Developing a new bariatric surgery program.
We initiated a new bariatric surgery program in February 2004. Before starting the program, we initiated a systemic planning process to design, develop, and implement a comprehensive, multidisciplinary program. Between May 2004 and June 2006, 178 patients underwent Roux-en-Y gastric bypass to treat morbid obesity at our institution. We have had no pulmonary emboli and no deaths. Twenty-one patients (11.8%) developed wound infection after surgery. Thirteen patients (7.3%) developed stenosis at the gastrojejunostomy. Five patients (2.8%) bled from the gastrojejunostomy. Four patients (2.2%) developed atelectasis. Three patients (1.6%) developed an internal hernia after surgery. One patient (0.5%) developed deep venous thrombosis. Two patients (1.1%) developed small bowel obstruction from adhesions. One patient developed a leak (0.6%). By 6 months after surgery, our patients have lost an average of 85 pounds (53% excess weight loss). By 12 months, they have lost an average of 104 pounds (65% excess weight loss). A focused effort to reduce infection has dropped our wound infection rate to 0 per cent in the past 6 months. Our results indicate that with proper planning, it is possible to initiate a new program and achieve excellent outcomes. Proper planning, systematic implementation, and a focus on patient education are critical to success.
Angstadt
John
J
Memorial Health University Medical Center, Savannah, Georgia, USA. johnangstadt@memorialhealth.com
Whipple
Oliver
O
D000328:Adult; D050110:Bariatric Surgery / Q000193:education / Q000592:standards* / Q000639:trends; D002983:Clinical Competence; D004502:Education, Medical, Continuing / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D010353:Patient Education as Topic; D016730:Program Development / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014481:United States