- Nearly 1 in 5 patients with Medicare who have laparoscopic adjustable gastric band surgery will end up needing at least one more device-related operation, either to remove or replace the band around the upper portion of their stomach, or to switch to a different stomach-remodeling approach. The results were published in JAMA Surgery.
- Additional device-related procedures for the operation were so common, in fact, that nearly half (47%) of the $470 million paid by Medicare for such procedures was for reoperations to revise or remove it. “If half the money we’re spending on a device is to revise or remove it, we ought to ask ourselves if we should still be using it,” says Ibrahim.
- Though this form of bariatric surgery has declined sharply in popularity in recent years, and now makes up only about five percent of all operations, there are still hundreds of thousands of people who have the devices from past operations. So failure of the devices to result in weight loss, or complications from their placement, pose a potential major issue. The study finds tremendous variation between surgical centers in the rate of reoperation that their patients faced.
- The new study looks at data from 25,042 people who had operations between 2006 and 2013, and who were covered by Medicare, which pays for about 15 percent of all bariatric operations.
Reference: JAMA Surgery, doi: 10.1001/jamasurg.2017.1093
- Another recent paper from the U-M team finds that even accredited bariatric “centers of excellence” can vary greatly in the rate of complications their patients suffer after their operations.
- Published in JAMA Surgery, the study looked at data from more than 145,500 patients and found a 17-fold difference between the centers with the highest and lowest rates of serious complications. It found that even within a single state, one bariatric surgery center can have nine times the complication rate of another center.
- “While we have made significant progress improving the safety of bariatric surgery over the last two decades, the presence of 17-fold variation in complications rates across accredited centers underscores that we need to improve further,” Ibrahim notes.