Portland, OR (PRWEB) December 20, 2012
More than one third of adults in the United States are obese. Obesity-related conditions include heart disease, stroke, type 2 diabetes, and certain types of cancer. Dr. Julie J. Kim, a board-certified general surgeon and Associate Professor of Surgery at Tufts University School of Medicine, noted that these are among the leading causes of preventable death. She proposed that a better understanding of the severity or spectrum of complications and the predictors after gastric bypass can be used to develop strategies to prevent complications, thereby improving overall results of weight-loss surgeries.
During a recent webinar hosted by AllMed Healthcare Management, Dr. Kim discussed common bariatric surgical procedures involving gastric bypass and their potential complications. According to Dr. Kim, the increase in the number of weight-loss surgeries performed in recent years results from a handful of factors, including the obesity epidemic, the recognition of obesity as a health hazard, the poor results with nonsurgical methods, the reproducible good results with surgical techniques, and the introduction of laparoscopic techniques.
Dr. Kim discussed the three types of approaches to bariatric surgery, which include procedures that restrict the amount of food intake by reducing the size of the stomach, procedures that limit the absorption of foods in the intestinal tract by bypassing a portion of the small intestine, and procedures that combine both restrictive and malabsorptive techniques. According to Dr. Kim, gastric bypass surgery, which combines both restriction and malabsorption, is the most common operation performed to treat extreme obesity, which is defined as a body mass index (BMI) of 40 kg/m2. She reviewed a number of procedures that involve gastric bypass to some degree, including gastric bypass with Roux-en-Y anastomosis (RYGB), distal (long limb) gastric bypass, biliopancreatic diversion (bypass) procedure, biliopancreatic diversion (bypass) with duodenal switch (BPD-DS), and mini-gastric bypass (MGB).
Longstanding guidelines developed by the National Institutes of Health (NIH) require individuals to meet specific medical necessity criteria in order to be considered candidates for surgery by health plans. Dr. Kim stressed that weight loss surgery should be considered a treatment of last resort, after first-line treatment involving diet, exercise, psychotherapy, and medications have failed. She also cited studies showing that clinical diagnosis of diabetes, open approach to surgery, and surgeon experience are independently predictive of complications after gastric bypass surgery. Surgeon experience and hospital volume are also important variables that influence the frequency of surgical complications.
Dr. Kim provided an in-depth look at potential bariatric surgery complications. Potential early complications of gastric bypass surgery, she said, include bleeding, anastomotic leak, wound infection, thromboembolism, and anastomotic strictures. Longer-term complications can include marginal ulcers, bowel obstruction, gallstones, and nutritional deficiencies. In conclusion, Dr. Kim noted that routine proctoring of a surgeon's early experience and increased use of laparoscopic techniques may decrease the risk for these complications, thereby helping patients to safely and effectively achieve the expected benefits of gastric bypass surgery, including long-term and sustained weight loss and improvement of obesity-related diseases. For more detail, download the companion white paper to this webinar here: http://bit.ly/VOkXbM
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