Risks Are Low for Reoperative Bariatric Surgery

According to analysis of a large medical database, reoperative bariatric surgery does not have harmful increases in morbidity and mortality rates that were once suspected. Research suggests differences between first and second time operations can be deemed negligible.

Dr.  Ranjan Sudan is a digestive disorders specialist who is vice chair of education in the department of surgery at Duke University, Durham, North Carolina. He believes the new data needs to reach stakeholders as soon as possible in order to open the door to patients are in need of reoperation.

Leading a study conducted by The American Society for Metabolic and Bariatric Surgery, Dr. Sudan and his colleagues analyzed data from more than 450,000 surgeries entered into the database over a five-year period ending in spring 2012. The procedures in the database were conducted by nearly 1,000 surgeons and 700 hospitals, according to Clinical Endocrinology News.

Researchers compared the rate of serious 30-day incidents, like leaks, bleeding, or pulmonary embolism, between first time operations and reoperative surgeries. According to Dr. Sudan, 1.61 percent of primary procedure and 1.66 percent of reoperative surgeries had one of these complications. The adverse effects of a second time surgery compared to a first time surgery are negligible.

Along with serious incident comparison, the study also analyzed differences in mortality among patients undergoing surgery. At 30 days, a patient undergoing a primary surgery had a mortality rate of 0.1 percent and 0.17 percent at the one year mark. The rates of a patient undergoing reoperative surgery were 0.14 percent and 0.26 percent respectively. Again, the results insinuated no difference in primary and secondary weight loss surgeries.

Dr. Ranjan Sudan said at the 2014 annual Digestive Disease Week conference, “These data demonstrate that outcomes after reoperative surgery are better than believed by insurance carriers, who often deny coverage for these procedures because of a misperception that complication rates are high and benefits uncertain.”

Corrective and secondary surgeries are not only needed in bariatric surgeries, but also coronary artery bypass grafting, heart valve surgery, abdominal wall hernia repairs, and oncologic operations, according to The American Society for Metabolic and Bariatric Surgery. Orthopedic, cardiac, and other specialty surgeries are all specifically covered in standard health plans, but health care plans discriminate when it comes to bariatric surgery.

Follow-up surgeries to correct bariatric surgery include conversion to another form of weight loss plan, such as insertion of a Lap Band®, or reversal or correction of the original bariatric procedure. All three options are vital to the population of patients who undergo an unsuccessful weight loss surgery.




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