What’s Best Weight Loss Surgery

A Structured Approach to Decision Making:
Choosing the Best Weight Loss Surgery

R Rutledge MD,
The Centers for Laparoscopic Obesity Surgery
www.CLOS.net
Email: DrR@clos.net

Abstract
Introduction
Obesity is now at epidemic proportions. Surgery has been found be a successful but flawed treatment. Several procedures have failed and been abandoned. Systematic tools help make rational decisions. The purpose was to apply tools to decision of selecting the “best” operation.
Methods
The Proact system was applied to the problem of selecting the Best” form of weight loss surgery. PR: Define the Problem, O: Objectives: Criteria for Success, A: Alternatives: Available Options, C: Consequences: Outcomes/Results, T: Tradeoffs: Weigh Pros & Cons. Proact is a systematic tool to make decisions.
Results
PR: State the Problem: Obesity epidemic with surgery essentially the only successful therapy, but present surgical procedures deeply flawed, leading to a spectrum of competing procedures. O: Objectives; we seek an “Ideal” Weight Loss Surgery. 30 point mul
Conclusions
Bariatric surgery is now racked with controversy. At least a dozen different procedures and variations vie for position as the “best” procedure for the treatment of obesity. Logical decision making by humans is often flawed and systems like Proact have been designed to aide in improving rational decision making. Applying the Proact tool to this problem allows use of a 30 point performance assessment tool. Arguably the Mini-Gastric Bypass meets this performance tool. The primary tradeoff has been seen to be the long term fear of gastric cancer when carefully reviewed is shown to be an insignificant concern.

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    Choose Best Weight Loss Surgery
    Pr: Choice of Obesity Surgery…

    Choose Best Weight Loss Surgery
    Pr: Choice of Obesity Surgery
    O: Objectives “Ideal” Weight Loss Surgery
    A: RNY, Band, Sleeve, MGB
    C: MGB meets almost all objectives/success criteria
    T: Fear of Gastric Cancer Not Supported by the Data
    Rational Decision Making: Best Choice; Mini-Gastric Bypass



    September 16, 2011 12:44 AM



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