A recently published study highlights the safety and feasibility of laparoscopic bariatric surgery on extremely obese patients as well as the outcomes of different surgical approaches.
Although it would seem that the most likely candidates for bariatric surgery are those with the most weight to lose, they often do not qualify for bariatric surgery. Surgery of any type, including bariatric surgery, is generally associated with greater surgical risks in patients with a very high body mass index (BMI), due to technical difficulties and severe weight related comorbidities.
In many cases, these potential risks often delay or postpone surgical intervention in extremely obese patients, even though they could greatly improve their health and quality of life with a significant reduction in excess weight that can be achieved with bariatric surgery.
For this study, researchers identified 49 patients within a BMI range of 70 to125 who underwent 61 bariatric surgeries at a bariatric surgery center of excellence in an academic medical center. The procedures performed were sleeve gastrectomy (26 patients), gastric bypass (11 patients), and a two-stage procedure (sleeve gastrectomy followed by gastric bypass, 12 patients).
The data showed that nearly all the surgeries were performed laparoscopically (60 cases, or 98.4%); complication rates were 16.4% for early complications (primarily minor), 14.8% for late complications, and there was one late mortality.
The following excess weight loss (EWL) results were observed at a mean follow up of 17.4 months in study patients:
- 54.5% EWL in patients who underwent a two-stage procedure
- 25.4% EWL in sleeve gastrectomy patients
- 43.8% EWL in gastric sleeve patients
The researchers concluded that laparoscopic bariatric surgery can be performed safely on patients with a body mass index (BMI) of 70 or greater and that a staged approach may offer better weight loss results.
The study, “Laparoscopic Bariatric Surgery in BMI of 70-125 kg/m2,” was published online October 17, 2011 in Surgery for Obesity and Related Diseases, the Official Journal of the American Society for Metabolic and Bariatric Surgery (ASMBS).