Saturday, May 30, 2009

Simulation Can Improve Laparoscopic Bariatric Surgery

We have always believed in employing simulation as a way to improve skills. The United States Space program has used simulation as an integral part of space mission planning for many years. And recent studies demonstrate the usefulness of simulation in training doctors -- including doctors that perform laparoscopic surgery.

A recent study at Yale University demonstrated how simulation can be useful in training doctors. Using simulation, student doctors were trained to successfully insert a “central line” or catheter into a major vein of the body. So employing simulation to train doctors can be a smart thing to do. Moreover, in the opinion of some experts, not using simulation to aid in training doctors is a mistake.

England's chief medical officer recently stated that because doctors don’t have enough simulators on which to practice, patients are subjected to harm. Airlines use simulators to train their pilots. And because of their regular training on simulators, pilots are better trained to fly planes than surgeons are to perform surgery.

Simulation may be even more important in laparoscopic surgical training, since laparoscopic surgery requires a higher level of skill than open surgery. And laparoscopic bariatric surgery, performed by a skilled surgeon, generally produces less trauma for the patient. As reported in a Health Grades study, for those bariatric surgeries requiring hospital stay, the patient receiving laparoscopic surgery spends less time in the hospital than the patient receiving open surgery. Further, the complication rate for laparoscopic bariatric surgery is less than the complication rate for open bariatric surgery.

A recent study has shown that simulation can help a doctor acquire the necessary skills to gain laparoscopic surgical proficiency. Therefore, more medical device providers might want to consider building and making cost-effective simulators for laparoscopic surgical practice. The provider that creates the most useful, economical simulators for practicing laparoscopic bariatric surgical procedures will likely gain a competitive advantage.

(Please leave a comment by clicking on the "COMMENTS" link at the lower right part of this blog post.)


Friday, May 22, 2009

Organizations Are Collaborating in the Fight Against Worldwide Obesity

Obesity is a serious problem in the world. And experts throughout the world are trying to come up with ways to fight obesity. Organizations in the U.S. and in Europe are bringing knowledgeable groups together to find ways to combat the disease, because obesity increases the incidence of illness and strains a country’s health care budget. Bariatric or weight loss service or product providers could play an important role in this fight, since these providers have a grasp of what works and what doesn't.

In the US, the organization, Strategies to Overcome and Prevent
(STOP) Obesity Alliance, is joining with consumers, health care providers, the government, businesses and others to come up with ways to fight obesity. And in Europe, “the UK National Obesity Forum (NOF) and the Belgian Obese Patients organization (BOLD) will” use results from a survey to gather information on fighting obesity.

Determining how to fight obesity is important since obesity is associated with a number of serious illnesses. For example, in the UK it is estimated that there might be as many as 19,000 British cases of cancers per year resulting from obesity.

That there is a high number of obesity-related diseases throughout the world is probably pretty much accepted now. However, maintaining a healthy weight as a way to prevent diseases is something we should focus on more. We have evidence to support the belief that losing weight and maintaining a healthy weight may enable an individual to avoid some diseases.

It is estimated, for example, that weight reduction through bariatric surgery has lowered by one-quarter the number of cases of diseases linked to obesity. So successfully combating obesity will increase health. And according to an Australian study, if we don’t successfully combat obesity, health care costs will rise worldwide.

To emphasize the importance of the obesity fight, some in the US believe that the US should “establish an End the National Obesity Epidemic (ENOE) task force.” It would probably be reasonable for this task force to collaborate with other organizations that are trying to find ways to fight obesity. Moreover, bariatric or weight loss service and product providers could join forces with obesity-fighting originations to try to find solutions to the worldwide obesity epidemic.

(Please leave a comment by clicking on the "COMMENTS" link at the lower right part of this blog post.)


Wednesday, May 13, 2009

Food Played the Larger Role in America's Thirty Year Weight Gain

We often say that lifestyle change is necessary for weight reduction. Lifestyle change usually includes diet modification and exercise. Diet and exercise are both important in weight reduction and weight control. However, some experts conclude that the number of calories we consume is more important than the exercise we get, when it comes to weight loss and weight control.

Of course, exercise is important for keeping the body in shape, and we should all engage in frequent exercise. Still, for weight loss or weight control, calorie intake appears to be the most significant factor. And a recent Australian study confirms the importance of calorie intake in weight gain.

We’ve all heard that the American sedentary lifestyle is a large contributor to the weight gain in American. We’ve heard that over the past few decades, Americans have spent more time working in offices than on farms and in factories. And leisure activities that include watching television and using a computer have replaced physical activity. Thus, sedentary activities have contributed heavily to Americans’ weight gain.

But according to the above mentioned Australian study, the weight gain in America over the past 30 years was due to an increase in calorie intake more so than a lack of physical activity. In fact, for American adults, there may even have been an increase in physical activity over the past 30-year period compared to previous years.

Therefore, the past 30-year American weight gain must be attributed to increased calorie intake. Moreover, according to the study, adults need to reduce their daily calorie intake by 500 calories to return the 1970 body weight numbers. And children should decrease their daily calorie intake by 350 calories.

These specific numbers should give weight loss centers calorie intake targets around which to design diets. Centers ought to design and market healthy diet programs that can reduce an adult’s calorie intake by 500 calories per day, and a child’s calorie intake by 350 calories.

(Please leave a comment by clicking on the "COMMENTS" link at the lower right part of this blog post.)


Sunday, May 3, 2009

Does Bariatric Surgery Volume Make a Difference In the Number of Surgery Related Complications?

A resent study done by Dr. Edward H. Livingston, of the University of Texas Southwestern School of Medicine and Department of Veterans Affairs in Dallas, indicates that the complication rate for patients undergoing bariatric surgery is essentially the same at Center of Excellence (COE) facilities as at non-COE facilities. The study concludes that ‘Designation as a bariatric surgery center of excellence does not ensure better outcomes. Neither does high annual procedure volumes.’

A 2008 Health Grades bariatric study concluded that volume is very important in reducing the complication rate in bariatric surgery. The Health Grades study found that those facilities that had done at least 125 surgeries during a year had fewer complications than those facilities that had done 25 or less surgeries.

A 125-surgery-per-year minimum is an important element in the COE criteria established by both The American Society for Metabolic and Bariatric Surgery (ASMBS) and the American College of Surgeons (ACS). Moreover, Medicare will consider paying for bariatric surgery only if the surgery is performed at a COE facility, certified by the ASMBS or the ACS. So, there is support for the 125 per year bariatric surgical minimum as a basis for achieving surgical proficiency.

Based on the Livingston study, facilities performing less than 125 surgeries per year -- actually, an average of 79 surgeries -- have a complication rate similar to facilities performing 125 surgeries or more per year. Although this conclusion may reflect an accurate assessment of the study results, we don’t feel that the results necessarily mean that volume doesn’t count. The results may indicate that performing 79 surgeries per year is a good number from which to gain bariatric surgical proficiency.

However, we don’t believe that the Livingston study results mean that a bariatric center that performs 15 surgeries per year is likely to have a lower complication rate than a center that performs 125 surgeries per year. We do believe that volume counts. Further, we believe that emphasizing a high volume is a good marketing tool for a weight loss center to use as part of an overall marketing strategy.
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