I am hoping to pick a few brains here and see what people’s impressions are of the gatric bypass surgeries that are performed now. I have seen some success stories and some nightmares. What causes the night mare cases to go wrong? Are there any projections into how these patients might be faring in another 20 or 30 years?
Thanks
E Lynne
I’ve seen patients come out with very good results, but I’ve seen complications too… deep post-op infection resulting in death.
My opinion with any surgery is to weigh one’s risk, or the patient’s risk, plus factor in the skill and experience of the surgeon and the whole surgical team, et al. That goes for any surgery that is not an emergent situation…
That said, “opinions” can stack up like “votes” and people giving opinions here or elsewhere are not in the same situation as you or your patients are — that is, don’t know the individual situation, surgeon, hospital, etc.
Going to Medline and doing a “review articles” and “case studies” search on gastric by-passes would likely give you a good sense of what the outcomes are, both stats-wise and otherwise. I’d be curious! Good luck!
Quote:
I am hoping to pick a few brains here and see what people’s impressions are of the gatric bypass surgeries that are performed now. I have seen some success stories and some nightmares. What causes the night mare cases to go wrong? Are there any projections into how these patients might be faring in another 20 or 30 years?
Thanks
E Lynne
Hi there,
In the hands of an experienced laparoscopic surgeon,Roux-en-Y gastric bypass is a safe procedure. It is currently the most effective means of obtaining permanent weight loss available. It is not for everyone and patient’s must meet stringent criteria to be eligible for the procedure at the best programs.
Currently, there are only two surgeons in this country that I could recommend as having the experience and programs to perform this procedure safely. They both perform the laparoscopic Roux-en-Y gastric bypass surgery. Both have elected not to perform vertical gastric banding because of the very high complication rate with this device.
This surgery is not easy to perform and this surgery requires a total commitment on the part of the patient. This is a major lifestyle change with lots of adjustments. Al Roker is a good example of how much work is required of the patient. Complications develop when patients lie or fail to carry out the required follow-ups. The work-up for these patients is neither simple nor quick. It takes literally months to properly prepare patients for this surgery both mentally and physically.
I have assisted on more than 70 of these procedures with the most common complication being breakdown of the intestinal anastomosis. This happens in about 1% of patients and can be repaired. Deaths occur when patients fail to follow directions in the face of an anastomotic leak. The other complications that have occured have been in heavy smokers as a result of undergoing general anesthesia. Some people have lied about smoking in order to have the surgery only to find that they develop complications from the anesthesia.
The long-term results of the Roux-en-Y laparoscopic gastric bypass have been excellent in terms of weight loss, decreased insulin dependence if diabetic,reduction in joint problems and hypertension. Again, this surgery is life changing and not for people who only need to lose a few pounds. Generally, this surgery is indicated for people who are younger than 65 who have a BMI of >40 without co-morbidities and > 35 with co-morbidities such as diabetes, hypertension or joint problems.
Young males tend to do best with the surgery; older females tend to do worse and are often able to defeat the bypass by eating very concentrated sweets. Patients must be ambulatory and must pass a stringent psychological evaluation. Patients must also have tried other methods to lose weight and failed.
I hope this information helps.
Natalie
I totally agree that the number one priorority regarding obesity surgery is The experience and outcomes of the surgeon performing the procedure. I am not yet satisfied, that we know which procedure is best. Therefore, I suggest we procede with caution in obesity surgery.
Hi!
Prior to starting RT school, I worked as a Paratech in Warren, OH on the Intermediate Care Unit at St. Joseph’s Health Center. When St. Joe’s decided to start doing Gastric Bypass surgery in the Summer of 2003, our unit had the responsibility if taking care of the patients post-op up until discharge. We had to observe two procedures during our staff training and, Dr. Nat is quite correct in her statement about the quality of the surgeon that is chosen to do the procedure as well as the committment of the patient to adhere to strict regimens that are required pre as well as post operatively. Most of the complications I obseved from my humble tech status had to do with anastamosis failures as well as patients simply eating too much and throwing off an already delicate electrolyte balance. There are websites available from hospitals and weight loss centers that participate in this procedure. There are also websites that give information from patients that have had the procedure as well as ratings on facilities that do Gastric Bypass surgery. One of the biggest issues that was relayed to us when we had staff training was the psychological aspects of the surgery…you have to be mentally prepared because it is a life changing process.
I am not an expert but I had a surgery similar to the gastric bypass (the lower third of my stomach was removed because of an ulcer surgery that didn’t work) and all I can say is that was the most painful recovery of my life, the most painful event of my life and I am still recovering from it (of course going off to work on campaign three weeks post-op didn’t help and was stupid).
This may be of no help but that’s my experience.
I will only add to Nat’s excellent observations to say that, follow-up, compliance with post-op regime, and the understanding of what is necessary is the most important part of the procedure. My mom had part of her stomach removed, similar to Calvin, with similar symptoms to bypass patients - dumping after meals (from the stomach to the intestines), diarrhea, sometimes uncontrolled, and in her case, adhesions. This surgery is permanent. Your digestive system is permanently cut apart and re-routed…and as you can tell, not my cup of tea. I also had a co-worker who had to eat in a particular order to keep from dumping. I would personally only recommend the surgery if your co-morbidities were life-threatening. That’s why I chose Weight Watchers, irst because I couldn’t afford the surgery and wouldn’t have it anyway after I saw a diagram of the re-route, I knew I didn’t want my lifestyle altered to that point, and despite a BMI of 64, yes, 64, I have no co-morbidities at this point. I don’t know your situation, but weigh the decision very carefully and find an very good surgeon. Best of luck.
Kathy
My best friend had a prcedure not even two years ago, and she’s doing great. I met here few months after the suregery, and when she showed me the pcictures from before I coudln’t believe it’s her. She looks and feels great. So far she didn’t have any side effects. Only first few weeks were painful, when she was getting adjusted to the new eating plan. At this point she can eat much more, she can eat all normal food, she loved before the surgery, just in reasoneble portions. She says it was one of the best things she ever done in her life.
E Lynne,
I think the most important factor regarding gastric bypass is the experience of the surgical team who performs the procedure. Complications are a definite concern. So many of the patients who undergo the procedure have comorbid conditions. But I believe that when the procedure is done by an experienced team, the odds are justified in relation to the risks. One needs to research the area in wich the procedure will be performed to determine who is best qualified. Talk with surgreons you know and trust.They can tell you who to consult with.
Paul
I should add that a friend of mine had it and had great results. She lost 160 pounds and because she was thinner, they found a tumor in her thyroid that had been hidden before.
Hate to admit but my post was mostly because I am a little bitter, not mad at anyone, and I can eat more now. For some reason Indian food works best with my new digestive system. Anyway, keep us posted.