Gastric sleeve surgery, also known as the sleeve gastrectomy, has become a popular choice for patients seeking excellent weight loss in a straightforward procedure that doesn’t require the maintenance and long-term complication rates of a Lap Band.
On January 1st, 2010 United Healthcare added gastric sleeve surgery to their list of covered surgeries for weight loss. Over the following two years, almost every other major insurance company followed suit. From 2010 to the 2015 gastric sleeves became the fastest growing bariatric surgery procedure.
It’s very difficult to get insurance companies to approve new procedures. So why would they approve gastric sleeve surgery?
- The evidence showed significant weight loss with low complication rates.
- Surgeons were already performing the procedure and insurance was paying!
Number 2 deserves some explanation.
Super Obese individuals (people with a Body Mass Index over 45) have an increased risk during any surgery. And the longer the time under anesthesia, the greater the risk. Gastric bypass surgery can last over 2 hours. Duodenal switch surgery often takes over 4 hours. That’s a long time to be under anesthesia.
So surgeons started breaking the procedure up into two stages. The first stage was to reduce the size of the stomach. The second stage would be done a year later after the patient lost some weight. The second stage of the procedure would include bypassing some of the intestines to reduce calorie absorption.
So surgeons started coding the first part of the procedure as the first half of a duodenal switch. Insurance was paying.
When patients came back a year later, they had lost so much weight that a second procedure wasn’t necessary.