Studies show that the number of bariatric surgeries being performed in the U.S. continues to increase. However, these procedures’ quality and safety vary widely from one hospital to another. HealthGrades, a Golden, Colorado-based, independent healthcare ratings organization, has released the findings of its fifth annual study of bariatric surgery. For this recent study, more than 190,000 patients who had undergone bariatric surgery from 2006-2008 were involved. These patients had been discharged from 684 hospitals in 19 states.

Surgical Complications Falling Nationwide
For the purposes of the study, the researchers assigned hospitals one of three ratings, indicating “best-performing,” “average-performing” and “poor-performing” facilities. And the good news? The ratings showed that the overall rates of risk-adjusted, in-hospital complications and mortality related to obesity surgery are decreasing!

Specifically, the researchers found that those patients at top hospitals experienced a 66.55% lower chance of experiencing complications than those patients who underwent bariatric surgery at a bottom-ranked hospital. In addition, the patients at top hospitals reported shorter lengths of stay. The researchers concluded that if all bariatric patients had surgery at levels similar to top-ranked hospitals, 5,046 patients could avoid major in-hospital complications during this three-year period.

Which Facility You Choose Plays A Large Part
But there is some bad news - The researchers did observe that there were large performance gaps among the different facilities. As an example, bariatric surgery mortality, which is rare, was found to occur four times more at bottom-performing hospitals than top-performing hospitals.

“Bariatric surgery has been proven to reduce caloric intake and control obesity, but the HealthGrades study demonstrates that where patients have this type of surgery matters-a great deal,” said Rick May, HealthGrades’ vice president of clinical consulting. “There is a subset of U.S. hospitals whose patients, the data show, have fewer complications and leave the hospital earlier.”

Source: Modernhealthcare.com/article/20100526/NEWS/305259974

Researchers have found that undergoing bariatric surgery may effectively eliminate ALL signs of type 2 diabetes. Bariatric surgery’s benefit for type 2 diabetes mellitus was the subject of a study recently published in The American Journal of Medicine. The meta-analysis, comprised of 621 studies from 1990-2006, showed that 78.1% of diabetic patients experienced complete resolution. In addition, the 86.6% of the patients’ diabetes improved or was resolved after undergoing bariatric surgery. Type 2 diabetes mellitus has been found to be directly influenced by obesity. The primary risk factor for this disease is obesity, and 90% of all patients are overweight or obese.

Understanding the Surgical Procedures’ Findings
The involved studies were far-reaching, and involved 135,246 patients.  Of these, 3188 patients experienced resolution of both the clinical and laboratory manifestations of type 2 diabetes. 11,175 patients reported both weight loss and diabetes resolution; these were completely separate from the 4,070 diabetic patients involved in those studies.

    These patients were categorized by the surgical method they underwent: laparoscopic adjustable gastric banding, gastroplasty, gastric bypass, and biliopancreatic diversion/duodenal switch (BPD/DS). The results were as follows: gastric banding (56.7% resolution); gastroplasty (79.7%); gastric bypass (80.3%); and BPD/DS (95.1%).
    Two years later, the resolutions were as follows: gastric banding (58.3% resolution); gastroplasty (77.5%); gastric bypass (70.9%); and BPD/DS (95.9%).
    As for the percent excess weight loss, the resolutions were: laparoscopic adjustable gastric banding (46.2%); gastroplasty (55.5%); gastric bypass (59.7%); and BPD/DS (63.6%).

“This systematic review and meta-analysis demonstrate that bariatric surgery has a powerful treatment effect in morbidly obese persons with type 2 diabetes; 82% of patients had resolution of the clinical and laboratory manifestations of diabetes in the first 2 years after surgery, and 62% remained free of diabetes more than 2 years after surgery (80% and 75% for the total group),” states Henry Buchwald, MD, PhD, Department of Surgery, University of Minnesota. “Randomized clinical trials comparing surgery and medical therapies for type 2 diabetes are urgently needed. Considering the potential benefits for millions of people, such trials should assess the risk/benefit ratio of surgery in less obese (BMI 30-35 kg/m2) populations, as well as in the morbidly obese (BMI>35 kg/m2) population.”
http://www.medicalnewstoday.com/articles/141314.php

Known as the endoluminal pouch reduction, this non-invasive technique is basically an interior corset. Medical professionals and obesity experts alike hope that this procedure will enable people to lose weight gained back after undergoing traditional stomach-reducing surgery.

With this procedure, bariatric surgeons descend a unique flexible device that includes a camera down patients’ throats to their stomachs. Once there, this device sucks up stomach portions. Then, this device fasten these portions down, forming a circular pattern of pleats. Essentially, this forms a corset; one requiring no surgical incisions and more importantly, a reduced time period in the hospital and for recovery.

While this procedure has demonstrated valuable benefits for patients, it’s only performed on 10-20% of patients. This is because many patients who have undergone bariatric surgery have stretched out their stomachs. This surgical side effect does not affect all recipients; why some are affected and some aren’t is itself a mystery.

However, for those who do qualify for the endoluminal pouch reduction, the procedure may offer the rare opportunity for a surgical “do-over.” Typically, having a second stomach stapling places the patient at risk for a 12-20% risk of bleeding and leakage; there’s a one-5% risk of bleeding and leakage during initial stomach stapling procedures.
http://www.canada.com/Health/Canada+first+stomach+corset+procedure+help+obesity/1327574/story.html

According to a study published in the Journal of the Society of Laparoendoscopic Surgeons (JSLS), patients may qualify for a revolutionary, quick AND effective weight loss procedure, performed on an outpatient basis. Surgeons and their teams are now offering minimally invasive adjustable gastric banding and gastric bypass surgeries, which are completed in less than two hours.

A Life-Saving Alternative for Patients
Healthcare professionals believe that this fast turnaround could not have come at a better time. Recent estimates show that the ever-growing obesity epidemic has skyrocketed. About 205,000 individuals underwent  bariatric surgery in 2005, compared to 1992’s 16,200 procedures.

Typically, these procedures – most often, either laparoscopic adjustable gastric banding (LAGB) or laparoscopic Roux-en-Y gastric bypass (LRYGB) – were performed in a hospital setting. But in an effort to drive more patients to having surgery, researchers sought out alternatives, especially that of ambulatory surgery centers (ASCs). Over the course of a six-year study (2002-2008), the researchers examined these facilities’ safety and effectiveness for these bariatric procedures. They performed a total of 248 weight loss surgical procedures (210 LAGB and 38 LRYGB procedures).

The findings showed that these facilities were as effective and safe as hospital settings. Those patients undergoing LRYGB procedures had an average body mass index (BMI) score of 44.7, while the average for those undergoing LAGB procedures was 43.79. However, 12 months after the procedures these BMI scores dropped an average of 69.62% and 32.58%, respectively. Meanwhile, the typical amount of time for the procedures was 112.80 minutes (for LRYGB surgery) and 72.10 minutes (for LAGB surgery).

“This marks a turning point in the battle against obesity, by shifting life-changing weight-loss surgery to the outpatient arena with minimally invasive surgery,” says lead author, Kent Sasse, M.D., M.P.H., FACS. “This study further validates the hypothesis that an overweight person can safely undergo weight-loss surgery in about two hours, at an outpatient surgical facility, return home later the same day, take very little time off, and lose a large amount of weight.”

It has been revealed that prior to undergoing weight loss procedures such as lap band surgery, or gastric banding surgery, the typical patient has tried their luck with an average of 24 diets and exercise regiments. These findings were spotlighted at the most recent annual meeting of the American Society for Metabolic and Bariatric Surgery.

Bariatric Procedures May Hold the Key to Success
The researchers focused on 409 bariatric surgery patients; these included those men and women who had undergone either gastric bypass or adjustable gastric banding procedures. It was shown that the majority were usually 100 or more pounds overweight before surgery. These patients also suffered from an average of five obesity-related conditions, including: type 2 diabetes, high blood pressure and/or sleep apnea.

The researchers noted that for those patients who most closely followed the advised post-surgical recommendations, an average of 123 pounds were lost during the first year. Those who didn’t follow the guidelines as closely typically lost about 92 pounds. At the five-year mark, the more diligent patients lost over 127 pounds, while the less responsible lost 100 pounds. According to healthcare and weight loss surgery professionals, the level of compliance is the “the difference between a good result and a great result.”

While every surgery team and patients may have unique guidelines to follow, there are certain points to consider. These post-surgical guidelines include: recommendations for regular exercise; changes to eating habits; receiving nutritional counseling and psychological support, and attending patient support groups; keeping a food diary; and visiting surgeons and/or doctors regularly. Estimates show that for 2007, about 205,000 people had bariatric surgery.