Choosing the right surgeon for a gastric sleeve surgery is extremely important in order to avoid negative outcomes and extreme side effects.
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 Type of Surgeon and the Gastric Sleeve Outcome
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%.
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%.
Potential Complications with Gastric Sleeve Surgery
The other surgical outcomes such as complications (gastric leak, gastro-esophageal 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.
Here are some complications that are increased if you don’t have an experienced surgeon:
- Infection: With any surgical procedure there comes a risk of infections. When you get gastric sleeve surgery there is a chance that you will get an infection, especially with an inexperienced surgeon.
- Bleeding: Excessive bleeding can happen after surgery. Experienced surgeons will take the proper precautions in order to minimize this risk.
- Leakage: When recovering from gastric sleeve surgery you might experience a leak from the incision site. This is a serious complication that can lead to infections and may require additional surgery.
- Stricture: Narrowing of the stomach opening (stricture) can occur, leading to difficulty swallowing.
- Gastroesophageal Reflux Disease (GERD): Some individuals may experience an increase in acid reflux symptoms after gastric sleeve surgery.
Gastric Leak After Gastric Sleeve Surgery
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 6 weeks 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. In a systematic review of 4,880 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%.
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.
Regurgitation of Food
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-esophageal reflux following gastric sleeve surgery. In one of such studies, the rate of gastro-esophageal reflux was found to be as high as 47% for some surgeons.
Choosing the Right Surgeon is Very Important
The choice of a gastric sleeve surgeon significantly impacts the outcomes of the surgery. Studies have shown that the surgeon’s skill and experience play a vital role in determining the success rate of weight loss, with the best surgeons achieving an estimated weight loss of 78% compared to 42% for less skilled surgeons.
In addition, the risk of complications such as gastric leaks and gastro-esophageal reflux also varies significantly among surgeons. A systematic review revealed that the best surgeons had a 0% leak rate, while the rate for the least skilled was as high as 7%.
It is extremely important for patients to thoroughly research and select a highly qualified and experienced gastric sleeve surgeon to maximize their chances of successful outcome and minimize the risk of complications.
