Puget Sound Surgical Center - The History of Weight Loss Surgery - Seattle Weight Loss Surgery and Bariatric Experts


	The History of Bariatric Surgery GASTRIC BYPASS (continued) The risk of dying in the first month after a RYGBP from complications of the operation is about 0.2 to 0.5% in expert centers. Studies have demonstrated that the mortality rate from hospitals with a low experience with the procedure is far higher than that reported by expert centers. The American Society of Bariatric Surgeons fully supports the initiative of the Surgical Review Committee to establish rigid criteria to certify that hospitals with quality programs will be designated as a “Center of Excellence.” Advantages of RYGBP: Better weight loss than after purely restrictive procedures Low incidence of protein-calorie malnutrition and diarrhea Rapid improvement or resolution of weight-related comorbidities Appetite reduction LAPAROSCOPIC GASTRIC BYPASS Although the open RYGBP can be performed with a relatively low morbidity and mortality, the wound-related complications such as infection and incisional hernia can be troublesome. Wound infection occurs in as many as 8% of patients after open RYGBP and late incisional hernia occurs in as many as 20% of patients. However, some surgeons have reported a much lower rate. The laparoscopic approach to RYGBP was initiated in an effort to improve the early outcomes including a reduction in postoperative complications arising from a large incision in a severely obese patient. Clinical studies of over 1,500 operations have demonstrated that laparoscopic RYGBP is a safe and effective alternative to open RYGBP for the treatment of morbid obesity. There have been three prospective, randomized trials comparing the outcomes of laparoscopic vs open RYGBP. Long-term weight loss after laparoscopic and open RYGBP should not differ, as the primary differences between the two techniques is largely in the method of access and not the gastrointestinal reconstruction.

GASTRIC BYPASS (continued)

The risk of dying in the first month after a RYGBP from complications of the operation is about 0.2 to 0.5% in expert centers. Studies have demonstrated that the mortality rate from hospitals with a low experience with the procedure is far higher than that reported by expert centers. The American Society of Bariatric Surgeons fully supports the initiative of the Surgical Review Committee to establish rigid criteria to certify that hospitals with quality programs will be designated as a “Center of Excellence.”

Advantages of RYGBP:

Better weight loss than after purely restrictive procedures
Low incidence of protein-calorie malnutrition and diarrhea
Rapid improvement or resolution of weight-related comorbidities
Appetite reduction

LAPAROSCOPIC GASTRIC BYPASS

Although the open RYGBP can be performed with a relatively low morbidity and mortality, the wound-related complications such as infection and incisional hernia can be troublesome. Wound infection occurs in as many as 8% of patients after open RYGBP and late incisional hernia occurs in as many as 20% of patients. However, some surgeons have reported a much lower rate. The laparoscopic approach to RYGBP was initiated in an effort to improve the early outcomes including a reduction in postoperative complications arising from a large incision in a severely obese patient.

Clinical studies of over 1,500 operations have demonstrated that laparoscopic RYGBP is a safe and effective alternative to open RYGBP for the treatment of morbid obesity. There have been three prospective, randomized trials comparing the outcomes of laparoscopic vs open RYGBP. Long-term weight loss after laparoscopic and open RYGBP should not differ, as the primary differences between the two techniques is largely in the method of access and not the gastrointestinal reconstruction.