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Obesity is a growing epidemic, and many individuals who can’t lose weight turn to surgery to fix the problem. The most common of these procedures is gastric bypass surgery. While this surgery does help, as studies have shown extremely obese patients have four or five times lower death rates if they undergo gastric bypass surgery compared with those who don’t, new concern has arisen for women who may consider pregnancy after the procedure.
As reported by doctors at Brigham and Women’s Hospital in a letter in the New England Journal of Medicine in August, “an obese Massachusetts woman and her 8-month-old fetus died of complications 18 months after stomach-stapling surgery.” This is an apparent first, but it is raises concerns because most of the people undergoing stomach bypass surgery in this country are women in their child-bearing years.
In this case, surgeon Edward Whang performed emergency surgery and found that “most of the woman’s small intestine had slid through a hernia, or tear, in an adjacent membrane, a defect sometimes left after the intestines are rearranged in the bypass operation.” He could not save her or her unborn child.
While a case like this has not been seen before, the benefits of bariatric surgery for many outweigh the risks. Harvey Sugerman, president of the American Society for Bariatric Surgery, which educates obesity surgeons, said that research exists that shows lower rates of pregnancy complications after weight loss surgery. However, complications still occur, and it’s estimated that for every 200 patients who undergo bariatric surgery, one to four may die.
Gastric Bypass Surgery – What It Is and What Can Go Wrong
Gastric bypass surgery is not a “quick fix” for obesity. When an individual cannot lose the weight needed and keep it off through diet and exercise, weight-loss surgery, like bariatric bypass or stomach banding, is considered.
In standard gastric bypass surgery, the stomach is divided into a small upper pouch and a much larger lower “remnant” pouch and then the small intestine is rearranged to connect to both. Usually, the small pouch at the stomach’s top is separated from the rest using staples. The top section of your stomach (called the pouch) is where the food you eat will go.
Like all surgeries, there are risks. Gastric bypass surgery complications are nothing new. As technology advanced in obesity surgeries, tools were created to simplify the procedure; they have, instead, caused new problems.
Since Ethicon Endo-Surgery, a subsidiary of Johnson & Johnson, started to manufacture the cutter-stapler in 1999, reports started to come in of staple line failures. Some stomach staple complications that can occur from a stapler misfire or lack of closure can include infections, hemorrhaging, and staple line leaks or separation. There were also failures to close bypass suture lines. These issues cause patients pain and suffering, can create a need for secondary or corrective surgeries, and in some cases end in death.
In May 2013, a Class II urgent worldwide recall occurred for the Ethicon Echelon 60 mm black reload staples used to close the stomach during reduction surgery. The recall included over 57,000 units “due to the potential for incomplete staple line formation from reload damage during the firing sequence.” In addition to Ethicon, other stapler manufacturers, including Covidien, have been accused of making and selling defective products.
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