Bariatric surgery should be more widely accepted.
Bariatric surgery is not widely accepted by the general medical profession because of several misconceptions. Many physicians believe that morbidly obese persons could lose weight if they used their willpower, that bariatric surgery is a major operation in a high-risk population, and that weight loss is unpredictable, follow-up is poor, the reoperation rate is high, and late weight gain is common. Using the results of our series of 500 vertical Silastic ring gastroplasties and a collected series of 3,237 cases, we respond to these objections. Nonsurgical methods of weight loss are successful in less than 5% of morbidly obese patients. The operative mortality in the collected cases was 0.2%. The average percentage of excess weight lost is 66%, with only 10% of patients failing to lose at least 40% of their excess weight. With diligence, a follow-up of more than 90% can be obtained. The reoperation rate among experienced surgeons averages 1% to 2% per year. Mild late weight gain occurs in about 15% of cases, but significant weight gain occurs in less than 5% of patients. We believe that vertical staple gastroplasty is safe and effective and that it should be accepted as such by the medical profession.