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Herman Praszkier
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Gastric Bypass Riskier Than Many Patients Know
Demand soars, but some surgeons not qualified

By Robert Bazell
NBC News
Updated: 8:09 p.m. ET April 1, 2004

CLEVELAND - In 1991 Diana Nejbauer hit 261 pounds and was thrilled to undergo surgery to reduce the size of her stomach. But the procedure didn't work. "I was sick from the very beginning," says Nejbauer.

Not only did she vomit constantly, but her weight, which fell initially, started climbing back up to where it had been. "It was devastating. I couldn't believe it," she adds.

Eventually Nejbauer found her way to Dr. Thomas Stellato, a weight surgery specialist at University Hospitals of Cleveland, who often repairs complications from other doctor's operations.

How much of his practice could be "re-dos" or fixes from previous operations, if he let it be that? "If I let it be that, I'd be quite busy," says Stellato.

Catherine Bast's husband Dave died from complications of his weight-loss surgery. "We would have never went through it knowing all the risks," she says.

No one knows the complication rate from obesity surgery because there is no national registry to track it. Estimates of the death rate alone are as high as 2 percent.

The number of Americans getting weight loss surgery has skyrocketed tenfold in the past decade to 103,000 last year, and surgeons say there is no end in sight for the demand.

There is such an incredible demand, says malpractice lawyer Herman Praszkier, that some surgeons are not adequately prepared. "Their training is basically limited to sometimes going to a three-or-four day seminar where they learn how to do it or they watch another physician doing it and then they start doing it."

A recent article in the New England Journal of Medicine warned the "surge in demand for these operations and the potential financial opportunities for physicians and hospitals that perform them are placing some patients at risk."

Internet pop-up ads even advertise the surgery at a discount from the usual cost of $20,000 to $50,000.

Stellato says a good program must include an experienced surgeon and extensive counseling of patients that includes warning them about the risks. Stellato routinely gives patients a questionnaire to fill out before surgery. "If patients check that the risk of the operation is low, that's a red flag for us," he adds.

After a second operation, Nejbauer is back to a healthier weight. "It's a wonderful procedure," she now says.

But it's a procedure that carries far more danger than many desperate patients know.

© 2004 MSNBC Interactive


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