Gastric Bypass Malpractice
Gastric Bypass is a surgical treatment for obesity. In Gastric Bypass surgery the stomach is surgically divided into two parts, an upper smaller portion, which is called the proximal pouch and a lower larger portion, called the distal pouch. The small intestines (the upper jejunum) is also divided and a portion of it called the "Roux limb" is brought up behind the distal pouch (lower stomach) and joined ("anastamosed") to the proximal pouch (upper stomach). The goal of this procedure is to create both a "new" smaller stomach from the proximal pouch as well as a tract to the small intestines, by which food "bypasses" the larger portion of the stomach and arrives more quickly in the small intestines. The result is the patient becomes fuller sooner and his or her appetite is decreased.
Studies show that in the first two years after a successful Gastric Bypass, a patient will lose on average 66% to 75% of their excess weight. Though typically some of this lost weight returns, studies also indicate that in the 5 to 15 years after the operation, the patient will, on average, keep off 50% of the additional weight. Many obesity related problems such as hypertension, diabetes, and sleep apnea generally improve dramatically with this weight loss.
Clearly, when this surgery is a success it can be a boon, significantly improving one's health and longevity, however, the operation is not with out its potential risks and side effects. Studies reveal that in the 2 months following Gastric Bypass surgery 5 percent of patients will have significant problems and 10 percent will have minor problems requiring medical attention. Of these patients, 10% will suffer hernias and 10-5% will suffer from psychological challenges related to the surgery. 2-3 % will suffer from anastamotic (staple line rupture), gastrostomy problem leaks, or incision infection, while 1% will suffer from arrythmia (cardiac irregularity), blood clots to lungs (pulmonary embolism), pneumonia, or thrombophlebitis. In rare cases the patient will suffer a heart attack (myocardial infarction), a stroke or kidney failure. In the period following the first two months, though chances of serious complications reduce, 1% will suffer from anastamotic ulcers, anastamotic stricture, small bowel obstruction and in rare cases vitamin deficiencies.
The mortality rate from Gastric Bypass is similar to other major operations performed on obese patients suffering from multiple health problems associated with obesity. About 1/350 patients will die. The risks associated with Gastric Bypass are primarily contingent on the patient's relative obesity, age, and health. As one might suspect, the healthier, less obese and younger patients, have the best chances of avoiding complications. The most common causes of death are infection secondary to staple line or suture line leaks, respiratory problems and pulmonary embolism. In the event of a complication, determining whether it was unpreventable or was the result of medical negligence will be of critical importance.
The most common life threatening, post surgery complication is the leaking of gastrointestinal fluids from sutured or stapled surgical connection lines. If these leaks are not addressed immediately they may cause serious infection, peritonitis, abscess, and even death. Generally, any pain resulting from a Gastric Bypass operation should be significantly reduced if not completely absent the second day after the operation. If leakage does occur; increased pain, back pain, left shoulder pain, increased anxiety, restricted breathing, excessive urinations, are all tell tale symptoms. The failure of a physician to respond immediately when a patient complains of symptoms resulting from leakage, or other complications, is a prime example of medical malpractice. In most cases the leak can be detected by a simple x ray. Yet in some cases it can not. In these cases, a surgeon's failure to perform immediate exploratory gastric surgery when symptoms indicate the probability of a leak, regardless of x-ray results, is another example of possible malpractice. It is also the surgeon's responsibility, not only to adequately monitor the patient's convalescence, but to properly educate the patient and his or her family on post surgery recovery so that should complications arise, the response will be swift.
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