It is estimated that 832 people a day die from obesity in the United States each year. It has been proven that the opportunity to have weight loss surgery saves and changes countless lives and many of you in the ObesityHelp.com community can attest to that! However, in recent months, obesity surgery, and especially Gastric Banding, has been reflected negatively in various media outlets. The firestorm was ignited after five Lap-Band patients were reported to have died after having surgery at two centers affiliated with the 1-800-Get-Thin ad campaign. Were the 1-800-Get-Thin affiliates operating purely from a volume perspective with little or no emphasis on the quality of care and aftercare? Or were the deaths the result of careless operating techniques and allegations of gross negligence? Whatever the answer may be, and that answer is significantly important, the reports unfortunately left a black eye on the bariatric community.
Patient Care Should Be The Gold Standard
In the midst of the negative hype and media fury, several very concerned Center of Excellence bariatric surgeons in the ObesityHelp community and beyond "banded" together and wrote to our US representatives in an effort to share an valuable message about patient safety and the importance of the multidisciplinary approach. They wanted to set the record straight. Their message? One surgery or center does not fit all and good surgery outcomes are more likely with specialists who offer a comprehensive program and gold standard patient care.
“We urge patients and colleagues alike to focus on a multidisciplinary approach to a complex chronic illness, and not rush to condemn a single procedure that has been a vital tool in the successful treatment of thousands of our patients.? wrote Dr. Sunil Bhoyru and his colleagues.
On behalf of the ObesityHelp community, we salute these very surgeons who change and improve lives daily and thank them for continuing to educate and support our community. Their advocacy, their care about the well-being of their patients and the community as a whole, is priceless. And we thank them for allowing us to share their valuable letter with the ObesityHelp.com community. Please read below and share your comments:
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January 24, 2012
Henry A. Waxman, California Ranking Member
Congress of the United States
House of Representatives
Committee on Energy and Commerce
2125 Rayburn House Office Building
Washington, DC 20515-6115
The Honorable Fred Upton
Chairman
Committee on Energy and Commerce U.S. House of Representatives
2125 Rayburn House Office Building
Washington, DC 20515
The Honorable Joseph R. Pitts Chairman
Subconunittee on Health
U.S. House of Representatives
2125 Rayburn House Office Building
Washington, DC 20515
The Honorable Cliff Stearns
Chairman
Subcommittee on Oversight and Investigations U.S. House of Representatives
2125?Rayburn House Office Building
Washington, DC 20515
Dear Sir/Madam:
As a diverse group of Bariatric Surgeons from around the country, we feel that the recent reports of adverse outcomes from obesity surgery, in particular Gastric Banding, is the direct result of a treatment-based rather than an illness-based approach to obesity.
Offering surgery to a patient who suffers from obesity is a complex decision, and is certainly not a competition between procedures. Our challenge, as physicians taking care of the most prevalent chronic illness in the US, is to match the best treatment choice to the needs of the individual patient. There are clearly patients who should not have any form of surgery, and then there are patients who may be better suited to one surgery over another. In our practice, as in other high volume practices in the United States that offer all surgical interventions, the choice of surgery is determined by a host of medical, social,psychological, and occasionally economic factors. For example, a single mother who is 200lbs over weight and has bad diabetes should probably not get the same operation as an otherwise healthy young male who is 80lbs overweight and has good social support. Critically, no surgical intervention is likely to be successful without a program that incorporates structured long-term follow up with dietary, lifestyle, and medical supervision. Finally, as our understanding of obesity, genetics, and chronic disease has vastly improved in the last few years, the importance of body composition, eating behaviors, and even the patients DNA all factor into the decision to operate and potentially the choice of procedure.
The recent reports of tragic deaths from the 1-800-GET THIN group in Los Angeles is an example of a “one size fits all surgical approach? with devastating consequences. In order to reduce the likelihood of such outcomes, national non profit organizations like the American Society of Metabolic and Bariatric Surgery, and the American College of Surgeons have set up “Center of Excellence? certifications for surgeons and hospitals alike to ensure the highest standards of care, and monitor outcomes prospectively. Medicare and many insurance companies now mandate that their subscribers receive treatment at one of these Centers of Excellence. None of the 1-800-GET THIN facilities were Centers of Excellence. American patients who suffer from obesity should be made aware that a good outcome is more likely from high volume obesity specialists who offer a comprehensive program, have rigid preparation and follow up, and in the 21st century medicine that we practice, the physicians belong to a body that monitors outcomes and maintains certification of the quality of their practice.
Recent press coverage has also focused on poor outcomes from European surgeons with Gastric Banding. None of the European reports have emerged from randomized studies (where patients are assigned to one treatment or another, allowing a valid comparison of the efficacy of each treatment), and furthermore, in the majority of the papers, patients that underwent gastric banding had their surgeries performed using an outdated technique (the perigastric technique) with outdated devices. The techniques and devices used have been widely recognized by our group and others in the US to lead to higher complication rates. Such selective negative reporting is potentially misleading to patients for whom Gastric Banding may be a reasonable surgical option. We therefore urge caution when interpreting results from these studies, and we suggest that they may not be applicable to patients undergoing obesity surgery in the United States today. There have been numerous American studies with outcome data that are far superior to those that have gained the recent press attention. For example, the NIH-funded LABS consortium published a study in the New England Journal of Medicine in 2009, Perioperative Safety in the Longitudinal Assessment of Bariatric Surgery, which looked at short-term safety of bariatric surgery and found gastric banding to be a safe procedure.
As a group that prides self on the highest standards, we offer our condolences to the families of those patients who have suffered. We urge that patients and colleagues alike focus on a multidisciplinary approach to a complex chronic illness, and not rush to condemn a single procedure that has been a vital tool in the successful treatment of thousands of our patients.
Sincerely,
Sunil Bhoyrul, MD, FACS, FRCS
Olde Del Mar Surgical
Emma Patterson, MD, FACS, FRCSC
Oregon Weight Loss Surgery
Christine Ren Fielding, MD
NYU Langone Weight Management Program
Jaime Ponce MD, FACS
Gastric Band Institute
George Fielding, MD
NYU Langone Weight Management Program
Mark Fusco, MD
Lifeshape Advanced Bariatric Center of Florida
Helmuth Billy, MD
Dr. Billy Bariatrics
Robert Snow, DO, FACOS
LoneStar Lap-Bands
Barry Greene, MD, FACS
Advanced Weight Loss Solutions
O. Layton Alldredge, MD, FACS
South Valley Surgical
Daniel G. Davis, DO, FACS
Stamford Hospital, Center for Surgical Weight Loss
Vafa Shayani, MD, FACS
Bariatric Institute of Greater Chicago
Adam Smith, DO, FACOS
Fort Worth Lap-Band
RoseMarie Jones, MD, FACS
Community Hospital North Bariatrics
Robert Michaelson, MD, PhD, FACS
Northwest Weight Loss Surgery
M.M. Gazayerli, MD, DS, FRCSC, PC
Troy Bariatric Weight Loss
Alana Chock, MD, FACS
Northwest Weight Loss Surgery
Daniel Cottam, MD
Bariatric Medicine Institute
David Provost, MD
Provost Bariatrics
Matthew Brengman, MD
Bon Secours Surgical Weight Loss
Scott Cunneen, MD, FACS
Cedars-Sinai Center for Weight Loss
Mona Misra, MD, FRCSC, FACS
Beverly Hills, CA
Terry Simpson, MD, FACS
Southwest Weight Loss
Thomas Brown, MD, FACS
Colorado Bariatric Surgery Institute
Thomas Umbach, MD, FACS
Blossom Bariatrics
Laura Machado, MD, FACS
Sacramento Bariatric Medical Associates
Toby Broussard, MD, FACS
WeightWise Bariatric Program
Kevin Montgomery, MD, FACS
Northwest Weight Loss Surgery
cc: Davan Maharaji, Editor
Los Angeles Times
202 West 1st Street
Los Angeles, California 90012
Congressman Brian Bilbray
380 Stevens Avenue, Suite 212
Solana Beach, California 92075
Eric D. Pinnar, M.D., FACS
Jacksonville Surgical Associates
Robert Cywes, M.D., PhD.
Jacksonville Surgical Associates
Batwingsman · 0 replies · 206 views
Batwingsman · 0 replies · 206 views