In the United States, along with many other countries throughout the world, obesity is a major problem that continues to grow each year among all ages, genders, ethnic groups and both smokers and non-smokers. The obesity rate in the U.S. was 15 percent or more in every state in the year 2000, except for Colorado, with twenty-two states having rates of 20 percent. Doctors recommend that obese patients lose the weight in an attempt to avoid health risks such as high blood pressure, high cholesterol, diabetes and various cancers. An estimated 42 percent of men and 38 percent of women that are obese are reported to have high blood pressure, while 22 percent of obese men and 27 percent of obese women have high cholesterol. In addition to that, about 70 percent of all diabetes risk is resulting from obesity. Higher death rates were seen in cancers of the esophagus, colon, rectum, liver, gallbladder, pancreas, kidney, stomach, prostate, breast, uterus, cervix and ovaries in people that were overweight. The risk of death from any cause, especially heart problems, in overweight people was found to be 50 to 100 percent higher than the risk for people with a normal body weight. Also, the more overweight a person is, the shorter their life expectancy. Extremely obese young white males (20-30) may lose up to 13 years of their life, while women in that range may lose up to 8 years. As for African Americans in that category, men can lose up to 20 years and women up to 5 years. People that are only moderately obese can still shorten their life expectancy by 2 to 5 years, making weight loss extremely important even for slightly overweight individuals.
Conclusions reached in 1991 by the National Institute of Health reported that about 95 percent of individuals who start a weight loss regimen regained their lost weight within 2 years of reaching their lowest weight. These results prompted the recommendation of two forms of bariatric surgery, vertical banded gastroplasty (VBG) and Roux-en-Y gastric bypass (RYGB), for extremely obese individuals or those facing life-threatening health risks because of their weight. Those eligible for bariatric surgery must have already attempted normal weight loss methods with no success and be completely educated about the procedure and its results. The American Society for Metabolic and Bariatric Surgery recommends that patients not only be well informed about their surgery, but also understand what variations to expect in their lifestyle as well as the need for extensive follow-up to their procedure. It is also important that a patient be evaluated before making a decision on which procedure to use, in order to best fit the choice to their needs. Doctors should administer a physical exam and assess the medical and dietary history of a patient, as well as their psychologic status, before considering them as a candidate. Patients should also be given extensive information on each bariatric surgery option so they can make an educated choice and have a successful procedure.
Laparoscopic procedures:
The most preferred bariatric surgeries are performed laparoscopically, or in a minimally invasive way. These methods have a lower death rate because they avoid thh sizable incision in the abdomen required of other surgeries. In the United States, Roux-en-Y gastric bypass, adjustable gastric band, biliopancreatic diversion with duodenal switch and sleeve gastrectomy are the most routinely performed procedures.
Roux-en-Y gastric bypass:
Laparoscopic RYGB is the most widely performed bariatric procedure for weight loss in the United States due to its familiarity among doctors. This surgery restricts the amount of food consumed by the patient, while reducing the number of calories the body can absorb from that food. During RYGB, doctors create a tiny pouch at the top of the stomach which reduces the amount of food a person can consume. The procedure also requires the gastrointestinal tract to be reconstructed so that food can leave both the pouch and the existing stomach. People that have this procedure develop a decrease in appetite because their body is telling them that they are fuller, sooner. This causes the person to consume less food at each meal, resulting in substantial weight loss. Patients must also monitor their eating habits, making sure that food is completely chewed, eaten slowly and they must not eat more than they can now fit to avoid nausea or vomiting.
This procedure comes with advantages and disadvantages that may influence a patient’s decision. One benefit of this procedure is that results are seen almost immediately, continuing for 18 to 24 months after the surgery is performed. This procedure is also permanent, meaning that a patient will not regain the weight lost years after the surgery. RYGB also reduces the health risks that were increased due to obesity, such as high blood pressure, obstructive sleep apnea, diabetes and hyperlipidemia, or high lipid levels in the blood, such as cholesterol. Some of the disadvantages of RYGB include the risk of leaks in any of the impacted areas, internal hernias and a longer follow-up time when compared to other procedures.
For more information, visit www.obesityhelp.com
Adjustable gastric band:
Following RYGB, the second most common laparoscopic surgery in the United States is the adjustable gastric band. The operation was approved by the Food and Drug Administration (FDA) in June of 2001, after becoming the most prominent weight loss operation in places like Latin America, Europe and Australia. In the U.S., two types of laparoscopic gastric bands are now available, Ethicon Endo-Surgery’s Realize Personal Banding Solution and Allergan’s Lap-Band adjustable banding system. Both of these products involve minimally invasive surgery with short operating times and hospital says, as well as an extremely minimal risk of death and reduced risk of pain and incisional hernias. Negatives of the procedure include decrease in the stomach’s tolerance of certain foods, reflux and pain, which should be discussed with a doctor if experienced.
Similar to the RYGB procedure, the gastric band creates a small pouch in the stomach, about the size of an egg. This operation employs an inflatable silicon band to create the pouch, decreasing the amount of food the person can consume, resulting in weight loss. The diameter of the band can be adjusted, which in turn changes the size of pouch, allowing for more or less to be consumed. Adjustments to the gastric band can be made whenever needed, allowing for an increase in weight loss when desired. Unlike RYGB, this procedure does not lower the number of calories the body is able to absorb, nor is it permanent. The laparoscopic adjustable gastric band procedure, or LAGB, has varying results, occurring over the course of 18 months to 3 years.
For more information, visit www.realizeband.com and www.lapband.com
Biliopancreatic diversion with duodenal switch:
This laparoscopic procedure, known as BPD, alters the way in which a person absorbs foods by shrinking the stomach. The operation creates a diversion around part of the small intestine, preventing the body from absorbing as many calories as before. A modification made to this procedure involving the duodenal switch (BPD/DS) allows the pylorus, or the valve at the opening of the stomach, to stay intact, while the roughly half of the stomach is removed permanently. As in the original BPD procedure, the stomach is then connected to the last 8 feet of the small intestine, with the rest of the small intestine connecting to the small bowel where food meets the digestive enzymes.
BPD/DS is completely irreversible, due to the removal of part of the stomach. Also, there is a risk that patients may experience long-term nutritional insufficiencies since their bodies are no longer able to absorb the same amount of nutrients via the small intestine. However, there are also important advantages of this procedure, including the prevention of dumping syndrome (click here for more info), where the undigested stomach contents are promptly emptied into the small intestine too rapidly, causing abdominal cramps and nausea. This is avoided because the pylorus valve is left intact in the at the outlet of the stomach. Another advantage is that patients can consume larger meal portions that with a gastric band because the remaining stomach is larger than that of the created pouch in other procedures.
For more information, visit www.duodenalswitch.com
Sleeve gastrectomy:
The laparoscopic sleeve gastrectomy represents approximately 2 percent of weight loss operations performed in the United States. This relatively new operation which shrinks the stomach down to 25 percent of its original size, reducing the body’s allowed food intake. As in the BPD/DS procedure, the pylorus remains intact, eliminating dumping syndrome. Also, the procedure normally lasts for less than an hour, although patients are required to stay in the hospital overnight. Normal recovery time is about 2 weeks or less, allowing the patient to resume work and normal activities after that time period. The procedure also avoids the malabsorbiton that may occur in the BPD/DS procedure, allowing patients to normally absorb nutrients in the small intestine. However, there is a risk of blood clots with this procedure and the operation is irreversible.
For more information, visit www.advancedobesitysurgery.com
All of these surgeries may have serious complications if performed incorrectly or carelessly by a doctor. If you or a loved one has medical malpractice questions in New York, please contact the malpractice lawyers of Silberstein, Awad & Miklos, serving clients in Nassau and Suffolk Counties and Brooklyn, the Bronx and Queens, Staten Island and Westchester County.
Fight for justice against FRIVOLOUS DEFENSES and DECEPTIVE DEFENSES.
Joseph Miklos
Silberstein, Awad & Miklos, P.C.
600 Old Country Road
Garden City, New York 11530
Call Toll-free 1-877-ASK 4 SAM
www.ask4sam.net
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