Does Choice of Gastric Sleeve Surgeon Impact Outcomes?
The ultimate goal of gastric sleeve surgery is to achieve the desired weight loss following the surgery. This is accomplished by two primary people, the surgeon, and the patient. The patient’s aspect is to maintain a health/weight reducing diet after surgery. However, it is the doctor’s duty to ensure a successful and quality operation devoid of complications.
The outcome of gastric sleeve surgery regarding percentage estimated weight loss (EWL) has been found to vary from one surgeon to the other with the best surgeon having EWL of 78% and the worst surgeon having EWL of 42% (Fischer et al., 2012). Take, for example, a patient that is 80kg overweight (80kg of excess weight) before surgery will lose about 62kg by the end of the first year of operation in the hands of the best surgeon. The similar patient will lose about 34kg at the end of the first year of operation in the hands of the worst surgeon.
In another study, the standard deviation from the mean percentage of excess weight loss among the surgeons was found to be +/- 19% (Gagner, Deitel, Erickson, & Crosby, 2013)
The other surgical outcomes such as complications (gastric leak, gastro-oesophageal reflux), the length of hospital stay are all dependent on the surgeon. As your mechanics are better than each other, so also are doctors better than each other.
The most dreaded complication of gastric sleeve surgery is a gastric leak along the surgical line. This usually occurs before complete healing and often within the first 6weeks post op. The gastric leak will lead to peritonitis, further abdominal surgery, increase hospital spending, and prolong the postoperative hospital stay.
Studies have shown that gastric leak after surgery occurs more with some surgeons than the others. Aurora et al. in a systematic review of 48,880 patients found that the risk of gastric leak after gastric sleeve was 2.4%. The best gastric sleeve surgeon had a leak rate of 0%, while the worst doctor had a leak rate of 7% (Aurora, Khaitan, & Saber, 2012).
The interpretation of this is that if the best gastric sleeve surgeon performed gastric sleeve surgery on 100 people, none of them would develop a gastric leak as a complication, but the worst doctor will have seven out of hundred patients developing a gastric leak. This is highly significant considering the consequences of this most feared complication. Thus, always find out about the past records of a gastric sleeve surgeon before you choose one.
The regurgitation of food from the stomach back into the esophagus is another complication that may follow gastric sleeve, especially in the hands of a bad surgeon. Studies done earlier have revealed that the surgeon is one of the major determinants of the likely occurrence of gastro-oesophageal reflux following gastric sleeve surgery. In one of such studies, the rate of gastro-oesophageal reflux was found to be as high as 47% for some surgeons (Sarkhosh, Birch, Sharma, & Karmali, 2013).
The above studies and findings have been able to demonstrate that your chance of developing complications such as gastric leak and gastro-oesophageal reflux following gastric sleeve surgery and your final weight loss outcome, all partly or wholly depends on your surgeon. Thus, the common question of whether the results of gastric sleeve surgery depends on the surgeon cannot have any other truthful answer but “YES.”
“Do your research about the gastric sleeve surgeon and choose the best surgeon to guarantee yourself an excellent outcome.”
- Fischer, L., Hildebrandt, C., Bruckner, T., Kenngott, H., Linke, G. R., Gehrig, T., … Buchler, M. W. (2012, May). Excessive weight loss after sleeve gastrectomy: a systematic review. – PubMed – NCBI. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/22411568
- Gagner, M., Deitel, M., Erickson, A. L., & Crosby, R. D. (2013, December). Survey on laparoscopic sleeve gastrectomy (LSG) at the Fourth International Consensus Summit on Sleeve Gastrectomy. – PubMed – NCBI. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/23912263
- Aurora, A. R., Khaitan, L., & Saber, A. A. (2012, June). Choice of Gastric Sleeve Surgeon Impacts Outcomes – Oliak Center. Retrieved from https://oliakcenter.com/gastric-sleeve-surgeon/
- Sarkhosh, K., Birch, D., Sharma, A., & Karmali, S. (2013, October). Complications associated with laparoscopic sleeve gastrectomy for morbid obesity: a surgeon’s guide. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3788014/
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