Commentary

Metabolic Surgery Merits Bigger Role in Diabetes Management


 

The best success one can expect from a Nissen fundoplication for control of gastroesophageal reflux disease is 85%-90%, a well-established benchmark. Why should the standards for bariatric surgery be set above thresholds we accept for other surgical interventions?

The mortality rates of minimally invasive bariatric surgery rival those of routine operations such as cholecystectomy and hip replacement. The laparoscopic era has led to reduced mortality, fewer surgical site infections, shorter hospitalizations, and faster return to full activity. But because bariatric surgery is delivered by a scalpel and not a pill, it has faced discrimination and resistance within the medical community.

Dr. Kothari is director of the Minimally Invasive Bariatric Surgery Center at Gundersen Lutheran Health System in La Crosse, Wis. He has been a consultant to Covidien, Valley Lab, and Life Cell, and has received research grants from Covidien. This column appears in Internal Medicine News, a publication of Elsevier.

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