Tuesday, May 17, 2016

Questions about Bariatric Surgery

Bariatric surgery is, according to some, the best form of weight loss treatment for severely obese persons. But still, there are lingering questions about the safety and effectiveness of the surgery. For example, one question is this: Is bariatric surgery safe and effective for obese persons over the age of 60? And another question is this: What is the minimum number of surgeries a bariatric surgical center should have to perform before the center is deemed competent to perform high quality weight loss surgeries?

Concerning bariatric surgery for persons over the age of 60, a recent retrospective study looked at two weight loss groups to determine if bariatric surgery can safely and effectively be performed on persons over 60. One of the groups consisted of 40 patients, age 60 and above, who had RYGB (Roux-en-Y gastric bypass) or SG (sleeve gastrectomy) surgery. And the other group consisted of 40 patients, below the age of 60, who had had RYGB or SG.

Both groups of patients were looked at postoperatively up to one year. And there was no significant difference in readmission rates, weight loss, or complications between the 60-or-above group members and the below-60 group members. Therefore, the researchers concluded that good outcomes could result from RYGB or SG for persons age 60 and above.

And concerning the number of surgeries a center needs to have under its belt to be deemed proficient, one formerly accepted minimum number of 125 bariatric surgeries per year has been challenged. One of the first instances of the challenge was in 2013 when the American Society of Metabolic and Bariatric Surgery (ASMBS) issued a draft which supported the elimination of the 125 minimum. One of the reasons given for the elimination was the difficulty some hospitals had had meeting the 125-surgery yearly minimum.

One of the reasons for the 125 minimum was to insure that the weight loss surgeries were done under quality conditions. But a recent study has shown that, at least for laparoscopic sleeve gastrectomy (LSG), safe and effective surgeries can be performed at facilities that have done less than 125 LSG surgeries per year.

Thus, it appears that people 60 and older can feel comfortable getting SG and RYGB weight loss surgeries. Further, patients can feel comfortable getting LSG surgeries at facilities that have performed less than 125 surgeries annually. But remember, it is always a good idea to ask a lot of questions before undergoing any surgery. 


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