More than 300,000 people in the United States die annually due to complications from obesity. Obesity is a cause of premature death second only to premature death from cigarette smoking. Obesity has been recognized as a chronic disease since 1985 and approximately one-third of all Americans are obese.
Each year, thousands of morbidly obese people are electing to have gastric bypass surgery. The surgery, often simply referred to as gastric bypass or stomach stapling, is the surgical creation of a small pouch in the stomach to restrict food intake to far less than could be eaten before the surgery. Typically, a bypass patient will only be able to hold a cup of food or less at a single meal. Weight is lost rapidly because far fewer calories are consumed and because a large section of the small intestine is bypassed, which caused a decreased ability to absorb nutrients in food.
It is estimated that 140,000 people had gastric bypass surgery in 2004 and the number is growing each year. For many patients, this surgery is a lifesaver; others are not so fortunate. When gastric bypass is successful, there are benefits such as having a more normal life due to drastic weight loss (bypass patients have been known to lose 100-200 pounds). Patients look and feel better and are able to have a normal, active lifestyle. Gastric bypass patients also drastically lower their risk of major illnesses and diseases associated with morbid obesity. When gastric bypass surgery is not successful, the consequences can be painful and sometimes deadly.
The death rate from gastric bypass surgery is alarmingly high: 1 out of 350 people. Those who do not die after the surgery may experience a plethora of serious complications that will be discussed below.
There are basically two ways to perform gastric bypass surgery. The first is surgery under anesthesia where the surgeon divides the stomach into a small upper section and a larger bottom section using staples that are similar to stitches. The top section of the stomach (called the pouch) will hold the food you take in. After the stomach has been divided, the surgeon connects a section of the small intestine to the pouch. When you eat, the food will travel from the pouch through the new connection bypassing the lower portion of the stomach.
Gastric bypass can also be performed using a laparoscope, which is a less-invasive procedure that allows the surgeon to make smaller incisions lowering the risk of scars and hernias after the procedure. With the laparoscopic method, your surgeon will make small incisions in your abdomen and pass thin surgical instruments through the narrow openings of the incisions. The surgeon passes a camera (the laparoscope) through one of the openings and does the surgery watching a video monitor of his actions. Not everyone is a candidate for this technique of gastric bypass. If you weigh more than 350 or have had past abdominal surgery, you are probably not a good candidate for this technique.
The many risks with both techniques are:
· Infections
· Bleeding
· Gallstones
· Gastritis
· Vomiting
· Iron or vitamin B12 deficiency
· Calcium deficiency
· Diarrhea
· Nausea
Critics of gastric bypass are warning potential patients that the risks of this procedure far outweigh the benefits. Studies have shown that in the thirty days following gastric bypass, as many as 1 in every 50 patients died. Approximately 3% of patients who had gastric bypass surgery were younger than 40 and died within 13 years. After 15 years, almost 12% of bypass surgery patients died. About 10-20% of all patients having gastric bypass require follow-up operations to correct complications, the most common one being abdominal hernias. More than one-third of the patients having the surgery develop gallstones. Other post-surgery complications are leaks, infection, ulcers and deep thrombo-phlebitis.
Because of the large number of people suffering complications and dying after having gastric bypass surgery, medical malpractice claims involving gastric bypass are increasing each year.
The most common causes of gastric bypass malpractice are:
· Inexperience surgeons performing the procedure
· Failure to diagnose and properly treat leakage of gastric fluid
· Failure to diagnose and treat pulmonary embolism
· Failure to diagnose and properly treat gastric bleed
· Failure to properly screen potential bypass patients
Clearly, there are both benefits and risks to having gastric bypass surgery. If you are morbidly obese and would like to learn more about this procedure, your physician can help you or direct you to a specialist in bariatric medicine.
