Sleeve gastrectomy or gastric bypass as revisional bariatric procedures: retrospective evaluation of outcomes. Abstract Background Methods:
|
|
- Branden Pitts
- 8 years ago
- Views:
Transcription
1 Sleeve gastrectomy or gastric bypass as revisional bariatric procedures: retrospective evaluation of outcomes. Mousa Khoursheed, Ibtisam Al-Bader, Ali Mouzannar, Abdulla Al-Haddad, Ali Sayed, Ali Mohammad, Abe Fingerhut. Surg Endosc 2013;27: Abstract Background: A considerable number of patients require revisional surgery after laparoscopic adjustable gastric banding (LAGB). Studies that compared the outcomes of revisional sleeve gastrectomy (r-sg) and revisional Roux en- Y gastric bypass (r-rygb) after failed LAGB are scarce in the literature. Our objective was to determine whether significant differences exist in outcomes between r-sg and r-rygb after failed LAGB. Methods: From 2005 to 2012, patients who underwent laparoscopic r-sg and r-rygb after failed LAGB were retrospectively compared and analyzed. Data included demographics, indication for revision, operative time, hospital stay, conversion rate, percentage excess weight loss (%EWL), and morbidity and mortality. Results: Out of 693 bariatric procedures, 42 r-sg and 53 r-rygb were performed. The median preoperative weight (107.7 and kg, respectively, p = 0.02) and body mass index (BMI) (38.5 vs kg/m2, respectively, p = 0.01) were statistically significantly lower in r-sg than in r- RYGB. The mean operative time and median hospital stay were significantly shorter in r-sg than in r-rygb (108.4 vs min, p\0.01) (2 vs. 3 days, p = 0.02), respectively. One patient underwent conversion to open surgery after r-rygb (p = 0.5). The reoperation rate was lower in r- SG than in r-rygb (0.0 vs. 3.8 %, p = 0.5). There was one
2 postoperative leak in the r-rygb, and the overall complication rate was significantly lower in r-sg patients than in r-rygb patients (7.1 vs %, p = 0.05). The mean follow-up was significantly shorter in the r-sg group (9.8 vs months, p>0.01). However, the mean postoperative BMI was not different at 1 year (32.3 vs. 34.7, p = 0.29) as well as mean %EWL was (47.4 vs %, p = 0.77). Conclusions: Both r-sg and r-rygb are safe procedures with similar outcomes in terms of %EWL. As a result of the long-term potential nutritional complication of r-rygb, r-sg may be a better option in this group of patients. Longer follow-up is needed. Critical Appraisal 1. This study retrospectively examined the outcomes for morbidly obese patients who underwent laparoscopic sleeve gastrectomies (r-sg) or laparoscopic roux-en-y gastric bypasses (r-rygb) after failed laparoscopic adjustable bands (LAGB). The study included all patients revised between the years 2005 and r-sg and 53 r-rygb patients were included in the analysis. The researchers compared patient demographics, indication for revision, operative times, hospital stay, conversion rate, percentage excess weight loss (%EWL), morbidity and mortality. 2. All patients had the band removed and either the r-sg or the r- RYGB performed at the same operative intervention. 3. Based on their data, they concluded that both procedures could be safely performed laparoscopically and as a single operative procedure. Additionally, although the mean postoperative BMI
3 and %EWL were similar for both procedures at the one year follow up, r-rygb procedures had statistically significantly longer operative times and lengths of stay, a higher reoperation rate, and a statistically significantly higher overall complication rate. 4. Only 1 patient required conversion from the laparoscopic to an open procedure for bleeding (1.9%) and there was only 1 leak (1.9%). The overall complication rates for the r-sg and the r- RYGB were 7.1% and 20.8% respectively, which are acceptable for revisional bariatric surgery and would suggest that the surgeons were adequately skilled in both procedures. 5. The authors conclude that the r-sg might be a better choice for patients electing to have their LAGB removed vs. the r-rygb since the weight loss is similar, the complication rate is lower, and the risk of long term nutritional complications less. Study Limitations 1. This was a retrospective analysis and not a prospective trial. The groups are not similar so the outcome comparisons must be interpreted with that in mind. The patients were not randomized into the 2 groups. The earlier patients were only offered the r- RYGB and more of the later patients the r-sg. There is no description for how patients were selected for the 2 procedures. Additionally, the r-rygb patients were older (although this was not statistically significant, it might be if the series was larger). Importantly, r-rygb patients were statistically heavier. Therefore, the change in BMI and %EWL results will be biased in favor of the lower weight group.
4 2. Mean follow up was not comparable between the 2 procedures. r- RYGB patients had a mean follow up of months vs months for the r-sg. It was statistically significantly longer for the r-rygb group (p <0.01). 3. The authors describe the operative techniques for the 2 procedures. For the r-rygb they report creating the gastric pouch below the band scar and do not state that the gastrogastric wrap was taken down. These operative steps could result in larger gastric pouched which could influence weight loss. 4. The authors do not define band failure. For example, how many patients lost no weight or gained all the lost weight back vs. how many patients had inadequate weight loss but lost some weight? Were these patients equally distributed between the groups? Is the one year follow up %EWL for the r-sg and r-rygb calculated from preop band placement or preop conversion? 5. One year follow up was poor for both groups, only 9 of the 42 r-sg patients (21.4%) were evaluated and 25 of the 53 r-rygb patients (47.2%). Therefore the 1 year outcome data presented must be viewed with caution. 6. The authors conclude that the r-sg might be a better choice for patients electing to have their LAGB removed vs. the r-rygb since the weight loss is similar, the complication rate is lower, and the risk of long term nutritional complications less. However: A. The weight loss results are biased by the lack of patient randomization, significant starting weight differences between the groups, potential for large gastric pouches in the r-rygb patients, and the poor 1 year follow up. B. The complication rate was lower in this study for the r-sg
5 patients which is compatible with other published data but maybe biased by the lack of similarity between the 2 groups. C. No nutritional data was presented to make any nutritional inferences in this patient population. Scott A. Shikora, MD, FACS, FASMBS Director, Center for Metabolic and Bariatric Surgery Brigham and Women s Hospital Associate Professor of Surgery Harvard Medical School Boston, Massachusetts, USA
Richard M Peterson, MD MPH FACS Chief UT Medicine Center for Bariatric and Metabolic Surgery Director Christus Weight Loss Institute Assistant
Richard M Peterson, MD MPH FACS Chief UT Medicine Center for Bariatric and Metabolic Surgery Director Christus Weight Loss Institute Assistant Professor of Surgery UTHSCSA None Laparoscopic adjustable
More informationThe Arguments: T2DM - tremendous economic burden globally Lifestyle / Pharm Rx:
James Cromie The Arguments: T2DM - tremendous economic burden globally Lifestyle / Pharm Rx: INEFFECTIVE and UNSUSTAINED Bariatric surgery is an Effective and Durable treatment option Well established
More informationTreatment for Severely Obese Patients
Treatment for Severely Obese Patients Associate Professor Jimmy So Senior Consultant Surgeon Director, Centre for Obesity Management and Surgery (COMS) National University Hospital Obesity Shortens Lives
More informationChoices Around Bariatric Surgery
Choices Around Bariatric Surgery What should you know? Richard Stubbs MD FRCS FRACS Wakefield Obesity Clinic, Wellington 152 kg / BMI 59 74 kg / BMI 29 Indications (NIH Consensus Statement 1991) BMI >
More informationOverview of Bariatric Surgery
Overview of Bariatric Surgery To better understand how weight loss surgery works, it is helpful to know how the normal digestive process works. As food moves along the digestive tract, special digestive
More informationRoux-en-Y Gastric Bypass
Roux-en-Y Gastric Bypass Restrictive and malabsorptive procedure Most frequently performed bariatric procedure in the US First done in 1967 Laparoscopic since 1993 75% EWL in 18-24 months 50% EWL is still
More informationEndoscopic gastric pouch plication - a novel endoluminal incision free approach to revisional bariatric surgery
Endoscopic gastric pouch plication - a novel endoluminal incision free approach to revisional bariatric surgery Authors: Chiranjiv S Virk, I Michael Leitman and Elliot R Goodman. Location: Beth Israel
More informationWhy a loop and new approach makes sense!
IP: tomach Intestinal Pylorus paring urgery Why a loop and new approach makes sense! Mitchell Roslin, MD, FAC Chief of Bariatric and Metabolic urgery Lenox Hill Hospital Northern Westchester Hospital Center
More informationThe GaBP Ring for Banding the Pouch in Gastric Bypass and Sleeve Gastrectomy Operations BARIATEC.COM
The GaBP Ring for Banding the Pouch in Gastric Bypass and Sleeve Gastrectomy Operations BARIATEC.COM GaBP Ring The GaBP Ring is a prefabricated, caliberated and sterilized silicone coated implantable device
More informationBariatric Surgery. Beth A. Ryder, MD FACS. Assistant Professor of Surgery The Miriam Hospital Warren Alpert Medical School of Brown University
Bariatric Surgery Beth A. Ryder, MD FACS Assistant Professor of Surgery The Miriam Hospital Warren Alpert Medical School of Brown University April 30, 2013 Why surgery? Eligibility criteria Most commonly
More informationWeight loss surgery more than just a gastric band
Weight loss surgery more than just a gastric band Presented by Ms Beth Murgatroyd Honorary Bariatric Nurse Practitioner Mr Ameet G Patel Consultant Surgeon Director of Bariatric Surgery at King s College
More informationTechnical Aspects of Bariatric Surgical Procedures. Robert O. Carpenter, MD, MPH, FACS Department of Surgery Scott & White Memorial Hospital
Technical Aspects of Bariatric Surgical Procedures Robert O. Carpenter, MD, MPH, FACS Department of Surgery Scott & White Memorial Hospital Disclosures Allergan, Inc. (Past) Faculty Member Educational
More informationBariatric Training and Education. Hallein Clinic, Austria Karl Miller, MD, FACS
Bariatric Training and Education Hallein Clinic, Austria Karl Miller, MD, FACS Obesity surgery is not only a craft but it also signifies consideration of the disease as a whole. An Operation Primer undertakes
More informationBariatric Surgery. OHTAC Recommendation. Bariatric Surgery
OHTAC Recommendation Bariatric Surgery January 21, 2005 1 The Ontario Health Technology Advisory Committee (OHTAC) met on January 21, 2005 and reviewed bariatric surgery for morbid obesity. Obesity is
More informationWhen, Why, and How to Revise a Failed Sleeve Gastrectomy
When, Why, and How to Revise a Failed Sleeve Gastrectomy Jin S. Yoo M.D. Assistant Professor of Surgery Duke University Medical Center April 6, 2013 When and Why Already Covered Let s Talk About How Overview
More informationUW MEDICINE PATIENT EDUCATION. Weight Loss Surgery. What is bariatric surgery?
UW MEDICINE PATIENT EDUCATION Weight Loss Surgery Divided proximal roux-y-gastric bypass, laparoscopic adjustable gastric banding, and laparoscopic sleeve gastrectomy. This section of the Guide to Your
More informationSouthcoast Center for Weight Loss
Introduction Introducing the Southcoast Center for Weight Loss Left: Tobey Hospital, Wareham Right: Southcoast Health System at Rosebrook Business Park, Wareham The Southcoast Center for Weight Loss is
More informationLaparoscopic One Anastomosis Gastric Bypass (LOAGB) How I do it
CENTER OF EXCELLENCE FOR THE STUDY AND OBESITY TREATMENT Laparoscopic One Anastomosis Gastric Bypass (LOAGB) How I do it Concepts and Results in a series of 11-years experience with 2,200 patients Miguel-A.
More informationConsidering Bariatric Surgery? Learn about minimally invasive da Vinci Surgery
Considering Bariatric Surgery? Learn about minimally invasive da Vinci Surgery The Condition: Obesity Obesity is defined as having a body mass index (BMI) of 30 or greater. Obesity is a serious medical
More informationScott A. Shikora, MD, FACS. Sleeve Gastrectomy. Sleeve Gastrectomy. Sleeve Gastrectomy 11/8/2013
DISCLOSURE Scott A. Shikora, MD, FACS Scott A. Shikora, MD, FACS Associate Professor of Surgery Harvard Medical School Director, Center for Metabolic and Bariatric Surgery Brigham and Women s Hospital
More informationEmerging Concepts in Bariatric Surgery
Emerging Concepts in Bariatric Surgery C Y N T H I A L. L O N G, M D, F A C S S I N A I H O S P I T A L O F B A L T I M O R E D E P A R T M E N T O F S U R G E R Y D I V I S I O N O F M I N I M A L L Y
More informationBARIATRIC SURGERY. Prerequisites. Authorization, Notification and Referral
BARIATRIC SURGERY Policy NHP reimburses participating providers for specific types of medically necessary bariatric surgery when needed to either alleviate or correct medical problems caused by severe
More informationDealing with weight regain after Rouxen-Y gastric bypass: surgical approach
Dealing with weight regain after Rouxen-Y gastric bypass: surgical approach Robin Blackstone, MD, FACS Masters of Minimally Invasive Bariatric Surgery April 5, 2013 Orlando, Florida Disclosures PI Enteromedics
More informationWeight Loss Surgery Information Session. WFBH Bariatric Surgery Program
Weight Loss Surgery Information Session WFBH Bariatric Surgery Program What makes us different? Center of Excellence (COE) High volume center > 1000 procedures since 2003 Less complications than non-coe
More informationPosition Statement Weight Loss Surgery (Bariatric Surgery) and its Use in Treating Obesity or Treating and Preventing Diabetes
Position Statement Weight Loss Surgery (Bariatric Surgery) and its Use in Treating Obesity or Treating and Preventing Diabetes People with diabetes Losing excess weight will assist in the management of
More informationSurgical Weight Loss Program for Teens
Surgical Weight Loss Program for Teens Surgical Weight Loss Program for Teens The Surgical Weight Loss Program team understands the impact that being severely overweight can have on your life. Our guiding
More informationBariatric i Surgery: Optimalizing Outcome Results. Dr. B. Dillemans AZ Sint-Jan AV Brugge-Oostende BARIATRIC SURGERY
Bariatric i Surgery: Optimalizing i Outcome Results Dr. B. Dillemans AZ Sint-Jan AV Brugge-Oostende THE OBESE PATIENT : A CHALLENGE FOR ANAESTHESIA, Ostend,14/11/09 BARIATRIC SURGERY 50 s : First Reported
More informationBariatric Surgery Guide
One Bariatric Surgery Guide Get back to enjoying the everyday moments. Obesity is one of the nation s leading health issues. More than half of Americans are overweight and roughly 12 million Americans
More informationValk J.W., Gypen B., Abdelgabar A., Hendrickx L. Schijns W., Aarts E., Janssen I., Berends F. Rheinwalt K.P., Schneider S., Plamper A.
Revisional Surgery for Weight Regain or Insufficient Weight Loss after Gastric Bypass using the Minimizer Ring: Short Term Results of a Multi Center Study Valk J.W., Gypen B., Abdelgabar A., Hendrickx
More informationAssessment Day Bariatric Surgery. 12266 DePaul Drive, Suite 310 Bridgeton, MO 63044 (P) 1-877-477-6954 ssmweightloss.com
Assessment Day Bariatric Surgery 12266 DePaul Drive, Suite 310 Bridgeton, MO 63044 (P) 1-877-477-6954 ssmweightloss.com Assessment Day Agenda Types of Surgery Complications Expectations Next Steps Questions
More informationBariatric Surgery: What the Internist Needs to Know
Bariatric Surgery: What the Internist Needs to Know Richard Stahl, MD, FACS Assistant Professor of Surgery Medical Director of Bariatric Surgery Disclosures None (sadly) Objectives Describe several myths
More informationObesity Affects Quality of Life
Obesity Obesity is a serious health epidemic. Obesity is a condition characterized by excessive body fat, genetic and environmental factors. Obesity increases the likelihood of certain diseases and other
More informationRedo Banding After Band Erosion Advantages of the MiniMizer Extra Band Conclusion Approximately 67% of the patients suffering from erosion have sought revisional surgery. The choice of redo procedures
More informationMorbid obesity is defined as a body mass index (BMI) >40 kg/m2 (normal BMI range: 19-25 kg/m2)
Medical Policy Manual Topic: Bariatric Surgery Date of Origin: January 1996 Section: Surgery Last Reviewed Date: August 2015 Policy No: 58 Effective Date: September 1, 2015 IMPORTANT REMINDER Medical Policies
More informationPREOPERATIVE MANAGEMENT FOR BARIATRIC PATIENTS. Adrienne R. Gomez, MD Bariatric Physician St. Vincent Bariatric Center of Excellence
PREOPERATIVE MANAGEMENT FOR BARIATRIC PATIENTS Adrienne R. Gomez, MD Bariatric Physician St. Vincent Bariatric Center of Excellence BARIATRIC SURGERY Over 200,000 bariatric surgical procedures are performed
More informationEndoscopic therapy for obesity and complications of bariatric surgery
Endoscopic therapy for obesity and complications of bariatric surgery Jacques Devière, MD, PhD Erasme University Hospital Brussels Belgium jacques.deviere@erasme.ulb.ac.be Obesity Affects 300 millions
More informationBARIATRIC SURGERY MAY CURE TYPE 2 DIABETES IN SOME PATIENTS
BARIATRIC SURGERY MAY CURE TYPE 2 DIABETES IN SOME PATIENTS Thomas Rogula MD, Stacy Brethauer MD, Bipand Chand MD, and Philip Schauer, MD. "Gastric bypass surgery has become a popular option for obese
More informationProcedure Type: Metabolic and Malabsorbtion. Procedure Names. Adjustable Gastric Band (LAGB) Realize Band. Vertical Sleeve Gastrectomy (VSG)
The following table explains and compares the various weight loss surgeries, and their differences. For more information, please also read our compilation of related medical journals & articles below the
More informationLaparoscopic Roux-En-Y Gastric Bypass Versus Laparoscopic Adjustable Gastric Banding in the
553148SJS0010.1177/1457496914553148LRYGB vs LAGB in super-obese patients (BMI >50)S. Giordano, et al. research-article2015 Original Article Scandinavian Journal of Surgery 104: 5 9, 2015 Laparoscopic Roux-En-Y
More informationSUMMA HEALTH SYSTEM BARIATRIC CARE CENTER. Laura Ilg RD, LD Adrian Dan MD, FACS
SUMMA HEALTH SYSTEM BARIATRIC CARE CENTER Laura Ilg RD, LD Adrian Dan MD, FACS GOALS The Many Benefits of Bariatric surgery and Weight Reduction Bariatric Care Center Surgical Weight Loss Program Medical
More informationImproving Outcome of Bariatric Surgery: Best Practices in an Accredited Surgical Center
DOI 10.1007/s11695-014-1209-y ORIGINAL CONTRIBUTIONS Improving Outcome of Bariatric Surgery: Best Practices in an Accredited Surgical Center Maher El Chaar & Leonardo Claros & George C Ezeji & Maureen
More informationMedical Coverage Policy Bariatric Surgery
Medical Coverage Policy Bariatric Surgery Device/Equipment Drug Medical Surgery Test Other Effective Date: 9/1/2011 Policy Last Updated: 11/01/2011 Prospective review is recommended/required. Please check
More informationCatholic Medical Center & Androscoggin Valley Hospital. Surgical Weight Loss Options For a Healthier Tomorrow
Catholic Medical Center & Androscoggin Valley Hospital Surgical Weight Loss Options For a Healthier Tomorrow Presentation Overview Obesity Health Related Risks Who Qualifies for Weight Loss Surgery? Gastric-bypass
More informationMetabolic and Bariatric Surgery Center
Metabolic and Bariatric Surgery Center www.bannerhealth.com/universitytucsonsurgicalweightloss 1 Welcome to Banner University Medical Center s Metabolic and Bariatric Surgery Center Thank you for choosing
More informationMorbid obesity is defined as a body mass index (BMI) >40 kg/m2 (normal BMI range: 19-25 kg/m2)
Medical Policy Manual Topic: Bariatric Surgery Date of Origin: January 1996 Section: Surgery Last Reviewed Date: May 2016 Policy No: 58 Effective Date: June 1, 2016 IMPORTANT REMINDER Medical Policies
More informationChanges to Bariatric Surgery Prior Authorization Guidelines
Update August 2011 No. 2011-44 Affected Programs: BadgerCare Plus, Medicaid To: Hospital Providers, Physician Assistants, Physician Clinics, Physicians, HMOs and Other Managed Care Programs Changes to
More informationLose the Weight, Find your Life
Bariatric Surgery: University of Iowa Lose the Weight, Find your Life Isaac Samuel, MD, FRCS, FACS Professor of Surgery Director, Bariatric Surgery 1 Present UI Bariatric Surgeons Jessica Smith, MD Peter
More informationPreservation and Incorporation of Valuable Endoscopic Innovations (PIVI)
Preservation and Incorporation of Valuable Endoscopic Innovations (PIVI) The American Society for Gastrointestinal Endoscopy PIVI on Endoscopic Bariatric Procedures (short form) Please see related White
More informationall about Bariatric Surgery
all about Bariatric Surgery What is Bariatric Surgery? Obesity Definitions Bariatric surgery is performed with the intention of inducing weight loss. It encompasses a range of medical operations which
More informationRoux-en-y gastric bypass - clinical perspectives
Roux-en-y gastric bypass - clinical perspectives Tom Mala Consultant surgeon Department of Gastroenterologic Surgery Oslo University Hospital Bariatric surgery weight loss Sjøstrøm L, JAMA 2012 Five-year
More informationDept. of Medical Imaging University of Ottawa
ED Visits Related to Bariatric Surgery: Review of Normal Post-Surgical Anatomy as Well as Complications Dept. of Medical Imaging University of Ottawa Disclosures Background Roux-en-Y Gastric Bypass Surgery
More informationOriginal article Laparoscopic adjustable gastric banding: a report of 228 cases
Gastroenterology Report 1 (2013) 144 148, doi:10.1093/gastro/got023 Advance access publication 11 August 2013 Original article Laparoscopic adjustable gastric banding: a report of 228 cases Xin Wang, Cheng-zhu
More informationIntraoperative Prevention of Stenosis for Laparoscopic Sleeve Gastrectomy
CASE REPORT Intraoperative Prevention of Stenosis for Laparoscopic Sleeve Gastrectomy Ramon Vilallonga, MD, PhD, Jacques Himpens, MD Division of Bariatric Surgery, AZ St. Blasius, Dendermonde, Belgium
More informationBariatric Surgery Support NEWSLETTER. info@bariatricsurgerysupport.co.za HAPPY HOLIDAYS FROM ALL OF US!
info@bariatricsurgery.co.za NEWSLETTER HAPPY HOLIDAYS FROM ALL OF US! The Christmas Holidays are nearly upon us, and, like you, our Bariatric Surgery Support is looking forward to a well-deserved rest
More informationUS experience with the LAP-BAND system
The American Journal of Surgery 184 (2002) 46S 50S US experience with the LAP-BAND system Christine J. Ren, M.D. a, *, Santiago Horgan, M.D. b, Jaime Ponce, M.D. c a New York University School of Medicine,
More information5. Conversion Procedures that change from an index procedure to a different type of procedure.
Benefit Coverage Covered Benefit for lines of business including Health Benefits Exchange (HBE), Rite Care (MED), Children with Special Needs (CSN), Substitute Care (SUB), Rhody Health Partners (RHP),
More informationTeresa LaMasters MD, FACS Minimally Invasive Bariatric Surgeon Iowa Health Weight Loss Specialists Throckmorton Surgical Society May 4, 2012
Laparoscopic Sleeve Gastrectomy Teresa LaMasters MD, FACS Minimally Invasive Bariatric Surgeon Iowa Health Weight Loss Specialists Throckmorton Surgical Society May 4, 2012 Objectives Understand the anatomy
More informationWeight Loss Surgery Info for Physicians
Weight Loss Surgery Info for Physicians As physicians, we see it every day when we see our patients more and more people are obese, and it s affecting their health. It s estimated that at least 2/3 of
More informationConsumer summary Laparoscopic adjustable gastric banding for the treatment of obesity (Update and re-appraisal)
ASERNIP S Australian Safety and Efficacy Register of New Interventional Procedures Surgical Consumer summary Laparoscopic adjustable gastric banding for the treatment of obesity (Update and re-appraisal)
More informationNHRMC General Surgery Specialists. Minimally Invasive Gastrointestinal Surgery Phone: 910-662-9300 Fax: 910-662-9303
Minimally Invasive Gastrointestinal Surgery Phone: 910-662-9300 Fax: 910-662-9303 W. Borden Hooks III, MD 1725 New Hanover Medical Park Drive Wilmington, NC 28403 Thank you for choosing NHRMC General Surgery
More information2016 Physician Quality Reporting System Data Collection Form: General Surgery (for patients aged 18 and older)
2016 Physician Quality Reporting System Data Collection Form: General Surgery (for patients aged 18 and older) IMPORTANT: Any measure with a 0% performance rate (100% for inverse measures) is not considered
More informationBariatric Surgery. Overview of Procedural Options
Bariatric Surgery Overview of Procedural Options The Obesity Epidemic In 1991, NO state had an obesity rate above 20% 1 As of 2010, more than two-thirds of states (38) now have adult obesity rates above
More informationLaparoscopic Sleeve Gastrectomy Versus Laparoscopic Adjustable Gastric Banding for the Treatment Severe Obesity in High Risk Patients
Laparoscopic Sleeve Gastrectomy Versus Laparoscopic Adjustable Gastric Banding for the Treatment Severe Obesity in High Risk Patients J. Esteban Varela, MD SCIENTIFIC PAPER ABSTRACT Background: Laparoscopic
More informationAdvancing the Field of Bariatric Surgery at University Hospitals
Advancing the Field of Bariatric Surgery at University Hospitals More Sharing ServicesShare Share on facebookshare on emailshare on favoritesshare on printrss Feed By: Alex Strauss Sunday, March 11, 2012
More informationThe following combinations of Primary CPT by Other CPT will also be included in the denominator:
2014 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) Qualified Clinical Data Registry (QCDR) Non-PQRS Measures Specifications MBSAQIP Measure # 1 Risk standardized
More informationSurgical Weight Loss Program SURG CAL WEIGHT LOSS. at University Medical Center
Surgical Weight Loss Program 1 SURG CAL WEIGHT LOSS at University Medical Center Welcome to the University Medical Center Surgical Weight Loss Program Thank you for choosing UMC for your weight loss surgery.
More informationGASTRIC SLEEVE SURGERY FOR WEIGHT LOSS. www.carepointhealth.org GASTRIC SLEEVE SURGERY FOR WEIGHT LOSS. 201-795-8175 CarePointHealth.
www.carepointhealth.org GASTRIC SLEEVE SURGERY FOR WEIGHT LOSS 201-795-8175 CarePointHealth.org 1 CONTENTS What is sleeve gastrectomy? Why choose sleeve gastrectomy? Health risks associated with excess
More informationLaparoscopic Revisional Gastric Bypass after open bariatric surgeries. Haider Alshurafa 1
Laparoscopic Revisional Gastric Bypass after open bariatric surgeries 1 Surgery Department, Riyadh Military Hospital, Riyadh, Saudi Arabia Haider Alshurafa 1 Objective: To confirm the feasibility of the
More informationGASTRIC SLEEVE SURGERY FOR WEIGHT LOSS. www.malleysurgical.com GASTRIC SLEEVE SURGERY FOR WEIGHT LOSS
GASTRIC SLEEVE SURGERY FOR WEIGHT LOSS www.malleysurgical.com GASTRIC SLEEVE SURGERY FOR WEIGHT LOSS 1 CONTENTS What is sleeve gastrectomy? Why choose sleeve gastrectomy? Health risks associated with excess
More informationhelping you lose weight { TO REGAIN YOUR LIFE }
helping you lose weight { TO REGAIN YOUR LIFE } Melinda LOST 117 LBS. and truly enjoys exercise now I cannot put into words how this surgery has changed my life. Just being able to do things walk, run,
More informationWeight Loss Surgery and Bariatric Nutrition. Jeanine Giordano, MS, RD, CDN
Weight Loss urgery and Bariatric Nutrition Jeanine Giordano, M, RD, CDN UA: Mean BMI trends (age standardized) Prevalence of Obesity Among Adults United tates 68% Australia 59% Russia 54% United Kingdom
More informationWeight-Loss Surgery for Adults With Diabetes or Prediabetes Who Are at the Lower Levels of Obesity
Weight-Loss Surgery for Adults With Diabetes or Prediabetes Who Are at the Lower Levels of Obesity A Review of the Research for Adults With a BMI Between 30 and 35 Is This Information Right for Me? If
More informationEndoluminal Bariatric Revision. Todd David Wilson, MD
Endoluminal Bariatric Revision Todd David Wilson, MD Surgical Endoscopy and the Bariatric Surgeon Preoperative Endoscopy Postoperative Endoscopy Revisional Endoscopy Primary Endoluminal Bariatrics Preoperative
More informationTreatment for severe GERD after Sleeve Gastrectomy: conversion to gastric bypass or endoluminal radiofrequency. Alfonso Torquati, MD, MSCI, FACS
Treatment for severe GERD after Sleeve Gastrectomy: conversion to gastric bypass or endoluminal radiofrequency. Alfonso Torquati, MD, MSCI, FACS Associate Professor and Chief Division of Metabolic and
More informationMorbid obesity is defined as a body mass index (BMI) >40 kg/m2 (normal BMI range: 19-25 kg/m2)
Medical Policy Manual Topic: Bariatric Surgery Date of Origin: January 1996 Section: Surgery Last Reviewed Date: January 2014 Policy No: 58 Effective Date: July 1, 2014 IMPORTANT REMINDER Medical Policies
More informationReal World Data: How It s Used at a Medical Device Company
MD MEDICAL SAFETY Real World Data: How It s Used at a Medical Device Company Myoung Kim, Ph.D., MBA. Andrew Yoo, M.D., M.S. Epidemiology and Health Informatics Medical Devices Johnson & Johnson May 29,
More informationXXXXX Petitioner File No. 113467-001 v. Issued and entered this _12th_ day of October 2010 by Ken Ross Commissioner ORDER I PROCEDURAL BACKGROUND
In the matter of STATE OF MICHIGAN DEPARTMENT OF ENERGY, LABOR & ECONOMIC GROWTH OFFICE OF FINANCIAL AND INSURANCE REGULATION Before the Commissioner of Financial and Insurance Regulation XXXXX Petitioner
More informationPARKVIEW COMMUNITY HOSPITAL MEDICAL CENTER DEPARTMENT OF SURGERY Bariatric Surgery
STANDARDS FOR PRIVILEGES In order to be eligible to request clinical privileges for both initial appointment and reappointment, a practitioner must the following minimum threshold criteria. In addition
More informationIEHP UM Subcommittee Approved Authorization Guidelines Bariatric Surgery for Morbid Obesity
According to the National Institutes of Health (NIH) Consensus Development Conference on Gastrointestinal Surgery for Severe Obesity, the risk for morbidity and mortality accompanying obesity increases
More information5/9/2012. What is Morbid Obesity? Obesity Trends* Among U.S. Adults BRFSS, 1990, 1998, 2007 (*BMI 30, or about 30 lbs. overweight for 5 4 person)
Obesity Trends* Among U.S. Adults BRFSS, 1990, 1998, 2007 (*BMI 30, or about 30 lbs. overweight for 5 4 person) 1990 1998 The Bariatric and Metabolic Center of Colorado Bariatric Surgery: Options, Care
More informationWhite Paper: Treating Clinical Obesity: When is Bariatric Surgery or Bariatric Surgery Revision Medically Necessary?
White Paper: Treating Clinical Obesity: When is Bariatric Surgery or Bariatric Surgery Revision Medically Necessary? For Health Plans, Medical Management Organizations and TPAs Introduction More than one
More informationOutcomes and options in the management of leak and gastric fistula after sleeve gastrectomy.
Outcomes and options in the management of leak and gastric fistula after sleeve gastrectomy. 1 Mercy Bariatrics, Perth Australia Leon Cohen 1 Leak and gastric fistula after sleeve gastrectomy remains one
More informationGastric Imbrication: The Future or Fantasy?
Opinions General Surgery News. Issue: July 2011 Volume 38:7 Gastric Imbrication: The Future or Fantasy? Expert Panel Meets To Discuss Major Questions About New Procedure for Weight Loss by Daniel Cottam,
More information# Title NQS Domain Measure Type
2014 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) Qualified Clinical Data Registry (QCDR) Non-PQRS Measures Specifications # Title NQS Domain Measure Type 1 Risk
More information"Inevitable weight regain: sleeve Gastrectomy and non -banded gastric bypass."
"Inevitable weight regain: sleeve Gastrectomy and non -banded gastric bypass." MAL Fobi Medical Director Center for Surgical Treatment of Obesity Carson CA, USA IEF web meeting in January 6, 2014. DISCLOSURES
More informationMedical Policy Bariatric Surgery
Medical Policy Bariatric Surgery Document Number: 001 Commercial MassHealth and Qualified Health Plans Authorization required X X Notification within 24 hours of service or next business day No notification
More informationweight bias resources for bariatric surgery clinics
Relevant research articles To view more research articles on weight bias, please visit http://www.yaleruddcenter.org/default.aspx?id=25. 1. Anderson DA, Wadden TA. Bariatric surgery patients' views of
More informationThe Link Between Obesity and Diabetes The Rapid Evolution and Positive Results of Bariatric Surgery
The Link Between Obesity and Diabetes The Rapid Evolution and Positive Results of Bariatric Surgery Michael E. Farkouh, MD, MSc Peter Munk Chair in Multinational Clinical Trials Director, Heart and Stroke
More informationThe Evolution of Bariatric Surgery. History of the Development of a Successful Bariatric Program at the University of Iowa Hospitals & Clinics
The Evolution of Bariatric Surgery History of the Development of a Successful Bariatric Program at the University of Iowa Hospitals & Clinics It s a BIG Problem & it s Getting Worse Obesity is now a disease
More informationSurgical Treatment of Obesity: A Surgeon s View
Surgical Treatment of Obesity: A Surgeon s View Jenny J. Choi, MD Director of Bariatrics Associate Director of Clinical Affairs Assistant Professor of Surgery Albert Einstein School of Medicine Montefiore
More informationWeight Loss Surgery: Pre- and Post-Operative Care
Weight Loss Surgery: Pre- and Post-Operative Care Dan Bessesen, MD Chief of Endocrinology; Denver Health Medical Center Professor of Medicine, University of Colorado School of Medicine Daniel.Bessesen@ucdenver.edu
More informationHOUSTON METHODIST SURGICAL WEIGHT LOSS
HOUSTON METHODIST SURGICAL WEIGHT LOSS Why choose surgical weight loss at Houston Methodist? Obesity causes many dangerous diseases and health conditions such as diabetes, high blood pressure, heart disease,
More informationCleveland Clinic Bariatric and Metabolic Institute. Weight Loss Surgery for Severely Obese Patients
Cleveland Clinic Bariatric and Metabolic Institute Weight Loss Surgery for Severely Obese Patients life-altering therapy requires close communication Careful patient selection for bariatric surgery is
More informationNATIONAL OSTEOPOROSIS FOUNDATION OSTEOPOROSIS CLINICAL UPDATES Bariatric Surgery And Skeletal Health CE APPLICATION FORM
NATIONAL OSTEOPOROSIS FOUNDATION OSTEOPOROSIS CLINICAL UPDATES Bariatric Surgery And Skeletal Health CE APPLICATION FORM First Name: Last Name: Mailing Address: City: State: Zip/Postal Code: Country: Phone
More informationDiabetes and Weight-Loss Surgery
WHITE PAPER Diabetes and Weight-Loss Surgery Treat the cause. Cure the symptom. Center of Excellence BARIATRIC SURGERY Written July 2011 Bariatric Surgery: The Cure for Type II Diabetes? For most individuals
More informationA five year Canadian laparoscopic adjustable gastric band experience
The American Journal of Surgery (2010) 199, 690 694 The North Pacific Surgical Association A five year Canadian laparoscopic adjustable gastric band experience Todd W. Swanson, M.D. a, Bao Q. Tang, M.D.,
More informationBariatric Weight Loss Surgery
BARIATRIC SURGERY Bariatric Weight Loss Surgery The heart and science of medicine. Weight loss surgery, also known as bariatric surgery, was developed as a tool to help people with morbid obesity reduce
More informationWeight Loss Surgery. Our Surgeons. A Patient s Guide
Our Surgeons Our bariatric surgeons and support staff provide the information and support necessary to achieve substantial and sustainable weight loss. Our surgeons: Weight Loss Surgery A Patient s Guide
More information12-05 1-13, 4-14, 6-15 Key Stakeholders: Surgery, IM Depts. Next Update: 6-16
HEALTHSPAN BARIATRIC SURGERY Methodology: Expert Opinion Champion: Surgery Issue Date: Review Date: 12-05 1-13, 4-14, 6-15 Key Stakeholders: Surgery, IM Depts. Next Update: 6-16 RELEVANCE: The CPG for
More informationBariatric Surgery 101
Bariatric Surgery 101 Dr. Brent Bell, MD Bariatric / General Surgeon Medical Conditions Caused By Morbid Obesity Type 2 DM Hypertension Cholesterol Sleep Apnea Fatty Liver Asthma Osteoarthritis Reduced
More information