Minimally Invasive Bariatric Techniques Found Cheaper and Safer than Open Surgery

Laparoscopic Roux-en-Y gastric bypass procedures are safer and cheaper than open surgery procedures, according to research published in the journal Archives of Surgery. Open surgery involves making a large abdominal incision. The authors claim that this is the first study to compare minimally invasive and open approaches to bariatric surgery at a national level.

Bariatric techniques are specifically used to deal with obesity and include several possible procedures which are performed on eligible patients. Either a medical device is implanted in the stomach to reduce its size (gastric banding), a part of the stomach is removed (sleeve gastrectomy or duodenal switch), or the small intestines are re-routed to a small stomach pouch which is created in the stomach (gastric bypass surgery).

According to senior author, John Morton, MD, "There have been single-center randomized trials that support the greater safety and efficacy of the minimally invasive approach, but what our study does is to confirm that those results are actually occurring in practice at hospitals and academic medical centers across the country.”

The researchers discovered that patients who underwent minimally invasive laparoscopic procedures had fewer complications, reduced hospital stays, and lower hospital bills. These findings were consistent even after adjusting for factors like other illnesses and socioeconomic levels.

In conducting the study, Dr. Morton and his team gathered data on over 150,000 (156,271) Roux-en-Y gastric bypasses which were carried out from 2005 to 2007 across the USA. Of these, 115,000 of them underwent laparoscopic procedures, while 41,000 had open surgery.

A Roux-en-Y gastric bypass involves creating a small pouch from the stomach’s upper part and connecting it directly to the middle section of the small intestine, thus bypassing most of the stomach and certain parts of the small intestine. Following the procedure, the patient cannot eat as much food in a single sitting and feels fuller more quickly with less food.

The patients who underwent laparoscopic procedures had fewer in-hospital complications in 15 out of 18 complication categories, including sepsis, blood transfusion requirements, and cardiac arrhythmia.

The study authors claim the findings were not a surprise. Dr. Morton added, "What did surprise me was the degree of superiority pretty much across the board compared with open surgery."
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