Expert: Ronald Levy, M.D. - 10/13/2010

Question
Im told I need a trach put in my throat so I will breath better for my gastric bypass operation. Im 550lbs. with copd,asthma and very bad sleep apnea, and dont want to wake up when operated on. Im reading up on this and this operation seems more dangerous for obese people than the gastric bypass! Is there a safer alternative than a larnyoscopy with anesthesia?

Answer
Maybe I'm not understanding the question exactly. If you are saying they need to do an awake tracheostomy prior to your gastric bypass surgery, then I can only assume that either by examination or by previous trouble intubating you, they feel that to put you to sleep and intubate you would be difficult. What I don't understnad is why they wouldn't just do an awake fiberoptic intubation. In either case, this has nothing to do with waking up during surgery as you will be asleep dor that procedure regardless of whether they intubate you or give you a tracheostomy. If I am misunderstanding the question, please write back with more information.

Ronald Levy, MD
Professor of Anesthesiology
UTMB-Galveston