Benchmark Statistics and Data in Bariatric Surgery
Over the past decade bariatric surgery has undergone an extraordinary evolution. It is essential for prospective patients to know and understand benchmark statistics and data provided by this office.
- The Overwhelming Majority of Bariatric Procedures should be performed via Laparoscopy [Minimally Invasive Surgery]
Since 1995, bariatric procedures have been added to the catalog of procedures performed by minimally invasive surgeons and almost all patients should be able to be managed via laparoscopic procedures. Most high volume bariatric services will have a negligible conversion rate [converting a laparoscopic procedure to an open procedure]. In addition, studies are demonstrating that the open procedures have a higher complication rate than the laparoscopic procedures.
There are select groups of patients such as patients who previously underwent a failed, open bariatric procedure [revisions] or a major open procedure who will be at risk to be converted to an open procedure. Your surgeon will and should clearly identify and explain these risks.
Your surgeons are minimally invasive surgeons whose specialty is laparoscopic procedures. All the bariatric procedures they will offer or propose will be laparoscopic procedures. Certain patients namely patients undergoing revisions of previous, failed bariatric procedures may need to undergo an open procedure.
Our current conversion rate is negligible. For the past 1000 laparoscopic cases, this office has no recorded, un-anticipated conversion.
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High Volume Bariatric Surgeons and Services have a lesser complication rate when performing bariatric procedures.
Surgical services performing a high volume of surgical procedures generate a lower surgical complication rate when compared to a low volume bariatric service. It is crucial for all prospective patients to enquire about the number of bariatric cases performed.
This bariatric service is a high volume bariatric service.
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Bariatric Patients have a better outcome in dedicated bariatric services
Bariatric services are geared toward caring for morbidly and super-obese patients. Bariatric procedures should be performed in Center of Excellence bariatric services only. Our two surgical, bariatric services at Providence Saint Joseph Medical Center and Cedars Sinai Medical Center are "state of the art, cutting edge" bariatric services offering a full line or bariatric procedures and services. These services are properly accredited by most major insurance carriers and surgical societies.
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Selecting a Center of Excellence or Center of Expertise Bariatric Service
Major insurances companies and surgical societies have formed Centers of Excellence or Expertise networks to route patients toward preferred, high volume bariatric services in order to decrease surgical complication rates. However, some insurance companies will also design some medical centers as Centers of Excellence or Expertise based on additional financial issues and charges.
Our two surgical services are designated as Centers of Excellence or Expertise by most healthcare carriers and surgical societies. In addition, our bariatric services are a major, bariatric referral center for bariatric surgery for numerous medical groups and insurance companies.
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Morbidly Obese and Super Obese Patients are shown to have a shorter life span that the normal weight patient population
It is well demonstrated that morbidly obese patients and super obese patients must correct their weight at all costs. Studies are increasingly showing that these patients develop numerous co-morbid conditions from their obesity that will deteriorate their health and shorten their life span. It is also clear that the average mortality rate for young, morbidly obese patients far exceed the average mortality of normal weight patients. For these reasons, obesity has been classified as one of the most urgent and severe health care issue facing the United States.
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Bariatric Procedures are complex surgical procedures and are associated with a significant national mortality and morbidity [complication] rate.
Open and laparoscopic procedures are associated with a significant mortality and morbidity rate. Aggregate reports are identifying an average mortality rate between 0.1 to 2.0% according to the bariatric services. This mortality rate is lowest in morbidly obese patients with no co-morbid condition and maximum in super-obese patients with multiple co-morbid conditions. All prospective patients should understand that bariatric procedures are complicated surgical procedures and that in spite of extensive prevention protocols severe complications and death can occurs. However, complication rates are at the lowest in high volume bariatric service.
To date, this office surgical mortality rate averages 0.04%.
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Safety - Risk Ratio of Bariatric Procedures
Some bariatric procedures have a higher complication rate than others while others are classified as safer. This service's catalog of bariatric procedures is extensive but will not include certain procedures which we classify as too risky or associated with severe long term side effects.
To date, the bariatric procedures we offer are as follows:
1. Laparoscopic Placement of an Adjustable Gastric Band or LapBand™ or LAGB
2. Laparoscopic Gastric Bypass with Roux Y Limb or LGB
3. Laparoscopic Duodenal Switch [BPD-DS] or LapDS
4. Laparoscopic Sleeve Gastrectomy or LapSG
5. Laparoscopic and Open Revisions of Failed Bariatric Procedures
6. Laparoscopic Hybrid Bariatric Procedures
Each procedure is tagged with a safety-risk ratio. For example, the LABG is found to be the safest of bariatric procedures. However long term weight loss is not as pronounced as with the LGB which is a procedure associated with more surgical risks. The LapDS has a reported better long term weight loss but has a higher rate of surgical complications and long term side effects and nutrient deficiencies than the LGB.
All prospective bariatric patients should understand this safety-risk ratio and should discuss it with their surgeon prior to making a selection.