Weight loss surgery continues to rise in California

Thursday, Oct. 27, 2011
Modesto hospital tops state in weight-loss surgery
Study eyes operations, patients and the results
By Ken Carlson

MODESTO -- The number of people getting weight loss surgery continues to rise in California, where nearly one in four residents are considered obese, a state agency reported this week.

The mortality rate at the 94 California hospitals where bariatric surgeries are performed remained low, at 1.5 deaths per 1,000 surgeries, or about 20 deaths per year.

The surgery count rose by nearly 7 percent from 2005 to 2009, according to the Office of Statewide Health Planning and Development, which did a study looking at the types of bariatric surgery, costs and patient safety.

BARIATRIC SURGERY AT A GLANCE

• The study, "Trends in Bariatric Surgery in California Hospitals, 2005 to 2009" can be accessed at www.oshpd.ca.gov.

• The 604 gastric bypass surgeries performed at Modesto's Memorial Medical Center in 2009 was the third highest among hospitals in the state.

• The hospital attributes the large number of surgeries to the prevalence of obesity in the San Joaquin Valley.

• Of the 668 bariatric surgeries at Memorial in 2009, 559 were laparoscopic gastric bypasses, 54 were Lap-Band procedures, 10 were vertical sleeve gastrectomies and five were open gastric bypasses.

• Some hospitals with weight-loss surgery programs have "center of excellence" certifications from the American Society for Metabolic & Bariatric Surgery or the American College of Surgeons.

The health group found that people seeking bariatric surgery commonly suffered from health conditions related to being severely overweight — such as nutritional and metabolic disorders, high blood pressure, joint problems, sleep apnea or diabetes — that can be relieved by the weight loss that comes after the surgery.

The operation often involves shrinking the stomach and bypassing a portion of the small intestine, so the person eats less and absorbs fewer nutrients. It's recommended for people with a body mass index of 30 or more and at least one serious medical condition after not losing weight through dieting.

"Californians should discuss all options for weight loss with their physicians to determine the most appropriate course of care," said the health group's acting director, Stephanie Clendenin.

She said patients can use the report for information on the types of bariatric surgery performed at hospitals and the risks for those procedures. The report does not give the mortality or complication rates for specific hospitals.

Modesto's Memorial Medical Center has the most active bariatric program in the Northern San Joaquin Valley, with 668 surgeries in 2009.

The study, which considered hospital data from 2005 to 2009, backed up previous findings that there are significant risks to bariatric procedures. It found that:

• About 13,500 bariatric surgeries were performed at hospitals in 2009.

• 13 percent of patients suffered post-surgical complications such as bleeding or infection during their hospital stay.

• 6.4 percent of patients were readmitted to the hospital within 30 days of surgery, a rate 2½ times higher than for other kinds of surgery.

The health group released the study as the state girds for stronger regulation of outpatient clinics that offer weight loss surgery. In Southern California, five patients have died in the past two years after Lap-Band procedures at clinics connected with the 1-800-GET-THIN promotions.

Gov. Jerry Brown signed a bill this month calling for inspections at outpatient surgical centers to ensure they meet safety standards.

With the recent study, the health group charted a dramatic shift in the types of bariatric surgeries done at hospitals.

In 2005, 2,289 patients underwent open Roux-en-Y gastric bypass surgery. The number declined to 367 by 2009. In the same period, the number of minimally invasive Lap-Band procedures exploded, growing from 737 to 3,260. Doctors performing a Lap-Band operation place a silicone band near the top of the stomach to restrict the passage of food.

About 90 percent of weight loss surgeries at Memorial Medical Center were laparoscopic gastric bypasses in 2009. Surgeons make a small incision and perform the operation with fiber-optic instruments.

"For a number of years, we have been able to perform the surgery with such small incisions the patients are not uncomfortable with the surgery," said Dr. Patrick Coates, director of Modesto's bariatric program. "We get them up walking two hours after the surgery. It decreases the amount of pain and improves the overall results."

Read more: http://www.modbee.com/2011/10/27/1923264/bariatric-surgeries-climb.html#ixzz1c6UUaOC5