Wednesday, May 24, 2017

Weight loss surgery still problematic

Every year, 200,000 Americans undergo some sort of weight loss, or bariatric, surgery. This has been going on for 20 years.

University of Michigan researchers, however, took a look at outcomes and have published several papers on the high level of variability of outcomes from facility to facility and the incidence of complications. (Annals of Surgery)

--Nearly one in five Medicare patients with adjustable gastric band surgery (done laproscopically through small incisions) end up needing at least one more operation, either to remove or replace the band or switch to another approach.

--Nearly half of the money Medicare spends on bariatric surgery--47%--is to repair or replace the bands.

--This form of surgery has declined in popularity and constitutes only 5% of operations, but hundreds of thousands of people still have the bands installed.

--In addition--there is tremendous variation between surgery centers in terms of the rates of re-operation.

--Even accredited "centers of excellence" can vary widely as to complications. The worst to the best, even in such centers, varies 17 fold. That's a huge swing.

--Hospitals with the lowest complications rate before the operations cheaper, too.

The conclusion? Efforts to improve the quality of this surgery would affect not only patients, but also costs.

Anecdotally, I also know people who have "eaten" though this surgery and have not achieved close to the expected weight loss or it has not been lasting if it has been achieved.

Do your research!

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