Minimally invasive approach to weight-loss surgery reduces complications, study shows
A study by researchers at Stanford University Medical Center has found that a popular weight-loss operation is safer and reduces hospital bills when done with minimally invasive techniques rather than open surgery, which requires a large abdominal incision.
The authors say that, to their knowledge, this is the first time the open and minimally invasive approaches have been compared at a national level. "There have been single-center randomized trials that support the greater safety and efficacy of the minimally invasive approach, but what our study does is to confirm that those results are actually occurring in practice at hospitals and academic medical centers across the country," said John Morton, MD, MPH, associate professor of surgery and senior author of the study, which is to be published online June 18 in the Archives of Surgery.
The patients who underwent the laparoscopic, or minimally invasive, procedure had lower mortality rates, lower complication rates, shorter hospital stays and lower hospital charges compared with those who underwent open surgery, even after adjusting for differences in the patients' socioeconomic levels and co-morbidities, the study reports.
The researchers examined 156,271 Roux-en-Y gastric bypass cases performed between 2005 and 2007 nationwide, including 115,177 patients who had the laparoscopic approach and 41,094 who had it done as open surgery.
The operation involves making a small pouch from the upper part of the stomach and connecting it directly with the middle section of the small intestine, bypassing the rest of the stomach and upper section of the small intestine. The result is that patients cannot eat as much food at one time and feel fuller with smaller portions.
Morton, who is also director of bariatric surgery at Stanford Hospital & Clinics and director of the Surgery Center for Outcomes and Research Evaluation at Stanford, said he wasn't surprised that the laparoscopic technique got good marks for patient safety. "What did surprise me was the degree of superiority pretty much across the board compared with open surgery," he said.
There were lower rates of in-hospital complications experienced by the laparoscopic patients in 15 out of 18 complication categories, including cardiac arrhythmia, sepsis and the need for a blood transfusion, the study reports. In addition, the patients who had the minimally invasive procedure were found to have shorter hospital stays.
The authors cite previous research in noting that "mortality and other complications are serious risks associated with bariatric surgery and are inversely correlated with the volume of cases performed by the surgeon."
They add: "The Centers for Medicare & Medicaid Services determined that bariatric procedures should only be performed at high-volume facilities that are either certified by the American College of Surgeons or the American Society for Metabolic and Bariatric Surgery/Surgery Review Corporation as a Bariatric Surgery Center of Excellence."
The Centers for Medicare & Medicaid Services define high-volume practices as those that perform 125 or more weight-loss surgeries annually.
Approximately 300 weight-loss operations are performed each year at Stanford Hospital, whose Bariatric and Metabolic Interdisciplinary Clinic is the is the only Bariatric Surgery Center of Excellence in Northern California to achieve Level 1A certification by the American College of Surgeons.
Journal reference: JAMA Surgery
Provided by Stanford University Medical Center
- After Medicare rule change, fewer facilities performed bariatric surgeries but outcomes improved Jan 18, 2010 | not rated yet | 0
- Complications, death rates similar at bariatric surgery centers of excellence, other hospitals Apr 20, 2009 | not rated yet | 0
- Robotic surgery lowers risk of a rare but serious complication of gastric bypass Sep 24, 2008 | not rated yet | 0
- Number of laparoscopic bariatric procedures continued to rise between 2003-2008 Aug 08, 2011 | not rated yet | 0
- Reducing obesity: UCI surgeons find bariatric surgery safer, gastric bypass most effective Mar 16, 2010 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Calculating on-axis elements of a solenoid
9 hours ago I wanted to mention that this solenoid has many winds over many layers. The thickness of the windings is 2.4 inches coming off of the engineering...
latitude & longitude & air pressure
11 hours ago Hi there, I have a peculiar question. Imagine that you are in a earth position, obtained by google, that gives you the latitude and longitude....
Differences of Classical Mechanics when learned with Calc vs algebra?
14 hours ago what are the differences? Every example I find usually has a derivative or integral or some kind of calculus defined concept that seems to make it...
what is the distance traveled
18 hours ago A rough sketch of experiment. Image: http://i43.tinypic.com/14t4sk5.png the red dots represent a side view of path traveled, F is downward force...
Image of a Convex Lens Cut in Half Horizontally
22 hours ago Hello everyone, A friend of mine came up with this question in class and I really do not have a good answer. Suppose you have a convex lens...
Ray tracing through optical system of thick lenses
22 hours ago Can you advise me a free software that allow to draw rays passed throught system of thick lenses (preferable in 3D)?
- More from Physics Forums - Classical Physics
More news stories
Johns Hopkins researchers have developed new guidelines—the first in more than 35 years—to govern the amount of blood ordered for surgical patients. The recommendations, based on a lengthy study of blood use at The Johns ...
Surgery 16 hours ago | 4 / 5 (1) | 0
Indian doctors said Wednesday they have successfully carried out a first round of reconstructive surgery on the skull of a baby suffering from a rare disorder that caused her head to nearly double in size.
Surgery 21 hours ago | not rated yet | 0
A 33-year-old Polish man received a face transplant just three weeks after being disfigured in a workplace accident, in what his doctors said Wednesday is the fastest time frame to date for such an operation. ...
Surgery 22 hours ago | not rated yet | 0
Surgeons investigated sexual function in 62 patients, 50 years and older, who had received extensive spinal–pelvic instrumentation for spinal deformity at the University of Virginia Health Center. Based on their results, ...
Surgery May 21, 2013 | not rated yet | 0
Physicians at Monash University and The Alfred Hospital in Melbourne, Australia describe the logistic, medical, and societal challenges faced in treating spine trauma in morbidly obese patients. Based on a case series of ...
Surgery May 21, 2013 | not rated yet | 0
US teen births have dropped to a record low, but the country still has one of the highest rates among developed nations, the US Centers for Disease Control and Prevention said Thursday.
1 minute ago | not rated yet | 0
Swiss scientists reveal the mechanism responsible for aging hidden deep within mitochondria—and dramatically slow it down in worms by administering antibiotics to the young.
17 hours ago | 4.9 / 5 (9) | 1 |
Researchers from Queen Mary, University of London have led the largest sequencing study of human disease to date, investigating the genetic basis of six autoimmune diseases.
17 hours ago | 4.7 / 5 (3) | 0 |
Until now, little was scientifically known about the human potential to cultivate compassion—the emotional state of caring for people who are suffering in a way that motivates altruistic behavior.
14 hours ago | 5 / 5 (2) | 2 |
Existing research shows that bicyclists who wear helmets have an 88 percent lower risk of brain injury, but researchers at Boston Children's Hospital found that simply having bicycle helmet laws in place showed a 20 percent ...
6 hours ago | not rated yet | 0
(HealthDay)—Migraines and depression can each cause a great deal of suffering, but new research indicates the combination of the two may be linked to something else entirely—a smaller brain.
14 hours ago | 4 / 5 (2) | 0 |