|
How
does the procedure work?
Gastric
bypass surgery reduces the patient's stomach to about the size of
a shot glass. A line of staples forms a small pouch that is cut
off from the rest of the stomach.
Laparoscopic
technology - used in a number of different surgical procedures -
is gaining in popularity in gastric bypass as well. The old method
was to slimply cut the patient's abdomen open and get to it. Now
surgeons can use a small opening through which customized tools
fitted with a special camera can snake their way through to where
the action needs to take place. This laparoscopic approach reduces
scarring and allows faster recovery.
Another
new technology - gastric banding - is also gaining in popularity.
Approved in 2001, this technique uses a silocon band to form the
pouch instead of staples. Weight loss is slower for patients who
opt for this route, but bands are more easily reversible - which
can be an important benefit considering some of the potential
risks and side effects.
The band can also be adjusted if the pouch turns out to be the wrong
size or to provide better nutrient absorption.
Are
you a candidate?
Generally,
patients with a body mass index (BMI) - which is a measure of how
much you weigh per unit of height, sort of like pounds per inch
but scaled differently - of at least 35 can be considered for gastric
bypass surgery if they are suffering serious health issues brought
on by overweight. The minimum BMI for patients in better health
is around 40. The table below will give you an idea of the minimum
weights for your particular height.
|
Height
|
Min
Lbs, with Health Issues
(BMI 35)
|
Min
Lbs, no Health Issues
(BMI 40)
|
|
Feet
|
Inches
|
|
5
|
0
|
179
|
205
|
|
5
|
1
|
185
|
212
|
|
5
|
2
|
191
|
219
|
|
5
|
3
|
198
|
226
|
|
5
|
4
|
204
|
233
|
|
5
|
5
|
210
|
240
|
|
5
|
6
|
217
|
248
|
|
5
|
7
|
223
|
255
|
|
5
|
8
|
230
|
263
|
|
5
|
9
|
237
|
271
|
|
5
|
10
|
244
|
279
|
|
5
|
11
|
251
|
287
|
|
6
|
0
|
258
|
295
|
|
6
|
1
|
265
|
303
|
|
6
|
2
|
273
|
312
|
|
6
|
3
|
280
|
320
|
|
6
|
4
|
288
|
329
|
|
6
|
5
|
295
|
337
|
Of
course, BMI is not the only consideration and in some cases is misleading,
but generally that is where the conversation starts.
An
Expensive Alternative
Prices
for gastric bypass surgery vary from about $20 to $50 thousand,
depending on your choice of surgeon and facility. Obviously, shopping
for a bargain should not be your primary motivation in selecting
your care providers. However, it may be worth while looking into
getting your surgery in a region where prices are lower, provided
- of course - you can arrange for the proper after-surgery care
you will need.
Additional
surgery can jack the price tag even higher. Many patients will also
require - or desire - skin removal surgery after losing weight.
Some patients (about 20%) have to undergo additional surgery to
take care of complications from the bypass. Obviously, all this
adds more to the cost.
Insurance
compance companies have been moving all around on whether they are
going to cover gastric bypass surgery. First it looked like many
were moving in that direction, as more and more obesity is considered
as a disease by the medical profession.
However,
the dramatic spike in claims associated with this procedure has
given some pause. The poor are overrepresented among the ranks of
the overweight, and it seems that insurance coverage for the procedure
opened a flood gate of patients who held off on the surgery because
they could not afford it. The medical community, swiftly getting
used to the hefty revenues associated with these procedures, is
quickly putting financing options in place to fill the gap.
|
