Vivek Prachand, MD

I am a nationally-recognized expert in minimally invasive abdominal surgery. I am skilled at the most advanced laparoscopic procedures, and perform more than 200 laparoscopic abdominal surgeries each year. One of my special interests is minimally invasive obesity surgery. In addition to performing the laparoscopic Roux-en-Y gastric bypass, sleeve gastrectomy, and Lap-Band procedures, in 2002 I was the first surgeon in the Midwest to perform a totally laparoscopic biliopancreatic diversion with duodenal switch. I am one of a handful of surgeons worldwide who regularly performs the laparoscopic duodenal switch for super-obese (body mass index greater than 50) and super-super-obese patients (body mass index greater than 60), and have performed this procedure in several hundred patients.

Of particular interest to me is the development of an evidence-based algorithm for bariatric procedure selection based on the severity of obesity and its associated co-morbidities, particularly in the setting of super-obesity, which is the group most rapidly increasing in prevalence and which historically has been the most difficult to treat medically or surgically. Accordingly, a major research interest of mine is to compare the mechanisms and effects of the different bariatric procedures on the pathophysiology of obesity and its related comorbidities, particularly Type 2 Diabetes (T2D). Bariatric surgery frequently leads to remission of T2D, although some operations are more effective than others, and the relative contribution of weight loss, dietary changes, and changes in gastrointestinal physiology to this exciting phenomenon is not well understood. Additionally, although there is a clear relationship between obesity and T2D, two- thirds of all severely obese individuals undergoing obesity surgery do not in fact have T2D: we hypothesize that these individuals may have important physiologic factors that protect them from developing diabetes despite their severe obesity. As such, through my research collaborations with other members of the Kovler Diabetes Center, we hope to understand these mechanisms that appear to be fundamental for both the prevention and treatment of Type 2 Diabetes.

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