Most-Experienced Obesity Surgeons Show Best Outcomes

A study has shown that the risk of complications following gastric bypass surgery for obesity is significantly lower when performed by high-volume surgeons.

The study involved data on 4,674 cases of gastric bypass surgery. Of these, 82% were female and age ranged from 16-74 years. The data encompassed 73 hospitals and 129 surgeons. There were 28 in-hospital deaths and 813 adverse outcomes during the period studied. Nearly 17% had postoperative complications while in the hospital. The outcomes showed that patients treated by high-volume surgeons had a 14% risk of adverse outcomes and 0.3% risk of death, while patients of surgeons performing fewer than 10 procedures per year had a 28% risk of adverse outcomes and a 5% risk of mortality.

"Surgeons performing only 10-50 cases per year, operating in low-volume hospitals had the highest adverse outcome rate of 55%, and those surgeons performing fewer than 10 cases per year in a medium-volume hospital had a mortality rate of 7%. Surgeons performing more than 50 cases a year did not operate in low-to-medium volume hospitals,” explained Anita Courcoulas, M.D., assistant professor of surgery at the University of Pittsburgh School of Medicine and director of bariatric surgery at the Medical Center's Shadyside Hospital (UPMC, PA, USA).

Dr. Courcoulas noted that the introduction of the laparoscopic approach has increased both the complexity and prevalence of gastric bypass procedures. In the procedure, a small stomach pouch is created to restrict food intake. Then a y-shaped portion of the small intestine is attached to the pouch to allow food to bypass the lower stomach, the duodenum, and the first section of the jejunum. This reduces the amount of calories and nutrients the body can absorb.




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