Newer method swelling U.S. weight-loss surgeries

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A boom in weight-loss surgeries in the United States appears to be driven in part by the growth of a less invasive procedure, which reduces pain and permits a quicker recovery, doctors said on Monday.

Use of a laparoscopic technique, which involves several small abdominal incisions and insertion of a miniature camera to guide the surgery, jumped from about 2 percent of bariatric surgeries in 1998 to nearly 18 percent in 2002, the report from the University of California Irvine Medical Center said.

During the same time the total number of U.S. weight-loss surgeries increased by 450 percent, the study said, to more than 72,000 in 2002. Growth has continued since then with about 140,000 total weight loss surgeries conducted last year.

Complications from such surgery can include intestinal leaks and blood clots, with a death rate of 0.5 percent to 1 percent of patients, according to experts.

In the next few years the laparoscopic technique will probably become more common than open surgery, in which an incision is made from the breast bone to the navel. The laparoscopic technique generally involves a shorter hospital stay, less post-operative pain, a quicker return to work and a shorter recovery time—though similar complications are possible from both open and closed bariatric surgeries.

The report, published in the December issue of the Archives of Surgery, said that in 2002 more than 90 percent of U.S. weight loss surgeries involved the so-called Roux-en-Y procedure in which the stomach is reduced by stapling or banding off part of it and connecting the remaining stomach to the middle part of the small intestine.

Weight loss surgery is often sought by people whose obesity is life-threatening.

“With the advantages of laparoscopic gastric bypass clearly apparent to patients and physicians, more physicians are likely to refer their patients for a surgical operation, and patients are more willing to undergo surgery for treatment of morbid obesity,” the report said.

About 8 million U.S. adults are categorized as morbidly obese, meaning they are 50 percent to 100 percent above their ideal body weight. Bariatric surgery, which shrinks stomach size, is currently the only effective option to bring such people sustained weight loss, the study said.

“Without a long-term, effective nonsurgical treatment for morbid obesity on the horizon, the rate of bariatric surgery will continue to increase and the procedure will become one of the most commonly performed gastrointestinal operations,” the study concluded.

SOURCE: Archives of Surgery December 2005.

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