Dr. Vitello @ UIC statistics/complication rates

Well, I had my consulation with my surgeon today. It went very well. I am more psyched than ever to have this operation and cannot wait for my surgery date to be scheduled (waiting on insurance approval). FYI - Here is a copy of a handout my doctor went over with me. These are my doctor's statistics, not national averages. I just thought some people may find this interesting. My surgeon has performed over 1000 of these surgeries. Taken from UIC The University of Illinois at Chicago Dr. Joseph Vitello, MD, FACS February 10, 2005 OVERALL: 80% DEVELOP DUMPING SYNDROME 30% DEVELOP LACTOSE INTOLERANCE 60-80% SUCCESS RATE 20-40% FAILURE RATE NOT A CURE FOR OBESITY, RATHER A TOOL TO BE COMBINED WITH DIETARY CHANGES, EXERCISE AND LIFESTYLE ADJUSTMENTS. COMPLICATIONS OF ROUX-Y GASTRIC BYPASS SURGERY (PLEASE NOTE: These are MY doctor's statistics. Your doctor's statistics will be different. I am only posting this for generalized information. Please seek advice from your doctor for any medical questions or concerns you may have before any procedure. Thanks, Ed) 1. INFECTIONS: antibiotics are routinely given to minimize these risks, however the risks never go to zero. a. WOUND INFECTION=5-7% This may result in opening your incision and frequent packing or dressing changes and the need for oral antibiotics. b. WOUND SEROMA=20-40% This is not really an infection, but results in the drainage of bloody fluid from your incision. c. PNEUMONIA=1-2% early ambulation, postoperative breathing exercises and stopping smoking, helps to minimize this risk. d. URINARY TRACT INFECTION=1-2% A catheter is placed in the bladder after your put under anesthesia and left for 24 hours to monitor your urine output. This can predispose you to this infection. 2. INCISIONAL HERNIA=10-15% This can develop weeks, months, or years after the operation and generally requires an operation to repair it. 3. WOUND EVISCERATION=0.006% This means your stitches break while still in the hospital allowing your wound to open up. It requires re-operation to repair. 4. SUTURE LINE LEAK=0.004% Where the stomach and small intestine are sewn together is one of the suture lines. If it leaks it requires re-operation to drain. You can become very sick if this happens. If it leaks you probably won't be able to eat or drink for several weeks while it heals. 5. DEEP VEIN THROMBOSIS=1% A blood clot that occurs in the deep veins of the leg, minimized with heparin (a blood thinner), ambulation and compression stockings. 6. PULMONARY EMBOLUS=0.5% A blood clot from the legs breaks off and travels to the lungs. This can be fatal. Minimized as in #5. 7. DEATH=1% 8. OPERATION FAILURE=20-40% a. failure to lose as much weight as you would like. b. Weight gain after weight loss, some patients will lose weight and then gain some or all of it back. 9. STRICTURE AT THE ANASTOMOSIS=1% Requires balloon stretching done by endoscopy. In rare cases it may require re-operation. 10. INABILITY TO EAT CERTAIN FOODS=VARIABLE The most common complaints are red meats, heavy breads, fried food, sometimes large pills. 11. VITAMIN AND MINERAL DEFICIENCIES These may develop unless you eat healthfully and take daily vitamins with iron and calcium supplements. a. Iron deficiency=40% chance especially in premonopausal women b. Vitamin B-12 deficiency=1% c. Folic Acid=1% d. Calcium deficiency=unknown, recommendations are to take 1000mg/day. 12. PROLONGED POSTOPERATIVE VENTILATION (breathing machine)=0.5% This can occur in patients who have significant lung problems. 13. INTENSIVE CARE UNIT STAY=0.5% Generally this is not required, but with any major complications an ICU stay occurs. 14. BLEEDING a. during the operation, estimated blood loss is usually less than 8oz. b. Need for blood transfusion=).005% and transfusion associated diseases: 1 hepatitis (1:500,000 units transfused); 2. AIDS (1:1.5 million units transfused) c. Splenectomy (0.006%))- post-splenectomy sepsis (rare) d. After the operation - need to return to the operating room and reopen the incision to control bleeding, 0.005% 15. PAIN=100% All patients experience pain. A patient controlled analgesia machine is used. For some patients an epidural catheter is possible. THE PAIN IS GENERALLY QUITE SEVERE. 16. FUTURE BOWEL OBSTRUCTIONS FROM ADHESIONS (SCAR TISSUE)=10% OVER A LIFETIME This can occur after any intra-abdominal operations. A bowel obstruction can result in the need for another operation. 17. NEED FOR FUTURE PLASTIC SURGERY=VARIABLE BUT AS HIGH AS 80% Common operations include tummy tuck (panniculectomy), breast reduction, liposuction, excision of excess skin from under arms or from thighs. 18. GALLSTONES=30% Patients undergoing rapid weight loss can develop gallstones. If you have gallstones, your gallbladder will be removed at the time of the gastric bypass. Otherwise you may be placed on prophylactic medication (Actigall) to prevent gallstones from developing. 19. HAIR LOSS=20% This can occur after any operation. It seems to be more common with gastric bypass. No one really knows why. It typically occurs around 3-6 months postoperatively. It generally resolves on it own. Although some people note thinner hair compared to before surgery; no one has gone bald. 20. SEVERE POSTOPERATIVE NAUSEA=1% This often requires rehospitalization for dehydration. Rarely it can result in malnutrition and need for intravenous nutrition. 21. AS WITH ANY SURGERY UNFORSEEN EVENTS CAN OCCUR WHICH CAN RESULT IN SERIOUS COMPLICATIONS AND EVEN UNPREVENTABLE COMPLICATIONS OR DEATH.

Good luck and best wishes and hope you get a date soon. My surgery is on monday the 14th with dr. vitello and I am very excited....hope to see ya on the losing side soon.....Dawn

Dawn, We are neighbors! I am so happy for you (and a little envious that your surgery is this Monday! ) Please keep me posted on how you're doing. What do you think of UIC and Dr. Vitello? How long did it take you to get a surgery date? Ed

HI Ed, I was really surprised on how quick my surgery came about. I began pushing forward with wanting the surgery in Sep 04 and by Nov 04 I had my consultation and by Dec I was approved and on Jan 4 is when I got my date. I hope yours goes just as quickly. I will keep you posted how things went...please feel free to e-mail at [email protected] Dawn

Qwwwww You guys are my neighbors too!! Glad to hear all is going well with both of you! Keep me posted too! I hope to have my surgery quickly too! But oh the insurance woes! I am still waiting for my PCP to write her letter to my health group....its such an intense game! Urgh.... Well good luck to you both! xoxoxjenn

I, too, had Dr. Vitello. I was so glad he gave me all the info you posted. I did end up in intensive care due to fluid overload. But I sure did get great care there and lots of attention. Also, alot of Dr. residents looking at my case. I was in ICU for 3 days then went to a regular room for one day before I went home. Dr. Vitello was great and always answered any questions I had. Once home, I did have a wound seroma at about 3 weeks out, but thanks to his discharge instructions, I did not totally freak out. I have had no other problems. I am almost 4 months out and have lost 92 lbs. as of today. Sometimes I can hardly believe how good I feel. This is the best thing I could have done for myself. Food no longer has a hold on me and I now eat to live rather than live to eat. Best wishes for a successful surgery and a NEW YOU ! ! Nancy