horizontal based gastric pouch) at the MGH site. Dr. Forse relocated to the USA in 1988. Dr. Nohr relocated to Alberta in 1995. Dr. LD MacLean retired from surgery in 1994 and Dr. APH McLean in 2000. Dr. Christou continued to offer open RYGBP to clients at the MUHC up to February 8th 2002. The most frequent complication observed after open bariatric surgery including RYGBP, was a wound infection and/or incicional hernia seen in 1 out of every 3 patients. One way to prevent the development of a wound infection is not to make a large incision. This could be accomplished by a laparoscopic approach to the Isolated RY gastric bypass. After visiting with experts in laparoscopic and bariatric surgery and months of simulator training Dr. Christou performed the first laparoscopic RYGBP at the MUHC on February 8th 2002 with Dr. Marvin Wexler assisting. The first case took 5 hours and 20 minutes to complete. The patient left the hospital in 60 hours! On February 25th 2003 Dr. Christou inserted the first laparoscopic adjustable gastric banding device. This was a Lap-Band® with Dr. Paul O’Brien a Visiting Professor at the MUHC assisting.
Dr. Simon Biron visiting professor from University of Laval in Quebec City (next to Dr. Christou) recently gave Grand Rounds to the Department of Surgery and also attended laparoscopic surgery sessions in the operating room. Next to him is Dr. Brian Colquhoun from Saskatchewan and Dr. Pieter Seshadri also from Saskatchewan (far left).
Dr. Olivier Court joined Dr. Christou at the MUHC in September 2005 and has added the laparoscopic biliopancreatic diversion with duodenal switch (BPDDS) to the armamentarium of bariatric surgery procedures offered by our team. |
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We also provide training in laparoscopic bariatric surgery to established surgeons across the country. Drs. Josee Mihangos and Dennis Bruilette from Val D’Or have been trained and currently perform about 25 laparoscopic RY gastric bypasses per year. Most recently Dr. Sylvain Beausoleil from Moncton NB finished a one month preceptorship at the MUHC and has performed his first 2 laparoscopic RY gastric bypasses in Moncton. He is the one at far left next to Ms. Lilly Poon, Head Nurse main OR theaters 11&12, and Dr. Fahad Bemeriz, laparoscopic fellow from McMaster University (here on a 2 month observational training). 
Some of our Alumni are also coming back for training in the laparoscopic RY gastric bypass and adjustable gastric banding at the MUHC. Dr. Carl Nohr recently completed a 2-day preceptorship along with Drs. Klein (far left) and Dr. L. Smith (far right) from Toronto. Dr. Jody Bothwall, a former resident is scheduled to come in January 2004 and Drs. Parek and Reed from Guelph are scheduled to train in February. They have scheduled their first cases for March 4-5th and Dr. NV Christou will go on site to proctor them to ensure all goes well. Surgeons from Saskatchewan are scheduled in March. 
Dr. Patrick Yau (far right) and Dr. J. Joffe (left of Dr. Christou) recently participated in a one day preceptorship in Laparoscopic RY gastric bypass surgery at the MUHC. They exchanged ideas with Dr. Christou and discussed all laparoscopic approaches including adjustable gastric banding
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