Weight-Loss Surgery Gains More Practitioners

Study also documents growth in less-invasive techniques, improved survival rates
By Mary Elizabeth Dallas

More doctors are performing weight-loss surgery today, and hospitals are touting better survival rates, a new study finds.

Researchers analyzing trends in bariatric surgery said increased use of less-invasive laparoscopic surgical techniques, such as adjustable gastric banding, has led to a greater acceptance of bariatric surgery by morbidly obese patients.
"We've identified a national trend in the use of bariatric surgery that is tied to the rapid expansion of the laparoscopic approach to bariatric surgery and the laparoscopic adjustable gastric banding operation," said Dr. Ninh T. Nguyen, chief surgeon for the division of gastrointestinal surgery at University of California, Irvine Healthcare, and lead author of a study published in the August issue of the Journal of the American College of Surgeons.
Gastric banding involves placing a band around the top of the stomach, effectively reducing the size of the stomach and making patients feel full after eating less.
Like all surgeries, bariatric surgery carries some risks, including serious infections, internal bleeding, blood clots, and death, according to the American Society for Metabolic & Bariatric Surgery (ASMBA).
In addition, a recent Belgian study following gastric banding patients over a 12-year period found that 40 percent had suffered major complications as a result of the surgery, while about half had to have their bands removed.
However, the study authors believe that the benefits of the surgery outweigh the potential risks.
"Many reports we looked at documented the long-term survival and metabolic benefits of bariatric surgery, and these benefits are having an impact on patients' willingness to accept bariatric surgery as an option for the treatment of morbid obesity," Nguyen continued in a journal news release.
For the study, researchers analyzed data on weight-loss surgeries from the Nationwide Inpatient Sample from 2003 to 2008. The proportion of laparoscopic weight-loss procedures jumped from about 20 percent at the start of the study period to more than 90 percent by 2008.
The in-hospital mortality rate related to these procedures fell from 0.21 percent to 0.10 percent during that time, and membership in the American Society for Metabolic and Bariatric Surgery surged 95 percent -- from 931 to 1,819.
Overall, the number of bariatric operations peaked in 2004 with 135,985 procedures performed, the study found. In 2008, just under 125,000 bariatric surgeries were undertaken.

SOURCE: Journal of the American College of Surgeons, news release, Aug. 8, 2011