3yearsleeve
CMS VS ASMBS STATEMENTS?? http://www.cms.gov/medicare-coverage-
Oct 05, 2012
I'm new on this forum and I feel that I have the obligation to shed light on a very misleading surgery, "Gastric Sleeve". Today, lets look at the CMS statement compared to the ASMBS statement on Sleeve. See below, they couldn't be farther apart and the reason for this, I believe is due to greedy surgeons who know that over 50% of patients that have the sleeve will come back to them within 3-5 years for a second procedure. Basically, the Surgeon gets a 2 for 1 deal - Unethical.CMS STATEMENT:
The Centers for Medicare & Medicaid Services (CMS) proposes that the currently available evidence is insufficient to conclude that the bariatric surgery known as laparoscopic sleeve gastrectomy (LSG) for the treatment of obesity (BMI ≥ 35 kg/m2) improves long-term beneficiary health outcomes. We therefore propose that coverage for LSG is not reasonable and necessary under § 1862 (a) (1) (A) of the Social Security Act.
The Centers for Medicare & Medicaid Services (CMS) proposes that the currently available evidence is insufficient to conclude that the bariatric surgery known as laparoscopic sleeve gastrectomy (LSG) for the treatment of obesity (BMI ≥ 35 kg/m2) improves long-term beneficiary health outcomes. We therefore propose that coverage for LSG is not reasonable and necessary under § 1862 (a) (1) (A) of the Social Security Act.
ASMBS STATEMENT:
The American Society for Metabolic and Bariatric Surgery (ASMBS) posted an update of their position statement:
Summary and Recommendations.
“Substantial comparative and long-term data are now published in the peer-reviewed literature demonstrating durable weight loss, improved medical comorbidities, long-term patient satisfaction, and improved quality of life after SG. The ASMBS therefore recognizes SG as an acceptable option as a primary bariatric procedure and as a first stage procedure in high risk patients as part of a planned staged approach.
Based on the current published literature, SG has a risk/benefit profile that lies between the laparoscopic adjustable gastric band and the laparoscopic Roux-en-Y gastric bypass. As with any bariatric procedure, long-term weight regain can occur and, in the case of SG, this could be managed effectively with re-intervention. Informed consent for SG used as a primary procedure should be consistent with consent provided for other bariatric procedures and should include the risk of long-term weight gain. Surgeons performing SG are encouraged to continue to prospectively collect and report outcome data in the peer-reviewed scientific literature.”
This update was posted on the ASMBS site but has not yet been published in a peer reviewed journal. Long term data were extracted from 6 single site observational studies all with small sample sizes (n < 50), high loss to follow-up (20 - 90%) and/or high rate of revisional surgery (> 20%).
