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HPV Vaccine: Who Should Get it and When?

Posted on 04/03/2018 at 10:00 AM

Child receiving a vaccination in the upper arm.

Sexually transmitted infections (STI) are still generally perceived as a taboo topic by much of society. In order to spread awareness and hopefully also lift the stigma associated with STI’s, today we are covering the human papillomavirus, otherwise known as HPV—the most common STI in the United States.

What is HPV?

The human papillomaviruses are a group of over 100 different virus types and strains that infect human skin and mucus membranes. HPV is the most common STI in the U.S. with the Center for Disease Control (CDC) stating that around “14 million people become newly infected each year,” and that nearly all sexually active people will get the virus at some point in their lives. The virus and its many strains can have many effects on the body including warts and even numerous cancers.

Often HPV is considered a women’s only issue, but that is not at all the case. The CDC reports that men are generally more at risk for HPV and are significantly more at risk for oral HPV: 11.5% of men age 18 to 69 compared to 3.3% of women.

In discussing HPV-associated cancers, the CDC states that cervical cancer is the most common for women, while oropharyngeal (throat) cancers are most common in men. Overall, the CDC sites that “more than 90% of anal and cervical cancers, about 70% of vaginal and vulvar cancers, and more than 60% of penile cancers,” are thought to be the result of HPV.

How effective is the vaccine?

Three approved vaccines prevent varying types of the virus. The most well know is Gardasil, which prevents types 6, 11, 16, and 18. There is also Cervarix, which just prevents types 16 and 18, and Gardasil 9, which prevents 6, 11, 16, and 18 as well as 31, 33, 45, 52, and 58.

As far as effectiveness goes, trials leading up to the approval of Gardasil and Cervarix found that they were nearly 100% effective, whereas the trials before the approval of Gardasil 9 found it to be closer to 97% effective.

Who should get it and when?

The CDC’s base recommendation suggests that women through the age of 26 and men through the age of 21 receive the vaccine. They go into more detailed recommendations for different sexual lifestyles and conditions toward the end of their HPV page for parents.

Should I get it?

While we recommend following the guidelines of the CDC, this vaccine is considered optional and we here at Surgical Associates of Grinnell support that this is a personal decision. We recommend consulting with your primary care provider or contacting our team to discuss the best care for you!

A Revolution in Non-Invasive Surgery: The da Vinci Surgical System

Posted on 03/07/2018 at 9:51 AM

The Da Vinci Surgical System robot. Though the new millennia has come and passed, the complete robot takeover promised by Hollywood during the latter half of the last century has not come to fruition (yet…); however, robots and robotic systems are becoming increasingly prominent in many industries, especially in health care.

The surgical robotics market has grown significantly since 2014 and estimates show that by 2020 it will have doubled in size to around $28.8 billion. This has led to big changes in the way doctors diagnose and the way surgeons develop procedures as these systems become more widespread in practices. One system is leading the charge.

Introducing the da Vinci Surgical System

First approved in 2000, the Da Vinci Surgical System is the first robotic surgery system approved by the FDA for general laparoscopic, also known as minimally invasive, surgery. The da Vinci system has been foundational in the development and improvement of new microsurgeries. Over the last 18 years, their prevalence across the United States and the world has grown significantly; as their numbers continue to grow, surgeons continue to discover the benefits.

Okay… how does it work?

The da Vinci system consists of a control console, an imaging cart, and three or four interactive arms, depending on the model. The surgeon uses the console to control the arms to perform the microsurgery while using the advanced 3D imaging cart to see what the arms see. The arms can hold many kinds of tools including scalpels, bovies, and scissors. The versatility of the system is continually tested and as time marches on, the abilities and precision of the system will continue to offer peace of mind to both surgeons and their patients.

How do we use it?

At Surgical Associates of Grinnell, we utilize the da Vinci Surgical System to assist our bariatric surgeons in performing internal laparoscopic surgery. Laparoscopic surgery is a technique where surgical procedures are performed through small incisions (typically around 1 centimeter). The da Vinci system allows our surgeons to perform laparoscopic procedures utilizing the advanced 3D imaging and the finely tuned finger controls. The superior visibility of the system and the precise controls reduce surgery and recovery time allowing for much higher overall success rates.

Want to learn more about robotic surgery and its history? Head on over here!

What is a Sleeve Gastrectomy?

Posted on 02/07/2018 at 3:49 PM

Women sizing her waist with measuring tape.

During the last century, surgical weight-loss procedures have advanced significantly as the understanding of gastrointestinal systems and bariatric treatments have progressed. The leading bariatric procedure since the 1960s has been gastric bypass, but a newer, less invasive procedure is gaining traction as an equally effective method of surgery-induced weight loss.

Sleeve Gastrectomy, also known as Gastric Sleeve Surgery, has seen a boom in acceptance from insurance companies, who are typically hesitant of new procedures, since 2010. However, this surprising change in pace from insurance companies does not come as a surprise to the surgeons conducting the procedure. Originally, the procedure is a part of another insurance-covered weight-loss procedure called duodenal switch surgery. Due to the length of the surgery, surgeons would divide the surgery into two stages, the first being the reduction of the stomach and the second being the bypassing of some of the intestines a year later. Reduction of the stomach entails removing the lower curvature of the stomach, which reduces the volume to about 15% of its original size and results in a sleeve structure remaining. The effectiveness of the first stage commonly resulted in surgeons not performing the second stage, and eventually, insurance companies caught on to the first stage’s effectiveness and reduced complications and started accepting it as a full procedure.

Sleeve Gastrectomy Compared to Gastric Bypass

There are many benefits and potential side effects to weigh for both gastric bypass and gastric sleeves. If you are considering either, the best way to learn which procedure is best for you is to consult your primary care provider and a bariatric specialist. Some of the differences are compared below, however.


Gastric Sleeve

Gastric Bypass

Weight Loss Method


Restriction and Malabsorption

Average Surgery Duration (in minutes)



Average Projected Weight Loss (%)



Complication Rate (%)



*Park JY, Kim YJ. Laparoscopic gastric bypass vs. sleeve gastrectomy in obese Korean patients. World Journal of Gastroenterology. 2015;21(44):12612-12619. doi:10.3748/wjg.v21.i44.12612.

**Lager CJ, Esfandiari NH, Subauste AR, et al. Roux-En-Y Gastric Bypass Vs. Sleeve Gastrectomy: Balancing the Risks of Surgery with the Benefits of Weight Loss. Obesity Surgery. 2017;27(1):154-161. doi:10.1007/s11695-016-2265-2.

These numbers should help give a very broad idea of the difference in results for both of these popular procedures, nonetheless, if you are looking into surgical weight loss please consult your doctor or contact our Bariatric Team for individualized, informed opinions on your bariatric health.

Resolution Check In: Are You Sticking To Your Goals?

Posted on 01/11/2018 at 2:03 PM

"Resolutions" spelled out in Scrabble tiles.

New Year’s has come and passed and with that many set resolutions to better themselves. Unfortunately, research shows that 80% of resolutions fail by mid-February. Below we outline some popular resolutions, why they typically fail, and some strategies for overcoming the challenges.

Around 44% of Americans make a resolution for the New Year and these resolutions all focus on self-betterment whether that is physical or mental. Below are the top five most common New Year’s resolutions:

1.       Exercise more – 38%

2.       Lose weight – 33%

3.       Eat more healthily – 32%

4.       Take a more active approach to health – 15%

5.       Learn new skill or hobby – 15%

We all know about the surge in traffic at the gym as the New Year begins and the quick resolve to normal as many give up on their resolution, but why? Why do so many give up on bettering themselves? Some of the typical reasons are:

  • Unrealistic expectations
    • Resolutions are meant to be a challenge, but choosing a resolution outside the realm of possibility for you immediately sets you up for failure.
  • Ill-defined resolutions
    • Just as unrealistic expectations can lead to abandoning your resolution so can having a vague or unmeasurable goal.
  • Wrong mindset
    • Being passive in reaching your goals instead of being proactive can lead to a misunderstanding of the amount of work your resolution will take, leading to a sudden realization that your goal is unobtainable.
  • Bad time management skills
    • Not planning enough time for you to work to reach your goal will keep you pushing the resolution off until the next New Year is here.
  • Distractions
    • Even minor distractions (excuses) can add up.

Overcoming these reasons for failure does not have to be a daunting task. There are powerful strategies to try:

  • Be specific
  • Make it measurable
  • Make it achievable
  • Make it realistic
  • Make it exciting

So, how are you doing so far in 2018? Have you given up already? There is still time! Of course, there is no shame in moving on, but there is even less in adapting your resolution to be more obtainable. Let us know how your 2018 has been so far in the comments below!

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