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Gastric bypass surgery is a rapidly growing procedure in which the stomach is reduced from its normal football-size to something between the size of a thumb and a hardboiled egg. In each case, the stomach itself is healthy: the purpose of the surgery is to force the patient to change behaviors that are leading to obesity.

The images above came from a live Webcast of a gastric bypass surgery performed at Tufts-New England Medical Center in Boston by Dr. Scott Shikora, Chief of Bariatric Surgery at Tufts-NEMC, along with bariatric surgeons Dr. Michael Tarnoff and Dr. Julie Kim. Click on the images to watch the complete video on YouTube.

You also can watch Dr. Stan Hoehn perform a minimally invasive gastric bypass at Shawnee Mission Medical Center in Kansas by clicking on the image below.

A Consensus Panel convened by the National Institutes of Health (NIH) indicates bariatric surgery for people with a body mass index (BMI) of 40 or higher, or people with a BMI of 35 or higher with one or more related comorbid conditions such as diabetes, hypertension, and cardiovascular disease.

Bariatric surgery is regarded by leading physicians on the panel as a lifesaving tool that enables, or in fact forces, the patient to change lifestyle and eating habits. Check out the BMI calculator below to see if you should be changing your behavior.

BMI Calculator (C) 2008 Brown2020.com

With 100 million Americans struggling with at least one chronic condition, and over 60 million Americans considered to be clinically obese, we can expect a lot of bariatric surgery ahead. Can we really address the issue of obesity by forcing ourselves to change behavior under the knife, or are there other ways to address this epidemic?

Stay tuned to this blog for an ongoing discussion of obesity and of new approaches to improving health behavior.

Patrick Goschy recently became a mini-hit on YouTube and then just made the evening news with a video shot in June 2000 demonstrating his invention of a hand-held accelerometer-based video game controller. Wearing only boxer shorts and a tee shirt, Goschy demonstrates his motion control unit playing Ready 2 Rumble on a Sega Dreamcast in his living room, Nintendo Wiimote style, years ahead of his time.

Much has been blogged about the ex-employee of video game company Midway and his purported plan to sue Nintendo for stealing the idea for the Nintendo Wii controller. Bloggers and commenters are raising two lines of questions: First, if accelerometers for detecting motion were around before 2000, how could Goschy claim to have invented the accelerometer-based game controller? Second, if Goschy did invent the video game motion controller over seven years ago, why did it take so long for this to come out?

Accelerometers may have been around for a while, but Pat Goschy’s video still looks like it could be full of inventive ideas given the fact that this was over seven years ago. It is not the invention of the accelerometer that is in question, and maybe not even the accelerometer as a game controller. The inventive steps may have been a series of innovations around design, coding, and calibration that would give game players the agility and speed to take on B. Knoximov in Ready 2 Rumble from the comfort of their living rooms.

Inventing is about taking that next creative step past the current frontier and making things a little better. The fact that Goschy was building motion-based controllers and hacking a Dreamcast interface in what looks like a very workable system seven years before the technology matured and became popular tells us there probably could have been some patentable material back in 2000.

There are two patents that list Goschy as a co-inventor: Patent 6,545,661, filed on June 21, 1999, entitled Video Game Systems Having A Control Unit With An Accelerometer For Controlling A Video Game, and patent 6,315,673, filed on October 5, 1999, entitled Motion Simulator For A Video Game. Both patents are assigned to Midway. These patents do not appear to claim the motion controller from the Goschy video. The 661 patent is the closest, but it is really about sensing light from the screen to know if you hit your target with a game controller gun.

The light sensor is required in all the claims. Here is the exact text of the first independent claim:

1. A video game system comprising:
a game controller;
a hand-held control unit coupled to the game controller and housing an accelerometer and a light sensor,
the accelerometer sensing tilt of the control unit with respect to an axis, the accelerometer producing an acceleration signal indicating the tilt of the control unit with respect to the axis,
the game controller processing the acceleration signal to control the movement of a game character on a video display coupled to the game controller and further processing the acceleration signal to control directional navigation of the game character through a game environment, said navigation corresponding to the tilt of the hand-held control unit,
the light sensor detecting one or more light pixels from the video display corresponding to a direction in which the hand-held control unit is pointing, the light sensor producing a detection signal to the game controller, the game controller determining from the detection signal the light pixels from the video display detected by the light sensor.

The question is not how did Goschy get a patent on this. He didn’t. The real question is why didn’t Midway patent the controller that Goschy is showing in the video? That would have been valuable, but then again, hindsight is always 20/20.

According to some of the blogs, Goschy circulated the video among Midway employees back in 1999 to show his idea, but the company obviously didn’t file patents and didn’t develop the technology either. This is a common fate of many great inventions. If you are early enough to have something truly new and innovative, and you are sufficiently ahead of the crowd to get great patents, chances are you are way ahead of the market and way ahead of the marketing people as well.

Great ideas and great patents need to be five to ten years too early, and they are usually only recognized in hindsight. Thank you, Pat Goschy, for reminding us of the many years of innovation and creative work that leads up to what most people see as an instant sensation when a product like the Nintendo Wii becomes a hit. We also shouldn’t forget that Nintendo has been a grandfather of the modern video game field, at it for the past two decades, and who knows what they also have in their labs that started many years ago.

The question is not why the video took so long to come out. The market has only just now emerged. If the video had come out earlier, we never would have found it.

Flip through these slides from the CDC to see a dramatic portrayal of the obesity epidemic in the U.S. The map shows the increasing prevalence of obesity over the past 20 years.

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