Bariatric Surgery

Recently I've been consumed with a most fascinating field of medicine - Baritatrics. No doubt bariatric surgery is life saving and life changing. The health benefits are numerous but it's not a surgery to rush into and requires careful consideration by the patient, a lot of research and a dedication to change a lifestyle.  It's not a cure-all.  You don't have it one day and the next, voila - you're skinny!  In fact it takes a lot of effort once the surgery is complete in order to ensure success.   

Relative to other fields of medicine and surgery, bariatrics is fairly new, really only widely available since the 1970's.  Innovations in medical technology have greatly enhanced bariatric surgical expertise. Surely this must be very rewarding for those surgeons and other allied health care professionals involved in the treatment and care of the bariatric patient.  Insurance companies that once considered this a cosmetic surgery now routinely cover the surgery which results in greatly reducing other expensive and life threatening co-morbidities.

Doctors can perform a wide number of gastric operations for obesity from Roux-en-Y, vertical banded gastroplasty, biliopancreatic diversion, LAP Band, or sleeve gastrectomy. The surgeon can perform the surgery via laparotomy (open)or by a minimally invasive  procedure known as laproscopic bariatric surgery. Laparoscopic surgery involves small incisions into which a camera and surgical instruments are inserted and the surgeon operates while watching the abdomen on a monitor.

Of course on my end of the bariatric realm, I get to see the less than ideal outcomes.  Certainly, there are accepted complications that arise from this very complex surgery.  That's not what I'm dealing with - primarily my cases involve failure to diagnose these known complications and to failure to treat them expeditiously, before a cascade of additional injury can occur.

Cases that involve malpractice or negligence can arise from gastrointestinal leaks or intra-abdominal leaks.  Surgical leaks can occur from a number of things such as anastomoses or staple lines.  Other complications include  deep venous thrombosis and pulmonary embolus, abdominal catastrophe resulting in peritonitis and sepsis.  Vigilant ost operative management: looking for and treating signs and symptoms of these complications (tachycardia, tachypnea, fever, low urine output, pain, pleural effusion, increasing white blood count among others) can prevent further internal injury.

Resources on bariatrics for those considering the surgery are voluminous.  The American Society of Bariatric Surgeons began credentialing surgeons, nurses and medical centers around 2004 in order to provide more consistent and safer patient care.  Surgeons and centers meeting ASBS criteria are known as as Centers of Excellence. stomach stapling, jejunem, morbid obesity, complications, deep venous thrombosis and pumonary embolus, abdominal catastrophe, peritonitis, sepsis, Centers of Excellence, American Society for Bariatric Surgery, ASBS, post-operative management, post operative leaks, perforations