Stomach Stapling a Double Risk

Severely obese people who undergo stomach stapling are at high risk for complications from the surgery itself and because their weight makes them poor surgical candidates, a doctor warned.

"This operation should not be considered a cosmetic procedure," said Elmar Merkle, a radiologist at Duke University Medical Center. "People need to be aware of the potential complications of gastric bypass surgery and treat it as a last option after other less invasive interventions have been tried."

In "Roux-en-Y" gastric bypass surgery, an increasingly popular treatment for severe obesity, the upper stomach is stapled to create a small pouch that is attached to the small intestine. It cuts the stomach's capacity and reduces the intestine's ability to absorb nutrients.

In a report delivered to the annual meeting of the Radiological Society of North America, Merkle said the procedure is risky in and of itself and because severely obese people run a high chance of complications such as blood clots and suture tears from any surgery.

Merkle headed a study of 335 people who had the surgery at University Hospitals of Cleveland. There were 57 complications, some of them multiple problems in the same patient, he said.

Within 30 days of surgery, 17 patients were readmitted for further treatment. Two people died.

He said the surgery should be considered the "last option we can offer the morbidly obese, after other less invasive interventions such as diet and exercise have been tried."

"There should be a long-term commitment by the patient. Eating habits must change ... patients will need lifelong vitamin supplements. Some patients lose weight, then gain it back again. Not everyone gets the results they want, but they all face the risk of these complications," he added.

The number of such surgeries is soaring, according to the American Society for Bariatric Surgery. The group said there were 63,000 procedures performed in 2002 in the United States and likely 100,000 this year.

Americans who are at least 100 pounds (45 kg) overweight are eligible for gastrointestinal surgery, according to government health guidelines. Patients with lower levels of obesity may have the surgery if their weight is causing a life-threatening problem, Merkle's report said.

Reference Source 89

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