Wednesday, October 22, 2014 12:00 AM

Sharing bariatric expertise internationally

When Dr. Andreé Kühnhardt wanted to further his surgical learning, his mentors at the suburban Madrid hospital in Spain where he practices recommended flying to Fresno to study under bariatric surgeon Kelvin Higa at Fresno Heart & Surgical Hospital.

On any given day the physicians assisting and observing Dr. Higa may be carrying passports from India, Mexico, Russia or Taiwan. Dr. Higa, medical director of the hospital’s Bariatric & Metabolic Surgery Program, performed the first laparoscopic, or minimally-invasive, gastric bypass in the Valley in 1998 with his partner Dr. Keith Boone. The two also pioneered the current technique used by many surgeons throughout the world.

Dr. Higa and Paul Obrien, a medical professor from Australia, performed the very first laparoscopic adjustable gastric band in Fresno. In addition to being a clinical professor of surgery at University of California, San Francisco, Dr. Higa was appointed to the National Faculty for Bariatric Surgery by the American College of Surgeons.

Part of that may be the volume of surgeries Dr. Higa performs, said Dr. Kühnhardt, compared to the five or six cases Dr. Kühnhardt’s colleagues see at their hospital in a year. Fresno Heart & Surgical consistently does more bariatric surgeries than other California hospitals because of the surgeons’ reputation for clinical excellence and because other surgeons send difficult and challenging cases to Dr. Higa and his partners – especially revisions of older bariatric surgery cases.

Dr. Kühnhardt said more and more Spaniards are seeking bariatric surgery because obesity is a growing problem. Spain’s government-run health care pays for the procedure as a way to cure diabetes, and improve the high blood pressure, sleep apnea and orthopedic problems that are associated with obesity, he said. Increasingly, countries with a more socialized medical system are recognizing bariatric surgery is a cost-effective treatment that improves lives and longevity, said Dr. Higa, who also lectures frequently internationally.

When possible, Dr. Higa prefers teaching from his own operating room while performing surgery. Fresno Heart & Surgical’s two new minimally-invasive surgical suites are set up for exactly that. Each suite features state-of-the-art, high-definition plasma screens and the capability of transmitting live video images worldwide from cameras inside the overhead lights and handheld wands inserted into the body. The technology also allows Fresno Heart & Surgical surgeons to interact with other surgeons and operating rooms, obtaining and providing consultations in real time.

This story was reported by Erin Kennedy. She can be reached at



“My tutors and my boss say Dr. Higa is probably the best in the world in bariatric surgery,” said Dr. Kühnhardt.