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Summary of Selected Presentations of ASMBS Meeting Part 4

Posted On : August 30, 2010

Insurance Mandated Medical Programs Prior to Bariatric Surgery: Do Good Things Come to Those Who Wait?

Timothy Kuwada Division of Minimally Invasive and bariatric Surgery, Carolinas Medical Center, Carolinas Laparoscopic and Advanced Surgery Program, Charlotte, NC

This study was conducted to define the influence of a mandated medical program (MMP) on pre and post operative weight loss. Data was accumulated regarding patients undergoing nonrevisional Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) or Laparoscopic Adjustable Gastric Banding (LAGB) in a three year time span. Cases were separated into the MMP and No MMP in which the MMP patients went through a guided program by medical bariatricians and nutritionists. Three hundred patients (mostly LAGB) were studied separately in terms of time to surgery and %EWL before surgery and various times after surgery. When comparing MMP and non MMP patients, there was no large difference in preoperative %EWL or later %EWL. Patients who undergo a standardized MMP have a significant delay in time to surgery and no major benefits in terms of weight loss. Hence, insurances shouldn’t assign preoperative medical weight loss programs for patients, since the data does not support any benefit to this requirements.

Note that this study did not include the duodenal switch or the sleeve gastrectomy procedures.

Laparoscopic Roux-En-Y Gastric Bypass and Insurance Mandated Medical Programs Prior to Bariatric Surgery - Central Valley Bariatrics

Summary of Selected Presentations of ASMBS Meeting Part 4

08.30.2010

Timothy Kuwada Division of Minimally Invasive and bariatric Surgery, Carolinas Medical Center, Carolinas Laparoscopic and Advanced Surgery Program, Charlotte, NC

This study was conducted to define the influence of a mandated medical program (MMP) on pre and post operative weight loss. Data was accumulated regarding patients undergoing nonrevisional Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) or Laparoscopic Adjustable Gastric Banding (LAGB) in a three year time span. Cases were separated into the MMP and No MMP in which the MMP patients went through a guided program by medical bariatricians and nutritionists. Three hundred patients (mostly LAGB) were studied separately in terms of time to surgery and %EWL before surgery and various times after surgery. When comparing MMP and non MMP patients, there was no large difference in preoperative %EWL or later %EWL. Patients who undergo a standardized MMP have a significant delay in time to surgery and no major benefits in terms of weight loss. Hence, insurances shouldn't assign preoperative medical weight loss programs for patients, since the data does not support any benefit to this requirements.

Table 1
LRYGB AGE Initial
BMI
Pre-Operative
#EWL
Days to Surgery 3 month %EWL 6
month %EWL
12 month %EWL

Non
MMP
N=176

42.6 46.1 7.1 174.5 34.3 51.3 67.1

MMP
N=53

43.7 46.6 8.26 317.9 34.4 48 61.7
P
value
0.47 P=0.284 P=0.96 P<0.001 1 0.96 0.96 0.23

 

Table 2
LAGB AGE Initial
BMI
Pre-Operative
#EWL
Days to Surgery 3 month %EWL 6
month %EWL
12 month %EWL

Non
MMP
N=67

45 45.1 6.44 188.5 13.9 22.8 30.3

MMP
N=19

48.4 47.3 11.71 309.6 18.2 21.5 37.7
P
value
0.19 0.69 P=0.018 0.002 0.05 0.76 0.19

Note that this study did not include the duodenal switch or the sleeve gastrectomy procedures.

 
 

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