Parts of these were picked up from reading other sites and other groups.
How long have you been doing Bariatric Surgery? You want SPECIFIC dates. Month and year.
What are your outcomes and how long have you been keeping your data and statistics?
The results at 2 years are longer are important to know and how many patients truly keep up. Is it only the “positive” ones or ones needing help due to weight regain? If the program can’t tell you that only 60% of their patients still follow up in 3 years, and if it is only the “no problem” patients, then what is a prospective patient going to expect from that program as far as their individual results?
‘There is a program is San Diego, for example, that quotes: “Long-term success rate of 99 percent since the program’s inception-patients maintain a 70 percent loss of excess body weight”. This type of reporting is harmful to patients in that NO program can achieve those results but people expect that the program will tell the truth!’
What are your (surgeon(s), group, hospital) specific complication rates for leak, DVT, stricture, bleeding and infection? What is your mortality rate?
A 1% complication rate is ridiculous to quote. ‘What you as a patient want to know is that the program keeps their statistics in an honest and realistic fashion. For example: we have looked at our first 1000 cases to fully evaluate OUR complications with the operation done the way we do it at our facility. Programs should quote their rates and not the “national rates”.’
What are the components of the program?
They should have multi disciplined approaches to obesity diseases, and the components to address all issues: specialized nursing care pre, post op, in the hospital, and present (my bariatric team didn’t have the nurse on staff as she told me, ‘I have a party to plan for’), exercise personnel, support groups that have major input from short, middle and long term, positive & negative patients, and psych help.
How far away is help if I need it in the hospital or soon after? What happens if the surgeon isn’t available? How does the local ER know how to deal with complications from surgery or recognize them? This would even be things like IV’s … banana bags are truly needed in our case, as the potential for a life threatening issue from B1 levels can happen.
Does the program offer all bariatric procedures?
‘Though a program does not need to do all operations and may feel more comfortable doing only one operation, they should still discuss all options in a relatively “non-biased” fashion. For someone to only push a Banding operation, for example, without offering any insight or opinion on the Gastric Bypass (or visa versa) would not be offering true informed consent to the prospective patient. If only one operation is done it might also be good to know why only one is done. Did the surgeon have too many complications with another operation? Is there some sort of industry support that may influence the choice? These are fair questions to ask.’
What is the data about the endoscopic pouch reduction?
‘We covered our thought about the pouch reduction issue in another section. There are several different “platforms” or techniques available and different technology is used for various approaches. It is very important that the surgeon have a lot of revision experience. There is a rather special mind-set that a surgeon needs to have to work through the complexities of failed or poor results. Since these are more or less unusual cases, the surgeon needs to have experience in treating patients with a number of different modalities. “If all you have is a hammer, all the world looks like a nail.” If the surgeon has never done a revision of a major operation then they may have a very biased look on what a patient might need. Add to this the factor of industry support and unfortunately, some surgeons allow their treatments to be guided by their pocketbook.’