Everyone with an interest in health care is not only focusing on cost, but also on the quality of care — and rightfully so. In 2012, the U.S. spent a whopping $2.8 trillion on health, according to the Centers for Medicare and Medicaid Services. That’s nearly 20 percent of our GDP. If we are going to spend this much money, we need to ensure that patients are receiving the best quality care possible.
This mantra is particularly applicable in my field, bariatric surgery — a procedure that more than 180,000 Americans undergo each year. Although we’ve seen reductions in complications from bariatric surgery, my colleagues and I continue to seek ways to improve the care we give our patients day in and day out. To that end, we are coming together at Digestive Disease Week® (DDW) to discuss our latest research and share best practices in bariatric surgery and digestive health overall. DDW is the world’s largest gathering of physicians and researchers in the fields of gastroenterology, hepatology, endoscopy and gastrointestinal surgery.
Over the past several years, we have seen dramatic improvement in how bariatric surgery is performed and in the outcomes our patients’ experience.
One significant factor for this improvement is the widespread adoption of laparoscopic surgery. With this approach, bariatric surgery is now much less invasive. Instead making a large incision as we did in the past, surgeons are now able to perform the procedure through a couple of small incisions that are about a half-inch long. As one would expect, this process shortens both the surgery and recovery times, reduces the amount of blood loss, and lowers the rate of complications.
Accreditation of surgeons and surgery centers is also contributing to the higher quality in bariatric surgery. Establishing standards with which health-care providers must comply ensures consistent quality across the nation.
In addition to these measures, health-care providers and patients are also working together to find ways to ensure patients’ weight loss success. For example, a team here at Stanford University is examining whether or not achieving some weight loss immediately before surgery influences weight loss success after surgery. Our findings show that preoperative weight loss improves weight loss 12 months after surgery for gastric band patients and reduces the chance of complications and, therefore, improves quality.
Not only is our field refining how we conduct and prepare patients for bariatric surgery, we’re also examining how this operation may have secondary benefits beyond weight loss.
Research being presented by Michel Murr, MD, professor of surgery and director of Tampa General Hospital and University of South Florida Health Bariatric Center, shows that this intervention holds promise in reducing (and in some cases eliminating) inflammation and fat deposits caused by nonalcoholic fatty liver disease (NAFLD). This is significant because NAFLD has the potential of being the next major public health concern. It is associated with obesity, diabetes, high blood pressure and other chronic diseases that are skyrocketing in prevalence globally.
This is an exciting time for bariatric surgery. I’m confident that some of the data we’re seeing will dramatically improve the quality of bariatric surgery and, more importantly, improve our patients’ quality of life.
Dr. Morton is chief of bariatric and minimally invasive surgery at Stanford School of Medicine and president-elect of American Society of Metabolic and Bariatric Surgery.