Need the DS Update

DS Facts
on 1/8/12 1:33 am
I could use some help, I need to get an update on the status of getting DS in Ontario so I can update my website.

I know we have one surgeon in Toronto who has been performing DS surgery. Can someone provide that surgeons name to me?

Is the process still to apply to the bariartic registry as the starting point?

Will other surgeons refer to the Toronto surgeon performing DS if the patient meets their criteria?

I assume the official criteria is still the > 60 BMI?

Are out of province referrals to Dr Gagner still happening? For first time surgeries or just revisions?

Thanks in advance for any help you can provide. Hope you are all happy and healthy.

B.
(deactivated member)
on 1/8/12 1:38 am, edited 1/8/12 1:43 am - Bumfuknowhere, Canada
Bev no first hand experience but I do read daily so here is what I have seen.

Dr Hong out of Hamilton is the only one doing virgin DS.  Someone posted last week that Dr. Reed in Guelph offered them a 2 part DS but have never seen anyone else post that he has done theirs.

Everyone has to be referred through the registry and can ask for a 2nd opinion with Dr. Hong.  The 2 part with Dr. Reed was over BMI of 60 but some with Dr. Hong were under 60.  I don't think they have any BMI set in stone for it, you have to make a case for it if they don't recommend it first.

There have been a few revisions done by Gagner but haven't seen anyone approved for a virgin DS with him.  I believe that Hong does the virgin ones but revisions go to Gagner.

ETA:  Here is the newest schedule of benefits from Sept 2011. 

29. Bariatric surgery
S120 (gastric bypass or partition), S189 (intestinal bypass) and S114 (sleeve gastrectomy)
are insured services only when all of the following four criteria are satisfied:
1. Presence of morbid obesity that has persisted for at least the preceding 2 years, defined
as:
a. Body mass index (BMI) exceeding 40; or
b. BMI greater than 35 in conjunction with any of the following severe co-morbidities:
i. Coronary heart disease;
ii. Diabetes mellitus;
iii. Clinically significant obstructive sleep apnea (i.e. patient meets the criteria for
treatment of obstructive sleep apnea); or
iv. Medically refractory hypertension (blood pressure greater than 140 mmHg
systolic and/or 90 mmHg diastolic despite optimal medical management);
2. The patient's bone growth is completed (18 years of age or documentation of completion
of bone growth);
3. The patient has attempted weight loss in the past without successful long-term weight
reduction; and
4. The patient must be recommended for the surgery by a multidisciplinary team at a
Regional Assessment and Treatment Centre in Ontario.
DS Facts
on 1/8/12 1:46 am
Fantastic, thanks so much Tracey.
DS Facts
on 1/8/12 2:03 am
Tracey can you lin me to the schedule of benefits, I can't find it on their site.

Thanks!
(deactivated member)
on 1/8/12 5:24 am - Bumfuknowhere, Canada
PatXYZ
on 1/8/12 2:14 am, edited 1/8/12 2:15 am
I only have a 43 BMI and Dr. Hong has agreed to do a DS on me. The main criteria for getting it approved seems to be ruling the others out as appropriate surgeries in your case. That may be due to other health conditions or complications, or due to having a BMI over 50.

You must apply to the registry and then meet with a surgeon in your apointed centre and then ask for a referral to Dr. Hong to be evaluated for the DS. Dr. Hong is of the opinion that more people should be getting the DS, so this is a good change in Ontario. It appears as though Dr. Hong is not required to get OHIP approval prior to performing the DS and can do it on his own discretion.

Out of province referrals for the DS are only to Dr. Gagner now, and are only for cases that Dr. Hong deems are too complicated for him to take (like a revision). In this case, he sends a letter to OHIP requesting permission to refer the patient to Dr. Gagner in Montreal which are usually approved and then the referral goes ahead. Patients will usually have to have extra testing done and forwarded to Dr. Gagner before the DS in Montreal.
DS Facts
on 1/8/12 2:15 am
Thanks Pat, this is Dr Hong?
Dr. Dennis Hong
, MD, MSc, FRCS(S), FACS
PatXYZ
on 1/8/12 2:17 am
Yes, but I have noticed that his profile on here is not up to date. Also, I've heard that Dr. Anvari in Hamilton is learning the DS as well, though he hasn't started performing them yet as far as I know.
Dutchy
on 1/8/12 10:29 pm - stittsville, Canada
Totally off topic,

Good to see you BEV :) 

DS Facts
on 1/9/12 6:43 am
Thanks you too, just an email away!
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