Medicine

Lap-Band Complications Could Tie Up Nation's E.R.

Monday, March 14, 2011

The FDA's recent expansion of gastric-banding weight-loss surgery to millions more Americans could burden the nation's E.R. with complications that patients discuss in online forums, such as vomiting and abdominal pain. The third of three stories.

Page 2 of 2

Online Forums Expose Complications

Gastric bands like Allergan's Lap-Band and Johnson and Johnson's Realize band have been marketed as safe and effective. However, the assessment is not unanimous. Online patient forums provide a window on some of the common complications.

In forums on sites such as http://www.lapbandtalk.com and www.obesityhelp.com gastric banding patients seek support from other "bandsters" about vomiting when the band is cinched too tightly or having to sleep sitting up to relieve abdominal pains. Some mention they'd like the device removed but their insurance won't cover a second operation.

Emergency room doctors at Northwestern Memorial Hospital in Chicago have seen more people coming into the emergency room with bariatric complications over the past five years and attribute the increase to the rise in weight loss surgery, according to a spokesperson for Northwestern.

Emergency room visits for weight loss surgery complications are common enough that the American Society for Metabolic and Bariatric Surgery, based in Gainesville, Fla., has published a colorful chart called Clinical Pearls for Emergency Care of the Bariatric Surgery Patient.

It instructs emergency room doctors on handling intra-abdominal bleeding, pulmonary embolisms, band slippage, vomiting and severe abdominal pain, just some of the common reasons gastric banding goes awry.

Besides acute complications, emergency room doctors also commonly see vitamin deficiencies and electrolyte imbalance in gastric banding patients due to failure to absorb nutrients in food (caused by the constricting nature of the band) and difficulty in swallowing.

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Alizah Salario is a freelance journalist based in Chicago. Her work has appeared in The Daily Beast, Ms. Magazine and elsewhere. You can learn more at www.alizahsalario.com or follow her on Twitter at http://twitter.com/Alirosa.

For more information:

The American Society for Metabolic and Bariatric Surgery's " Clinical Pearls for Emergency Care of the Bariatric Surgery Patient":
http://207.234.185.112/$sitepreview/asmbspreview.com/downloads/er_poster/ASMBS_ER_Poster9-20-10.pdf

"Bariatric Surgery: The View From a Doctors’ Group," The New York Times:
http://www.nytimes.com/2011/01/20/opinion/lweb20obese.html?scp=1&sq=bariatric%20physicians&st=cse

"Allergan seeks bigger market for Lap-Band weight-loss device," Los Angeles Times:
http://www.latimes.com/health/la-fi-allergan-20110116,0,5957731.story

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