Less-invasive weight loss surgery safer.

(Reuters) / 23 June 2012

Minimally invasive weight loss surgery is safer than open surgery, with patients suffering fewer complications during those procedures, according to a US study of more than 150,000 people who underwent gastric bypass surgery.
Patients left the hospital sooner, and with a slightly smaller medical bill, after undergoing so-called laparoscopic gastric bypass procedures, in which only a few small cuts in the stomach are made, said researchers at Stanford University in California.
During gastric bypass, the surgeon creates a pouch out of the top portion of the stomach, then connects it to the small intestine so fewer calories are absorbed during digestion, with one large cut being made. Laparoscopic surgery involves a small camera being inserted, and several small cuts.
“The consensus is now overwhelming to suggest a laparoscopic approach first,” said John Morton, who led the research, noting that close to 90 per cent of gastric bypass surgery patients now have it done laparoscopically.
“Pretty much across the board (it has) much better outcomes for patients.”
Morton and his colleagues analysed data on weight loss procedures done at about 1,000 US hospitals each year between 2005 and 2007, including 41,000 open gastric bypass surgeries and 115,000 laparoscopic surgeries.
Looking at safety records, the researchers found about 19 per cent of patients undergoing open surgery had at least one complication, such as developing pneumonia or needing a blood transfusion. Just over 12 per cent of those who had less-invasive surgery developed complications.
One in 500 obese patients in the open surgery group died during or shortly after the procedure, compared with one in 1,000 in the laparoscopic group, according to findings published in the Archives of Surgery.
Open surgery patients also had longer hospital stays, 3.5 days versus 2.4 days, on average.
According to data from the American Society for Metabolic and Bariatric Surgery, about 220,000 people in the United States had weight loss surgery, including gastric bypass, in 2009.
“From the surgeon’s perspective, the ability to see (during) the surgery is enhanced doing it laparoscopically,” said Anita Courcoulas, a professor and bariatric surgeon from the University of Pittsburgh Medical Center, who wasn’t involved in the study.
“From the patient’s perspective, there’s much less pain, so they can walk and move and return to normal activities sooner.”

Reuters - 23rd June 2012