Comparative Study between 3 Up to Date Different Surgical Options for Morbid Obesity

Comparative Study between 3 Up to Date Different Surgical Options for Morbid Obesity

Surgical Options for Morbid Obesity

            The World Health Organization declared obesity a global pandemic because in the last decade, the disease has become a public health challenge. Its prevalence is increasing around the world at an alarming rate (Choban et.al, 2002). Morbid obesity is associated with other complications that lead to psychological and physical challenges (Christou et al, 2004). The treatment of the disease requires a therapeutic approach that includes surgery and the involvement of a multidisciplinary team (Khodja & Lance, 2005). Today, there exist several surgical options for morbid obesity that have been proved effective. Bariatric surgery has been reported to be the most effective type of surgery in managing morbid obesity (National Obesity Observatory, 2005). There are several surgical techniques being employed today for the treatment of morbid obesity using bariatric surgery. These techniques are Laparoscopic adjustable gastric banding (LAGB), Laparoscopic or open Roux-en-Y gastric bypass (GBP) and Laparoscopic or open sleeve gastrectomy (SG) (National Obesity Observatory, 2005). The three surgical treatments are referred to as the Laparoscopic procedures, which offer many advantages to patients. According to Regence publication (2015), GBP is the most commonly preferred and performed procedure with much evidence available to support its effectiveness. The procedure combines both the restrictive and malabsorptive components (Schigt et al, 2013). It is associated with superior weight loss compared to the other two (Cleveland Clinic, 2008). The Sleeve gastrectomy on the other hand involves inducing food restrictions.

Despite the fact that GBP is the most performed procedure, findings conducted by several individuals and institutions indicate that LAGB is the safest procedure. A study conducted by a team led by Buchwald found that the LAGB has the lowest risk of death (Cited in Brethauer et al, 2006). Moreover, LAGB as compared to other surgical procedures has lower adverse effects. According to Victoria Government Initiative (2009), “unlike gastric bypass procedures, LAGB is not associated with an increased chance of abdominal sepsis, bowel obstruction, or other abdominal catastrophes that can result in death if not rapidly treated”, (pp. 13). Moreover, a study done on 411 patients undergoing treatment through LAGB in Netherlands found that 77 percent of patients were successfully treated in a period of two years (Riele, 2011). SG on the other hand is irreversible and study reports indicate critical complications after the performance of the procedure. Findings of a research conducted to compare the short and long-term results of LAGB and GBP among 7457 adult patients from 2005 to 2009 suggests that LAGB cannot be said to be the most effective procedure. In contrast to other reports, the findings of this study claimed that LAGB is associated with late complications and higher rates of surgical interventions as compared to other bariatric procedures (Group Health, 2014). Guo and Harstall (2005) support the use of GBP for treating severe cases of morbid obesity as compared to other procedures. The authors further ads that all bariatric surgeries are effective though they differ in the amount of weight lost and the post-surgery complications. A study undertaken on treatment of severe obesity using the LAGB and GBP found both to be substantially effective (Steffen et al, 2008). Based on the above findings and evidences, it is difficult to make definitive conclusions on the most effective surgical procedure of treating morbid obesity. According to Stephen and Hogan, (2007), each of the three types has benefits and disadvantages, but research evidence is more inclined to GBT and LAGB. The National Institute of Diabetes and Digestive and Kidney Diseases also state that each surgery technique has its own risks and benefits, and therefore patients and service providers should work together to determine the best option.

References

Brethauer, S., Bipan, C., & Schauer, P (2006). Risk and Benefits of Bariatric Surgery: Current Evidence. Cleveland Clinic Journal of Medicine, 73(9).

Choban, P.S., Poplawski, S., Jacckson, B., & Bistolaridies, P. (2002). Batriatic Surgery for Morbid Obesity: Why, who, when, how, where and then what? Cleveland Clinic Journal of Medicine, 69(11), 897.

Christou, N. V., Sampalis. J.S., Liberman, M., Look, D., Auger, S., McLean, A., & MacLean, L. (2004). Surgery Decreases Long-term Mortality, Morbidity and Health Care Use in Morbidly Obese Patients. Annals of Surgery, 240(3), 416.

Cleveland Clinic. (2008). Weight Loss Surgery for Severely Obese Patients: Information for Physicians from the Cleveland Clinic Bariatric and Metabolic Institute.

Group Health. (2014). Clinical Review Criteria: Bariatric Surgery. Group Health Cooperative.

Guo, B., & Harstall, C. (2005). Laparoscopic Adjustable Gastric Banding for the Treatment of Clinically Severe (Morbid) Obesity in Adults: An Update. Alberta Heritage Foundation for Medical Research. 44.

Khoja, R.H., & Lance, J. M. (2005). Surgical Treatment of Morbid Obesity: An Update. Quebec, iii

National Institute of Diabetes and Digestive and Kidney Diseases. (n.d.). Bariatric Surgery for Severe Obesity. US Department of Health and Human Services, 3-5

National Obesity Observatory. (2010). Bariatric Surgery for Obesity. Association of Public Health Observatories, 1-2

Regence. (2015). Bariatric Surgery. Medical Policy Manual. Washington.

Riele, W. (2011). Clinical Outcome of Gastric Banding and Gastric Bypass in Morbidly Obese Patients. 18

Schigt, A., Gerdes, V.E.A., Cense, H.A., Berends, F.J., Dielen, V., Janssen, I., Larr, A.V.D.,Wagensveld,V, Romijn, J.A and Serlie, M.J. (2013). Bariatric Surgery is an Effective Treatment for Morbid Obesity. The Journal of Medicine, 71(1), 6.

Steffen, R., Potoczna, N, H, F.F., & Bieri, N. (2008). Successful Multi-Intervention Treatment of Severe Obesity: A 7-year Prospective Study with 96% Follow-up. 8-9

Stephenson, M., & Hogan, S. (2007). The Safety, Effectiveness and Cost Effectiveness of Surgical and non-surgical Interventions for Patients with Morbid Obesity. New Zealand Health Technology Assessment, iv

Victoria Government Initiative. (2009). Surgery for Morbid Obesity: Framework for Bariatric Surgery in Victoria’s Public Hospitals. Melbourne, 13