Patient Records

Bariatric Surgery Analysis Examines Effectiveness and Risks

Patient RecordsA comprehensive investigation into the outcomes of bariatric surgery shows that the majority of bariatric patients experience substantial and lasting weight loss and improvements in obesity-related comorbidities.

The review also confirms the relative safety of the current bariatric procedures based on a reasonable risk of complications, a low reoperation rate, and a very low mortality rate.

According to the researchers, the prevalence of obesity and outcomes of bariatric surgery are well established, but the study was important because an analysis of surgery impact has not been updated since 2003 and much has changed in the last decade.

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Bariatric Surgery Risk vs Reward

Weight Loss Expectations vs Risk in Bariatric Surgery Patients

Bariatric Surgery Risk and RewardBariatric surgery has been shown to greatly improve health and lead to significant weight loss, but all too often patient expectations are not consistent with clinical reality.

A new study published online in March in JAMA Surgery examines this matter and provides additional insight into the unrealistic expectations of patients considering weight loss surgery.

Researchers interviewed hundreds of patients considering weight loss surgery and found that most weight loss surgery patients have high weight loss expectations and are willing to accept more risk to achieve those expectations.

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FDA Lap-Band Warning

5 Points on Safety and Risks of Lap Band Surgery

Safety and Risks of Lap Band SurgeryOn December 13, 2011, the U.S. Food and Drug Administration announced that it had issued warning letters to eight California surgical centers and the marketing firm 1-800-GET-THIN LLC, for misleading advertising of the Lap-Band, a medical device approved by the FDA for weight loss in obese adults.

According to the FDA, the Lap-Band ads used by these companies failed “to provide required risk information, including warnings, precautions, possible side effects and contraindications.”

The “FDA’s concern”, says Steven Silverman, director of the Office of Compliance in FDA’s Center for Devices and Radiological Health, “is that these ads glamorize the Lap-Band without communicating any of the risks. Consumers, who may be influenced by misleading advertising, need to be fully aware of the risks of any surgical procedure.”

In support of this action, here are five points on the safety and risks of lap band surgery for prospective patients to consider:

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Extreme Obesity

Bariatric Surgery Safety and Outcomes in Extremely Obese Patients

Bariatric Surgery in Extremely Obese PatientsA 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.

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Duodenal Switch Study

More Weight Loss, More Risk: Duodenal Switch vs Gastric Bypass

Duodenal Switch Weight Loss and RisksDuodenal switch surgery leads to greater weight loss than gastric bypass, but also involves a greater risk of complications that may offset any potential benefits, according to a new study reported in a recent issue of the Annals of Internal Medicine.

Each year, in the United States, about 220,000 people undergo bariatric surgery. Gastric bypass surgery is one of the most popular procedures, while only 1% undergo the duodenal switch surgery. Other popular types of weight loss surgery are laparoscopic adjustable gastric banding and sleeve gastrectomy.

Gastric bypass and the duodenal switch both involve a restrictive and malabsorptive component to facilitate weight loss. The primary differences between the two procedures are how the stomach is resized and how much of the small intestine is bypassed. The duodenal switch is a more extreme procedure and is primarily reserved for “superobese” patients with a body mass index (BMI) of 50 or higher.

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Bariatric Surgery Risk Factors

Top Six Risk Factors for Bariatric Surgery

Bariatric Surgery Risk FactorsA new study from the University of California at Irvine evaluated data from more than 100,000 bariatric surgery patients and identified the top six risk factors for bariatric surgery.

While researchers agree that bariatric surgery is safer than ever, they also realize that individual risk varies. The study showed that a patient with one or more of the risk factors had an increased risk of non-survival before discharge from the hospital.

The researchers say knowing the risk factors can help doctors and patients as the information may influence the choice of weight loss procedure, provide a better understanding of individual risk, and further increase safety of bariatric surgery.

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Fracture Risk After Bariatric Surgery

Fracture Risk After Bariatric Surgery

Fracture Risk After Bariatric SurgeryThe risk of breaking bones after bariatric surgery may be even higher than previously thought, according to findings presented by Mayo Clinic College of Medicine in Rochester, Minnesota.

The study found that bariatric surgery patients compared to the general population had a 2.3-fold increased risk of a fracture at nearly all skeletal sites. Initial results presented two years ago in a small subset of study participants had found only a 1.8-fold increased risk. The risk of breaking a hand and foot was found to be especially high, about three times more than expected.

While “the link between bone health and bariatric surgery is not a new issue,” states Kurt Kennel, MD, assistant professor of medicine in the endocrinology division at Mayo Clinic, “the problem is that lately we see evidence in the literature that people who are trying to get enough vitamin D and calcium still show signs that their bones are changing in a negative way.”

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Drinking Alcohol After Gastric Bypass Surgery

Gastric Bypass Surgery Intensifies Effects of Alcohol

Drinking Alcohol After Gastric Bypass SurgeryGastric bypass patients are engaging in risky behavior if they choose to drink alcohol after their operation, according to a new study conducted by researchers at Stanford University.

By comparing the preoperative and postoperative alcohol metabolism in gastric bypass patients, researchers found that patients exhibited a much higher breath alcohol content and required significantly more time to sober up after surgery than before surgery.

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HealthGrades Rates Bariatric Surgery Hospitals

Study Finds Bariatric Surgery Disparities Among US Hospitals

HealthGrades Bariatric SurgeryThe number of bariatric surgeries performed every year continues to rise, as more and more Americans decide they are willing to undergo drastic measures to control obesity and improve health. Based on the popularity of bariatric surgery, it is apparent that many individuals are willing to accept the potential risks in order to gain the anticipated benefits.

When individuals make the decision to undergo bariatric surgery, the focus is often on the safest or most effective type of procedure. A new study, however, highlights the fact that no matter which bariatric surgery is performed, the rate of complications and length of hospital stays can be reduced depending on where the surgery is performed.

As prospective patients look into their weight loss surgery options, they would do well to consider the findings of HealthGrades, an independent healthcare ratings organization, in the recently released The Fifth Annual HealthGrades Bariatric Surgery Trends in American Hospitals Study, concerning the overall safety of bariatric surgery in various hospitals across the United States.

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Revisional Bariatric Surgery

Study Reveals Complications and Benefits of Revisional Bariatric Surgery

Revisional Bariatric SurgeryRevisional bariatric surgery is risky but potentially beneficial for most patients, according to a recent study published in the February issue of JAMA’s Archives of Surgery. Researchers found that although complications are likely to occur, most patients ended up with overall positive outcomes after revisional bariatric surgery.

The purpose of the study was to evaluate the safety and effectiveness of revisional bariatric surgery. Revisional bariatric operations, which are increasing in number, are performed when patients have unsuccessful weight loss or intolerable complications following the initial bariatric intervention.

Based on study findings, the researchers concluded that although revisional bariatric surgery is associated with a higher risk of complications than the original procedures, it appears to be safe and effective when performed in experienced centers.

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