Weight loss surgery. Bariatric surgery. Metabolic surgery. Whatever you call it, as American waistlines have grown over the last three decades, so, too, has the popularity of this type of surgery.
As a Houston, Texas medical malpractice attorney, I’ve investigated and handled numerous bariatric medical malpractice cases. Over the years, I’ve seen trends of different types of procedures that fall into and out of favor.
The methods for each type of procedure differ, but the goal is the same: surgically modifying the patient’s anatomy to allow less space in the stomach to hold and process food. The idea behind it is that with a smaller stomach, patients will feel full and eat less.
For many years, the lap band was very popular, but since 2008, this procedure has declined to almost nothing. The gastric bypass procedure was steadily on top from the mid-1990s until around 2005 and has declined in popularity since then.
Since 2008, every year more and more surgeons and patients choose the sleeve gastrectomy (gastric sleeve) procedure. It’s currently the most common weight loss surgery in America, accounting for nearly 60% of all bariatric procedures.
What is sleeve gastrectomy?
In a gastric sleeve procedure, the surgeon physically cuts out and removes a significant portion of the patient’s stomach. The remaining stomach is surgically stapled back together and is roughly the size and shape of a banana.
Surgeons typically perform a sleeve gastrectomy laparoscopically, rather than as an open procedure.
In an open procedure, the surgeon makes a large incision in the abdomen and can directly see and touch the stomach. For laparoscopic procedures, the surgeon makes a few small incisions in the patient’s belly and uses them to insert instruments including a scope and camera.
All in all, if there are no complications, the surgery takes an hour or two. Many surgeons perform the surgery and discharge the patient the same day, while others keep them at least overnight.
Some surgeons perform bariatric procedures at normal acute care hospitals, while others prefer outpatient or ambulatory surgery centers. It’s often the case that surgeons have a financial interest in the surgery centers, which motivates them to steer patients in that direction. From my experience in handling medical malpractice cases, I think hospitals are safer because they’re typically better equipped with personnel, equipment, and supplies to handle emergencies.
With that said, most complications from weight-loss procedures don’t happen in the operating room, but rather after-the-fact.
Complications you should know about
As with any surgery, there are a lot of things that can go wrong. Some of them might not be obvious while the patient is still in the operating room. The standard of care requires surgeons to assess patients post-operatively and to be on the lookout for signs and symptoms of problems.
This is where I see a lot of medical malpractice. Based on my experience in reviewing a lot of bariatric medical malpractice cases, many weight loss surgeons handle large numbers of patients at any given time. Many of my clients have described the feeling of being in an assembly line. One of the significant risks and drawbacks of this approach is that it can cause surgeons and their staff members to not assess and think about patients as individuals.
This is particularly true when it comes to two common post-operative complications, nausea and vomiting, and pain. Surgeons expect all patients to have a normal amount of all of these symptoms for a day or two after surgery. When a patient has an excessive amount of nausea and vomiting, or it lasts too long, the surgeon needs to evaluate it and figure out what’s wrong. The same is true when a patient’s pain levels are severe or aren’t getting better after a few days.
Nausea and vomiting can lead to a condition called gastric outlet obstruction. This is sometimes caused by an improper surgical procedure, such as overly-tight stitching or a kink, fistula, or blockage. The surgeon can evaluate the symptoms by ordering a diagnostic radiology procedure like a barium swallow (esophagram) or abdominal CT scan.
Severe pain, particularly when it’s accompanied by a fever, can be a sign that the surgeon accidentally nicked, cut, or lacerated the stomach or a nearby vital organ, like the bowel, during the procedure. In almost all cases, medical experts contend that this in and of itself is not negligence. The failure to assess the patient properly for these symptoms, though, is medical malpractice and can also be deadly. Leaking of stomach or bowel contents into the abdominal cavity leads to an infection and can cause deadly sepsis. If a leak is identified, it requires a quick return to the operating room for an emergency surgery.
If you or a family member has been seriously injured as a result of complications after a weight-loss surgery, you should contact one of the best medical malpractice lawyers in Houston, Texas for help in evaluating your potential claim.