Farah Husain

Interests

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Courses

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Scholarly Contributions

Chapters

• Husain, F. A. (2023). Marginal Ulcer and Gastrogastric fistula. In Metabolic and Bariatric Surgery examination and board review(pp 219-221). USA: McGraw Hill.
• Husain, F. A., & Pottorf, B. J. (2023). Gastric Cancer. In General Surgery Examination and Board Review(pp 108-111). McGraw Hill.
• Husain, F. (2019). Laparoscopic Sleeve Gastrectomy and Roux-en-Y Gastric Bypass. In Netter’s Surgical Anatomy and Approaches.
• Husain, F. (2020). Hiatal Hernia and Bariatric Surgery. In Difficult Decision Making.
• Husain, F. (2018). Bariatric Meditourism (Bidirectional).. In SAGES Manual of Bariatric Surgery..
• Husain, F. (2018). Open Lateral to Medial Right Colectomy. In Master Techniques in General Surgery Colon and Rectal Surgery: Abdominal, ed. II.
• Husain, F. (2016). Gastric Adenocarcinoma. In General Surgery Examination and Board Review. 1 st Ed..
• Husain, F. (2012). Recurrent Incisional Hernia. In Advances in Abdominal Wall Reconstruction..
• Husain, F. (2011). Open Right Colectomy: Lateral to Medial.. In Master Techniques in General Surgery Colon and Rectal Surgery: Abdominal, ed. 1..
• Husain, F. (2011). Single-incision Laparoscopic Right Colectomy. In Atlas of Minimally Invasive Surgery..

Journals/Publications

• Clapp, B., Janik, M., Corbett, J., Vahibe, A., Ul Hassan, O., Husain, F., Pullat, R., & Ghanem, O. M. (2023). Duodenal switch without versus with laparoscopic cholecystectomy: a perioperative risk comparative analysis of the MBSAQIP database (2015-2019). Surgical endoscopy, 37(1), 219-224.
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  The results of concurrent cholecystectomy with Roux-en Y gastric bypass and sleeve gastrectomy have been well elucidated. Large-scale data on the outcomes of concomitant cholecystectomy during biliopancreatic diversion with duodenal switch (BPD-DS) are still lacking. Our study aimed to explore whether simultaneous cholecystectomy with BPD-DS alters the 30-day postoperative outcomes.
• Husain, F. A. (2023). Invited Commentary: Evolution of Metabolic and Bariatric Surgery. Journal of the American College of Surgeons, 236(1), 166-167.
• Kermansaravi, M., Husain, F. A., Bashir, A., Valizadeh, R., Abbas, S. I., Abouzeid, T., Amini, M., Davarpanah Jazi, A. H., Elfawal, M. H., Gado, W., Gee, T., Habeeb, T. A., Al Hadhrami, B., Inam, A., Vaziri, N. M., Mokhber, S., Al-Momani, H., Omerov, T., Pazouki, A., , Rezapanah, A., et al. (2023). International survey on complications of religious fasting after metabolic and bariatric surgery. Scientific reports, 13(1), 20189.
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  Religious fasting in Ramadan the 9th month of the lunar year is one of five pillars in Islam and is practiced for a full month every year. There may be risks with fasting in patients with a history of metabolic/bariatric surgery (MBS). There is little published evidence on the possible complications during fasting and needs stronger recommendations and guidance to minimize them. An international survey was sent to surgeons to study the types of complications occurring during religious fasting in patients with history of MBS to evaluate the risk factors to manage and prepare more evidence-based recommendations. In total, 21 centers from 11 countries participated in this survey and reported a total of 132 patients with complications occurring during religious fasting after MBS. The mean age of patients with complications was 36.65 ± 3.48 years and mean BMI was 43.12 ± 6.86 kg/m. Mean timing of complication occurring during fasting after MBS was 14.18 months. The most common complications were upper GI (gastrointestinal) symptoms including [gastroesophageal reflux disease (GERD), abdominal pain, and dyspepsia], marginal ulcers and dumping syndrome in 24% (32/132), 8.3% (11/132) and 23% (31/132) patients respectively. Surgical management was necessary in 4.5% of patients presenting with complications (6/132) patients due to perforated marginal or peptic ulcer in Single Anastomosis Duodenoileostomy with Sleeve gastrectomy (SADI-S), one anastomosis gastric bypass (OAGB) and sleeve gastrectomy (SG), obstruction at Jejunojenostomy after Roux-en-Y gastric bypass (RYGB) (1/6) and acute cholecystitis (1/6). Patients after MBS should be advised about the risks while fasting including abdominal pain, dehydration, and peptic ulcer disease exacerbation, and a thorough review of their medications is warranted to minimize complications.
• Kermansaravi, M., Parmar, C., Chiappetta, S., Shikora, S., Aminian, A., Abbas, S. I., Angrisani, L., Bashir, A., Behrens, E., Bhandari, M., Clapp, B., Cohen, R., Dargent, J., Dilemans, B., De Luca, M., Haddad, A., Gawdat, K., Elfawal, M. H., Himpens, J., , Huang, C. K., et al. (2023). Best practice approach for redo-surgeries after sleeve gastrectomy, an expert's modified Delphi consensus. Surgical endoscopy, 37(3), 1617-1628.
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  Sleeve gastrectomy (SG) is the most common metabolic and bariatric surgical (MBS) procedure worldwide. Despite the desired effect of SG on weight loss and remission of obesity-associated medical problems, there are some concerns regarding the need to do revisional/conversional surgeries after SG. This study aims to make an algorithmic clinical approach based on an expert-modified Delphi consensus regarding redo-surgeries after SG, to give bariatric and metabolic surgeons a guideline that might help for the best clinical decision.
• Craggs-Dino, L., El Chaar, M., Husain, F. A., Rogers, A. M., Lima, A. G., Sadegh, M., Bashiti, J., Chapmon, K., & , A. S. (2022). American Society for Metabolic and Bariatric Surgery review on fasting for religious purposes after surgery. Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery, 18(7), 861-871.
• Hermes, S. M., Bharadwaj, M., Miller, N. R., Waslo, C., Husain, F. A., Wolfe, B. M., & Tanne, E. (2022). Long-Term Outcomes of Bariatric Surgery in Idiopathic Intracranial Hypertension Patients. The neurologist.
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  Idiopathic intracranial hypertension (IIH), a rare neurological disorder, has limited effective long-term treatments. Bariatric surgery has shown short-term promise as a management strategy, but long-term efficacy has not been evaluated. We investigated IIH-related outcomes 4 to 16 years postsurgery.
• Husain, F., Su, W., & Tomaiko-Clark, E. (2022).

  Weight loss and atrial fibrillation: a review

  . Current Opinion in Cardiology, 38(1), 6-10. doi:10.1097/hco.0000000000001004
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  Despite technological advancements in catheter ablation, patients with atrial fibrillation often require multiple ablations, with diminishing returns depending on duration and persistence. Although early ablation is vital, modification of atrial fibrillation disease can be achieved with modification of existing risk factors. Obesity is an important modifiable risk factor, but there does not appear to be a consensus on the best method or goal for weight reduction.The relationship between atrial fibrillation and obesity has been acknowledged. This review examines the clinical evidence demonstrating the benefit of weight reduction in the management of atrial fibrillation. In particular, this review compares the different approaches of recent studies.On the basis of the literature, the authors recommend a structured weight loss programme with dietary and behavioural modifications individualized to each patient and including the implementation of physical activity. Consideration of bariatric surgery is appropriate in certain patients with obesity.
• Lyo, V., Stroud, A., Wood, S., Macht, R., Carter, J., Rogers, S., & Husain, F. (2022). Reoperations after sleeve gastrectomy: a dual academic institutional experience. Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery, 18(5), 641-649.
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  Although laparoscopic sleeve gastrectomy (LSG) is the most common bariatric operation performed worldwide, patients can experience complications and poor outcomes that warrant reoperations. The incidence, indications, and outcomes of reoperations are not well understood.
• Majid, S. F., Husain, F. A., Choi, Y., Gill, S., Schirmer, B., Kroh, M., & Kurian, M. (2022). The SAGES MASTERS program presents the 10 seminal articles for Roux-en-Y gastric bypass. Surgical endoscopy, 36(1), 6-15.
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  One of the eight clinical pathways of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) Masters Program is bariatric surgery which includes three anchoring procedures. For each anchoring procedure sentinel articles have been identified to enhance participant surgeon lifelong learning. Roux-en-Y gastric bypass (RYGB) is one of the 3 anchoring procedures for the Bariatric Pathway. In this article we present the top 10 seminal articles regarding the RYGB which surgeons should be familiar with.
• Thurston, T., Dolan, J. P., Husain, F., Stroud, A., Funk, K., Borzy, C., & Zhu, X. (2022). Assessment of muscle activity and fatigue during laparoscopic surgery. Surgical endoscopy, 36(9), 6672-6678.
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  Cumulative musculoskeletal stress during operative procedures can contribute to the development of chronic musculoskeletal injury among surgeons. This is a concern in laparoscopic specialties where trainees may incur greater risk by learning poor operative posture or technique early in training. This study conducted an initial investigation of the physical stress encountered during the conduct of foregut laparoscopic surgery.
• Thurston, T., Dolan, J. P., Husain, F., Stroud, A., Funk, K., Borzy, C., & Zhu, X. (2022). Correction: Assessment of muscle activity and fatigue during laparoscopic surgery. Surgical endoscopy, 36(11), 8697.
• Worrest, T., Malibiran, C. C., Welshans, J., Dewey, E., & Husain, F. (2022). Marijuana use does not affect weight loss or complication rate after bariatric surgery. Surgical endoscopy, 36(9), 6931-6936.
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  Marijuana use has been legalized in several states. It is unclear if marijuana use affects weight loss outcomes or complication rates following bariatric surgery. The purpose of this study was to determine if patients who use marijuana had higher complication rates or lower weight loss compared with non-users.
• Mahawar, K. K., Omar, I., Singhal, R., Aggarwal, S., Allouch, M. I., Alsabah, S. K., Angrisani, L., Badiuddin, F. M., Balibrea, J. M., Bashir, A., Behrens, E., Bhatia, K., Biertho, L., Biter, L. U., Dargent, J., De Luca, M., DeMaria, E., Elfawal, M. H., Fried, M., , Gawdat, K. A., et al. (2021). The first modified Delphi consensus statement on sleeve gastrectomy. Surgical endoscopy, 35(12), 7027-7033.
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  Sleeve gastrectomy (SG) is the commonest bariatric procedure worldwide. Yet there is significant variation in practice concerning its various aspects. This paper report results from the first modified Delphi consensus-building exercise on SG.
• Pouwels, S., Omar, I., Aggarwal, S., Aminian, A., Angrisani, L., Balibrea, J. M., Bhandari, M., Biter, L. U., Blackstone, R. P., Carbajo, M. A., Copaescu, C. A., Dargent, J., Elfawal, M. H., Fobi, M. A., Greve, J. W., Hazebroek, E. J., Herrera, M. F., Himpens, J. M., Hussain, F. A., , Kassir, R., et al. (2021). The First Modified Delphi Consensus Statement for Resuming Bariatric and Metabolic Surgery in the COVID-19 Times. Obesity surgery, 31(1), 451-456.
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  The purpose of this study was to achieve consensus amongst a global panel of expert bariatric surgeons on various aspects of resuming Bariatric and Metabolic Surgery (BMS) during the Coronavirus Disease-2019 (COVID-19) pandemic. A modified Delphi consensus-building protocol was used to build consensus amongst 44 globally recognised bariatric surgeons. The experts were asked to either agree or disagree with 111 statements they collectively proposed over two separate rounds. An agreement amongst ≥ 70.0% of experts was construed as consensus as per the predetermined methodology. We present here 38 of our key recommendations. This first global consensus statement on the resumption of BMS can provide a framework for multidisciplinary BMS teams planning to resume local services as well as guide future research in this area.
• Stroud, A. M., Dewey, E. N., Husain, F. A., Fischer, J. M., Courcoulas, A. P., Flum, D. R., Mitchell, J. E., Pories, W. J., Purnell, J. Q., & Wolfe, B. M. (2020). Association between weight loss and serum biomarkers with risk of incident cancer in the Longitudinal Assessment of Bariatric Surgery cohort. Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery, 16(8), 1086-1094.
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  Bariatric surgery reduces cancer risk in populations with obesity. It is unclear if weight loss alone or metabolic changes related to bariatric surgery cause this effect.
• Bonanno, A., Tieu, B., Dewey, E., & Husain, F. (2019). Thoracoscopic truncal vagotomy versus surgical revision of the gastrojejunal anastomosis for recalcitrant marginal ulcers. Surgical endoscopy, 33(2), 607-611.
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  Marginal ulcer is a common complication following Roux-en-Y gastric bypass with incidence rates between 1 and 16%. Most marginal ulcers resolve with medical management and lifestyle changes, but in the rare case of a non-healing marginal ulcer there are few treatment options. Revision of the gastrojejunal (GJ) anastomosis carries significant morbidity with complication rates ranging from 10 to 50%. Thoracoscopic truncal vagotomy (TTV) may be a safer alternative with decreased operative times. The purpose of this study is to evaluate the safety and effectiveness of TTV in comparison to GJ revision for treatment of recalcitrant marginal ulcers.
• Turner, M., Vigneswaran, Y., Dewey, E., Wolfe, B. M., Stroud, A. M., Spight, D., Flum, D. R., Courcoulas, A., Mitchell, J. E., Pories, W. J., Pomp, A., & Husain, F. A. (2019). Weight loss and co-morbidity resolution between different races and ethnicities after gastric bypass. Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery, 15(11), 1943-1948.
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  Several studies have demonstrated that minorities and Hispanic ethnicities have disproportionally greater burden of morbid obesity in the United States. However, the majority of bariatric procedures are performed in the non-Hispanic white population.
• Bauer, F. L., Donahoo, W. T., Hollis, H. W., Tsai, A. G., Pottorf, B. J., Johnson, J. M., Silveira, L. J., & Husain, F. A. (2018). Marijuana's Influence on Pain Scores, Initial Weight Loss, and Other Bariatric Surgical Outcomes. The Permanente journal, 22, 18-002.
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  Pain management can be challenging following bariatric surgery, and patients with obesity tend to increase opioid use after undergoing surgery. This report quantifies marijuana (MJ) use and its relationship to pain and other surgery-related outcomes in a population from a state that has legalized MJ.
• Husain, F. A. (2018). Comment on: portomesenteric vein thrombosis in sleeve gastrectomy: a 10 year review. Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery, 14(3), 276.
• Husain, F., Jeong, I. H., Spight, D., Wolfe, B., & Mattar, S. G. (2018). Risk factors for early postoperative complications after bariatric surgery. Annals of surgical treatment and research, 95(2), 100-110.
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  Vertical sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) are currently the most common bariatric procedures. Although the safety of these operations has markedly improved, there continues to be a certain rate of complications. Such adverse events can have a significant deleterious effect on the outcome of these procedures and represent a costly burden on patients and society at large. A better understanding of these complications and their predictive factors may help ameliorate and optimize outcomes.
• Hansen, S. K., Pottorf, B. J., Hollis, H. W., Rogers, J. L., & Husain, F. A. (2017). Is it necessary to perform full pathologic review of all gastric remnants following sleeve gastrectomy?. American journal of surgery, 214(6), 1151-1155.
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  This study attempts to determine if enough pathological abnormalities in gastric remnants from sleeve gastrectomy exist to warrant full pathologic evaluation in all remnants.
• Pottorf, B. J., Husain, F. A., Hollis, H. W., & Lin, E. (2014). Laparoscopic management of duodenal obstruction resulting from superior mesenteric artery syndrome. JAMA surgery, 149(12), 1319-22.
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  Duodenal obstruction by compression from the superior mesenteric artery (SMA) can be managed using minimally invasive techniques initially developed for bariatric patients requiring gastric bypass.
• Davis, S. S., Husain, F. A., Lin, E., Nandipati, K. C., Perez, S., & Sweeney, J. F. (2013). Resident participation in index laparoscopic general surgical cases: impact of the learning environment on surgical outcomes. Journal of the American College of Surgeons, 216(1), 96-104.
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  The NSQIP database enables measurement of postoperative outcomes across a spectrum of practice settings. This allows for observations about potential effects of resident participation in surgical care during training.
• Nandipati, K., Lin, E., Husain, F., Perez, S., Srinivasan, J., Sweeney, J. F., & Davis, S. S. (2013). Factors predicting the increased risk for return to the operating room in bariatric patients: a NSQIP database study. Surgical endoscopy, 27(4), 1172-7.
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  The objective of the study was to assess the risk factors associated with return to the operating room in bariatric surgery patients.
• Brockmeyer, J. R., Simon, T. E., Jacob, R. K., Husain, F., & Choi, Y. (2012). Upper gastrointestinal swallow study following bariatric surgery: institutional review and review of the literature. Obesity surgery, 22(7), 1039-43.
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  The aim of this study was to determine the efficacy of routine upper gastrointestinal imaging following the three forms of laparoscopic bariatric surgery completed at our institution (laparoscopic Roux en Y gastric bypass (LRYGB), laparoscopic sleeve gastrectomy (LS), and laparoscopic adjustable gastric banding (LAGB)).
• Nandipati, K. C., Lin, E., Husain, F., Srinivasan, J., Sweeney, J. F., & Davis, S. S. (2012). Counterclockwise rotation of Roux-en-Y limb significantly reduces internal herniation in laparoscopic Roux-en-Y gastric bypass (LRYGB). Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 16(4), 675-81.
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  Internal hernias continue to be a significant source of morbidity after LRYGB. Literature addressing the technique of Roux limb construction as a predisposing factor is sparse. The objective of this study is to evaluate the impact of Roux limb construction technique on the development of internal hernias.
• Simon, T. E., Scott, J. A., Brockmeyer, J. R., Rice, R. C., Frizzi, J. D., Husain, F. A., & Choi, Y. U. (2011). Comparison of staple-line leakage and hemorrhage in patients undergoing laparoscopic sleeve gastrectomy with or without Seamguard. The American surgeon, 77(12), 1665-8.
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  Laparoscopic sleeve gastrectomy (LSG) has been recognized as a primary procedure for the surgical management of morbid obesity. Staple-line leaks and hemorrhage are two associated complications. Staple-line buttressing materials have been suggested to decrease these complications. When used during LSG, few published papers exist that compare the incidence of leak or hemorrhage to that of nonreinforced staple-lines. The purpose of this study was to compare the incidence of leak and hemorrhage in patients who did and did not receive reinforcement with Seamguard (W.L. Gore & Associates, Flagstaff, AZ). This is a retrospective analysis of patients undergoing LSG. All patients met National Institutes of Health criteria and each had an extensive preoperative evaluation. Data was collected from inpatient and outpatient medical records. Fifty-nine patients received reinforcement and 80 patients did not. There was no significant difference in mean body mass index, age, or gender make-up between the two groups. The overall incidence of leak was 3.60 per cent. The incidence was 3.39 per cent in patients who received reinforcement and 3.75 per cent in those who did not. This was not statistically significant. There was no incidence of staple-line hemorrhage in either group. There is no conclusive evidence that Seamguard reduces staple-line leakage or hemorrhage. Studies involving a larger number of patients are necessary before recommending staple-line reinforcement.
• Rice, R. D., Simon, T. E., Seery, J. M., Frizzi, J. D., Husain, F. A., & Choi, Y. U. (2010). Laparoscopic sleeve gastrectomy: outcomes at a military training center. The American surgeon, 76(8), 835-40.
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  Laparoscopic sleeve gastrectomy (LSG) has gained support as a single-staged and stand-alone bariatric procedure. Reports of excess weight loss of 35 to 83 per cent, reduction in comorbidities, and decreased operative morbidity have garnered support for LSG. This study represents an initial outcome analysis of LSG performed solely at a military treatment center. This study is a retrospective analysis of all patients receiving LSG at Dwight D. Eisenhower Army Medical Center from September 2007 to December 2009. The patients were planned for a stand-alone procedure. One hundred and fifteen patients received LSG over this time period with a mean body mass index of 45.5 +/- 6.2 (range 35.1-58.3). The average age was 47.4 +/- 12.5 years. Diabetes mellitus was seen in 47 per cent and 68 per cent of patients had hypertension. The mean and median length of operation was 124 +/- 48 and 115.5 minutes. The mean percentage of excess weight loss was 16.6 +/- 6.40 per cent at 1 month, 31.5 +/- 7.6 per cent at 3 months, 41.2 +/- 13.9 per cent at 6 months, and 53.7 +/- 12.5 per cent at 1 year from surgery. One or more of patient's preoperative diabetic or hypertensive medications were improved postoperatively in 18.7 per cent and 16.3 per cent, respectively. Incidence of major complications occurred in 4.35 per cent of patients in this study to include four leaks (3.4%), one death (0.87%), and 10 readmissions. Midterm analysis of outcomes related to LSG as a single-stage bariatric procedure is promising as long-term outcome data is collected; the efficacy of this procedure as a sole bariatric procedure will continue to be borne out.
• Martin, M. J., Husain, F. A., Piesman, M., Mullenix, P. S., Steele, S. R., Andersen, C. A., & Giacoppe, G. N. (2004). Is routine ultrasound guidance for central line placement beneficial? A prospective analysis. Current surgery, 61(1), 71-4.
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  Portable ultrasound devices have become more readily available in the intensive care unit setting, but their utility outside of controlled trials remains unproven. We sought to determine how the availability of ultrasound guidance affected the types and number of complications during central line placement.
• Husain, F. A., Martin, M. J., Mullenix, P. S., Steele, S. R., & Elliott, D. C. (2003). Serum lactate and base deficit as predictors of mortality and morbidity. American journal of surgery, 185(5), 485-91.
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  To determine whether lactate levels and base deficits in critically ill surgical intensive care unit (SICU) patients correlate and whether either measure is a significant indicator of mortality and morbidity.

Reviews

• Ghanem, O. M., Orenstein, S., Lloyd, S. J., Andalib, A., Race, A., Burt, H. A., Husain, F., Goldblatt, M., Kroh, M., & , S. M. (2023. Management of abdominal wall hernias in patients with severe obesity(pp 6619-6626).
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  Obesity is a risk factor for abdominal wall hernia development and hernia recurrence. The management of these two pathologies is complex and often entwined. Bariatric and ventral hernia surgery require careful consideration of physiologic and technical components for optimal outcomes. In this review, a multidisciplinary group of Society of American Gastrointestinal and Endoscopic Surgeons' bariatric and hernia surgeons present the various weight loss modalities available for the pre-operative optimization of patients with severe obesity and concurrent hernias. The group also details the technical aspects of managing abdominal wall defects during weight loss procedures and suggests the optimal timing of definitive hernia repair after bariatric surgery. Since level one evidence is not available on some of the topics covered by this review, expert opinion was implemented in some instances. Additional high-quality research in this area will allow for better recommendations and therefore treatment strategies for these complex patients.
• Tomaiko-Clark, E., Husain, F., & Su, W. (2023. Weight loss and atrial fibrillation: a review(pp 6-10).
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  Despite technological advancements in catheter ablation, patients with atrial fibrillation often require multiple ablations, with diminishing returns depending on duration and persistence. Although early ablation is vital, modification of atrial fibrillation disease can be achieved with modification of existing risk factors. Obesity is an important modifiable risk factor, but there does not appear to be a consensus on the best method or goal for weight reduction.