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Editorial: Research needed to overcome bariatric surgery objections
October 16, 2007Bariatric surgery has become more acceptable, but additional research is needed to demonstrate to insurance companies and the public that it is the best long-term treatment for obesity, according to an editorial in the October issue of Archives of Surgery, one of the JAMA/Archives journals. The editorial, written by Edward H. Livingston, M.D., of the University of Texas Southwestern Medical Center, Dallas, is part of a theme issue on bariatric surgery.
"The studies presented in this issue of the Archives provide us with more knowledge about these procedures' risks, outcomes, complication profiles, improved functionality associated with surgically induced weight loss, need for long-term monitoring and equivalency of the various laparoscopic banding operations," Dr. Livingston writes. "However, we will need more to convince the non-believers in bariatric surgery that it is the appropriate therapy for morbidly obese patients who have, or may develop, complications from their excessive weight."
Papers in the theme issue suggest that:
* Routine upper gastrointestinal (GI) studies-expensive tests typically performed following bariatric procedures-may not be necessary
* Current techniques for examining the upper GI in patients with abdominal symptoms can be modified to accommodate those who have had gastric bypass
* Anastomotic leaks at the surgical site can have devastating consequences and should be treated as early as possible
* About 4.4 percent of patients experience bowel obstructions after gastric bypass
Such ongoing research is necessary due to the lack of alternatives for obese patients, Dr. Livingston notes. "Nonsurgical weight loss efforts in the morbidly obese result in transient weight loss, if any at all," he writes. "There are no anti-obesity drugs in the pipeline that will be released soon, and even so, none of the medications in development appear to have major impact on morbid obesity. Thus, weight loss surgery is here to stay since it is the only treatment modality with proven success at inducing profound and sustained weight loss for the morbidly obese."
"This edition of the Archives goes a long way to addressing the critical issues facing this field," Dr. Livingston concludes.
JAMA and Archives Journals
* Routine upper gastrointestinal (GI) studies-expensive tests typically performed following bariatric procedures-may not be necessary
* Current techniques for examining the upper GI in patients with abdominal symptoms can be modified to accommodate those who have had gastric bypass
* Anastomotic leaks at the surgical site can have devastating consequences and should be treated as early as possible
* About 4.4 percent of patients experience bowel obstructions after gastric bypass
Such ongoing research is necessary due to the lack of alternatives for obese patients, Dr. Livingston notes. "Nonsurgical weight loss efforts in the morbidly obese result in transient weight loss, if any at all," he writes. "There are no anti-obesity drugs in the pipeline that will be released soon, and even so, none of the medications in development appear to have major impact on morbid obesity. Thus, weight loss surgery is here to stay since it is the only treatment modality with proven success at inducing profound and sustained weight loss for the morbidly obese."
"This edition of the Archives goes a long way to addressing the critical issues facing this field," Dr. Livingston concludes.
JAMA and Archives Journals
Bariatric Surgery Current Events and Bariatric Surgery News RSSPhysical activity after bariatric surgery improves weight loss, quality of life
A new study by researchers from The Miriam Hospital's Centers for Behavioral and Preventive Medicine suggests increased physical activity after bariatric surgery can yield better postoperative outcomes.
Plastic surgeons warn of malnutrition in body contouring patients
Identifying malnutrition before surgery in massive weight loss patients seeking body contouring will significantly decrease surgical complications, accelerate wound healing, improve scar quality and boost patient energy levels, according to a study in the December issue of Plastic and Reconstructive Surgery.
Robotic Surgery Lowers Risk of a Rare but Serious Complication of Gastric Bypass
The use of a robot to assist with the most commonly performed weight-loss surgery appears to significantly lower a patient's risk of developing a rare but serious complication, according to a study published in the most recent edition of the Journal of Robotic Surgery.
Johns Hopkins researchers suppress 'hunger hormone'
Johns Hopkins scientists report success in significantly suppressing levels of the "hunger hormone" ghrelin in pigs using a minimally invasive means of chemically vaporizing the main vessel carrying blood to the top section, or fundus, of the stomach.
Study shows that surgical weight loss does not eliminate obstructive sleep apnea
A study in the August 15 issue of the Journal of Clinical Sleep Medicine shows that surgical weight loss results in an improvement of obstructive sleep apnea (OSA), but most patients continue to have moderate to severe OSA one year after undergoing bariatric surgery.
Bariatric patients have 65% lower chance of complications at top hospitals: HealthGrades study
Bariatric surgery patients treated at highly rated hospitals have, on average, a 65 percent lower chance of experiencing serious complications compared to patients who undergo surgery at poorly rated hospitals according to a study released today by HealthGrades, the nations leading independent healthcare ratings organization.
ASGE issues guidelines on the role of endoscopy in the bariatric surgery patient
The American Society for Gastrointestinal Endoscopy (ASGE) has issued guidelines on the role of endoscopy in the bariatric surgery patient.
Study links gastric bypass surgery to increased risk of kidney stones
Morbidly obese patients who undergo a particular type of gastric bypass surgery called Roux-en-Y gastric bypass (RYGB) are at an increased risk of developing kidney stones - small, pebble-like deposits that can result in severe pain and require an operation to remove them - earlier than previously thought.
Weight-loss surgery can cut cancer risk
Successful bariatric surgery allows morbidly obese patients to lose up to 70 percent of their excess weight and to maintain weight loss.
Weight loss after gastric bypass surgery may protect against infection and cancer
Another health benefit of bariatric weight-loss surgery may be a heightened immune defense against cancer and infections, a new study suggests. The results will be presented at The Endocrine Society's 90th Annual Meeting in San Francisco.
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