By JENNIFER PETER, Associated Press Writer
BOSTON - The risks of weight loss surgery can be reduced if only doctors who have been through a rigorous certification process perform the operations in facilities that conduct at least 100 of the increasingly popular procedures each year, according to a new report.
State Public Health Commissioner Christine Ferguson, who talked publicly Wednesday for the first time about her own struggles with excess weight and weight loss surgery, established the panel in February in response to several recent deaths related to gastric bypass surgeries,
The 24-member panel, made up of obesity experts, doctors, nurses and an ethicist representing 80 percent of the facilities that offer the procedure, made more than 100 recommendations in the report released Wednesday. They range from nursing care to patient education to the special anesthesiology needs of overweight patients.
Three Massachusetts patients have died following gastric bypass surgery since the beginning of 2003, triggering increased concerns about safety.
"Every surgical procedure carries risk," Ferguson said. "In this particular instance, the reason that I asked for the study had less to do with deaths, and more to do with the upswing in the number of surgeries that were being done."
In 1998, 402 of the surgeries were performed. That shot up to 2,761 in 2003.
Panel chairman Dr. Alan Harvey, an anesthesiologist at Brigham and Women's Hospital, said this was the first time nationally that a panel of experts has developed best practices based upon a systemic review of the medical literature related to weight loss surgeries.
The 69-page report is also the first major product of the Betsy Lehman Center for Patient Safety and Medical Error Reduction. The center was created last year in memory of a Boston Globe columnist who died in 1994 after a chemotherapy overdose at Boston's Dana-Farber Cancer Institute.
The recommendations will not be imposed on hospitals. Instead, the expectation is that hospitals and doctors � many of whom were represented on the panel � will adopt the practices voluntarily.
Ferguson said her goal in going public with her own surgery is to empower others to make the decisions they must in order to lose weight, whether through surgery, a change in diet, or an increase in exercise.
"There are a lot of people who have a weight problem who hide," she said. "My hope is that I spur them to understand that there is hope out there."
Ferguson had a less invasive operation called laparoscopic adjustable gastric banding in July 2003, which so far has helped her lose about 100 pounds. She has combined the surgery with changes in her diet and exercise regimen and hopes to lose another 100 pounds.
The panel recommended that facilities have specially equipped operating rooms, with extra wide operating tables, extra long abdominal tools, and wider wheelchairs, stretchers and walkers.
The panel said that weight loss surgeries should only be performed on well-informed, motivated patients, who have not been able to achieve long-term weight loss through other means.
The most recent death from gastric bypass surgery occurred in January at Beth Israel Deaconess Medical Center when Howard Reid, 37, of Boston, went into cardiac arrest immediately after the procedure.
Ferguson had her surgery long before she commissioned the panel.
"I commissioned the panel and I attended most of the meetings, but I tried to be very careful not to influence or try to influence what they said," she said.