A study conducted by the University of Michigan Health System reveals that in recent years the preferred surgery seems to have shifted from Roux-en-Y gastric bypass (RYGB) to sleeve gastrectomy (SG or gastric sleeve). This study shows that patients and surgeons seem to be leaning more toward the sleeve gastrectomy in correcting obesity over the other forms of surgery available for weight loss and continued weight management.
The sleeve gastrectomy provides weight loss by reducing the amount of food that can be taken into the stomach and by controlling the hunger of the patient. This procedure has become the surgery of choice for type 2 diabetes patients according to the study published in JAMA on September 3, 2014. The reasons for the change are not yet completely determined or verified.
Shift in Preferred Bariatric Surgery According to Study
Bariatric surgery is the necessary procedure or therapy used to assist patients with morbid obesity. Through the years, there have been significant changes to procedures to ensure that they are safe and effective for patients, thus making the procedures more available to patients. With reduced recovery time and a better idea of how the surgery is effective, surgeons and primary care physicians are more likely to recommend surgical procedures to develop real solutions.
While the long-term results of sleeve gastrectomy are not yet apparent, the change in preference may be due to the higher level of safety with the procedure as well as the success rate for patients when it comes to weight loss. The weight loss for patients at the second and third year after sleeve gastrectomy show significant weight loss in the patients and a reduced if not removed the existence of pre-existing comorbidity. This means patients are safer with the procedure, and they are getting excellent results overall.
Related: Gastric Sleeve Weight Loss Timeline
Knowing what these trends changes are in the bariatric practice and why they occur can dramatically assist the primary care physicians in how they inform their patients and the direction that they recommend. Additionally, it is beneficial to the surgeon when providing pre-operative counseling to their patients.
The study that developed this information was conducted by Bradley N. Reams, M.D., M.S., a surgical resident at the Department of General Surgery as well as Justin Dimick, M.D., M.P.H., an assistant professor of surgery as well as chief of the Division of Minimally Invasive Surgery at the University of Michigan Health System. In the study, they analyzed the data of 43,732 adult patients that had bariatric surgery. This data was a compilation of information from 39 hospitals.
It was discovered that sleeve gastrectomy was selected in 6.0 percent of the procedures in 2008 and 67.3 percent of the systems in 2013 cases. That translates into an increase in choice of sleeve gastrectomy of 61 percent. Additionally it was discovered that Roux-en-Y gastric bypass was selected 58.0 percent of the time in 2008 and 27.4 percent of the time in 2013 and laparoscopic adjustable gastric banding went from being selected 34.5 percent of the time in 2008 to 4.9 percent in 2013. Patients over the age of 65 years, type 2 diabetes and those with gastroesophageal reflux disease seemed to have stayed with surgeries other than sleeve gastrectomy.
It is clear from these findings that there is a shift in the bariatric surgical preference for patients to sleeve gastrectomy. Whether or not this trend will continue or not is unclear and will require continued study and research. Many surgeons find the sleeve gastrectomy to be less invasive than other procedures and very efficient in reducing the weight of the patient. The long term results of these patients are still unknown and with time there will need to be more studies conducted to see how they do in the long run.