Everyone wants to know what the next big thing is, be it where to go, who’s doing what, of how it’s being done. In the field of laparoscopic surgery, it’s SINGLE INCISION surgery. There have been a few other hot topics, like robotic surgery and NOTES, but these don’t have the same potential to significantly transform how we do surgery across America.
SINGLE INCISION surgery is exactly what it states: the surgeon only makes one small cut to perform the operation. There are a lot of different names for this technique like SILS, LESS, and SPA, but they pretty much mean the same. Generally, the one cut is only about an inch long, and can often be hidden within the belly button fold. The technique is considerably more difficult that the traditional approach of making multiple small cuts. With new training and new instruments designed specifically for single incision surgery, the popularity of this method will grow.
Why would patients be interested in SINGLE INCISION surgery? Well, if the operation can be performed safely and efficiently, then why not have a surgery with a hidden scar? Weight loss surgeons currently can perform Bands and Sleeves via this technique. Don’t be shy to ask your surgeon if they do laparoscopic surgery, and if they do, can they perform SINGLE INCISION.
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On December 3rd, an FDA Advisory Panel ruled in favor of indicating the LapBand procedure for patients with a BMI of 35 and greater, and for patients with a BMI of 30-35 with a significant medical comorbidity. This is a significant step in allowing patients access to surgical weight loss who were excluded previously due to BMI limitations. Keep in mind this is only an Advisory Panel decision, and the FDA will make a final ruling in the next few months. In general, the FDA will follow the recommendations they receive from such panels.
How does this impact us? Well, assuming the FDA makes its final decision in favor, some insurance companies may adjust their coverage criteria to match the FDA guidelines. This would probably increase the number of LapBand procedures being performed in the US.
I am in favor of the current ruling because there are plenty of patients (who I have had to turn away) who would benefit form surgical weight loss and fall within the BMI 30-40 class.
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On December 3rd, an FDA Advisory Panel ruled in favor of indicating the LapBand procedure for patients with a BMI of 35 and greater, and for patients with a BMI of 30-35 with a significant medical comorbidity. This is a significant step in allowing patients access to surgical weight loss who were excluded previously due to BMI limitations. Keep in mind this is only an Advisory Panel decision, and the FDA will make a final ruling in the next few months. In general, the FDA will follow the recommendations they receive from such panels.
How does this impact us? Well, assuming the FDA makes its final decision in favor, some insurance companies may adjust their coverage criteria to match the FDA guidelines. This would probably increase the number of LapBand procedures being performed in the US.
I am in favor of the current ruling because there are plenty of patients (who I have had to turn away) who would benefit form surgical weight loss and fall within the BMI 30-40 class.
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Join us at one of our support groups near you! If you have any questions, please call our office or contact us.
| Maui |
Kona, Big Island |
| Date: 8/23 then 3rd Tuesday at 6:00pm
Location:
Maui Medical Group
2180 Main St.
Wailuku, 96793
Annex Building
|
Date: 8/24, then 4th Tuesday at 6:00pm
Location:
Aloha Center
73-4080
Huilikoa Drive
Kailua-Kona
|
| Hilo, Big Island |
Kauai |
| Dates: 8/23, then 4th Tuesday at 6:00pm
Location:
Living Waters Assembly of God
89 Maikai St.
Hilo, HI
|
Date: 8/23, then 4th Tuesday at 6:00pm
Location:
New Beginning Christian Center
3-4251 Kuhio Hwy
|
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The CMS, Centers for Medicare and Medicaid Services, recently announced a decision to review the current literature on the vertical sleeve gastrectomy. CMS determines coverage criteria for surgical weight loss procedures. This is an optimistic step towards possible sleeve coverage by Medicare. A preliminary decision should be released in March 2012, with a final policy decision in mid 2012. Medicare currently only recognizes the Bypass, Band and Switch for surgical weight loss operations performed at Centers of Excellence, COEs.
If Medicare decides to recognize the Sleeve as another option with similar criteria to the current procedures, this could create a wave of private insurers following suit. I personally look forward to seeing UHA and HMA recognize the sleeve, and especially for HMSA to remove their 60 BMI barrier to this operation.
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