Bariatric Procedures Explained

Sunday, February 5th, 2012

There are a multiple types of bariatric procedures available for weight loss. One general type is known as restrictive bariatric surgery. This procedure reduces the size of your stomach but does not change your digestive process.

Another category is called malabsorption or malabsorptive procedures. This type of weight loss surgery shrinks the stomach and also bypass the duodenum and sometimes the jejunum. The resulting “malabsorption” means fewer calories are taken in by your body. Fewer calories absorbed = greater weight loss.

Restrictive Bariatric Surgery

Restrictive bariatric surgeries include Adjustable Gastric Banding (AGB) and Vertical Banded Gastroplasty (VBG). These procedures do not alter your digestive system; however they do reduce the amount of food you can ingest. After the surgery, a person can only eat about one cup of food at a sitting.

If you eat more than the recommended amount you will probably throw up and might also stretch your new stomach, causing the surgery to fail. Vertical Banded Gastroplasty is also known as stomach staple surgery.

Adjustable Gastric Banding is familiar to many as the Lap Band. The advantages of the lap banding are fewer complications than other bariatric procedures. The drawbacks to this procedure are slower weight loss and also the fact that you cannot have other health complications present in order to be approved for lap-banding. But the process is less invasive than other surgeries, and the lap band can be removed later if the patient so chooses.

Malabsorptive Bariatric Surgery

Malabsorptive bariatric procedures work by reducing the size of the stomach and effectively bypassing the duodenum and sometimes also the jejunum. Malabsorption weight loss surgery includes Roux-en-Y, commonly called gastric bypass surgery, the Duodenal Switch, the Fobi Pouch, and Biliopancreatic Diversion.

In the Duodenal Switch procedure, the surgeon blocks off part of the stomach, making it smaller. This reduces the amount of food that can be ingested and also limits calorie absorption. However, within a few months, a patient can resume eating the same food as they did before (with certain limitations, of course).

New Bariatric Procedures

The latest bariatric procedures are focused on minimally-invasive techniques. Laparoscopic bariatric surgery was the first of these newer techniques, and the past couple of years have seen the introduction of an improved technique in which endoscopic surgical instruments are inserted through the patient’s mouth.

Known as StomaphyX™, a hose-like surgical device is inserted through the mouth, allowing the bariatric surgeon to grasp the stomach tissue and employ suture anchors. The physician creates several tissue folds in the stomach wall, thereby reducing its capacity to hold food. In most cases, the StomaphyX procedure can be performed as outpatient surgery.

Does Insurance Cover Bariatric Surgery?

Medicare currently reimburses for bariatric procedures on a regional basis and is the primary payer for approximately 20% of all procedures performed. There are procedure reimbursement codes for bariatric surgery with prior authorization.

However, some weight loss surgeries are considered cosmetic and likely won’t be covered by your insurance. Be sure to research and thoroughly understand the insurance issues involved before going ahead with any type of bariatric surgery for weight loss.