Bariatric Surgery
Laparoscopic adjustable gastric banding (LAGB) is a routine surgery of the stomach for the reduction of weight. During this surgical procedure, a gastric band is tightened around the stomach to constrict the stomach and reduce its volume (Code 43770). The band is adjustable so that the surgeons can go back and narrow the band more; this reduces the volume of the stomach gradually (Code 43771). The smaller the volume of the stomach, the less food the stomach can hold, and the more weight the patient can lose. Sometimes the band can cut through the stomach wall. When this happens, either the band is expanded (Code 43771) or the band is removed (Code 43772) or the old one is removed and a new one put in (Code 43773) (Medicare Billing and Coding Guidelines, 2006).
The procedure is safe because it is relatively non-invasive compared to other bariatric procedures, because the surgeons do not have to cut into the stomach. LAGB is also very effective; it can reduce excess weight by around 50% within 5 years (Buchwald, 2004).
Clinical Indications for Bariatric Surgery
Generally, LAGB is indicated only for morbidly obese adult patients who have failed to lose weights through conventional weight reduction programs.
It is a highly effective treatment to reduce the weight of moderately or morbidly obese patients. Candidate patients have a body mass index (BMI) that is greater than 40.
Sometimes obese patients with BMIs lower than 40 need to undergo LAGB for weight reduction for special medical reasons. Morbid obesity puts a lot of stress on the heart, so LAGB has been used in patients with cardiovascular diseases. Obesity is also a contraindication to a number of life-saving procedures; for example, organ transplants. In cases like these the patient is made to under LAGB prior to undergoing this major procedure (Picot, 2009).
Works Cited
Buchwald et al. “Bariatric Surgery: A Systemic Review and Meta-analysis.” JAMA
292 (2004):1724-173. Print.
Medicare Billing and Coding Guidelines: Bariatric Surgery for Morbid Obesity (2006).
Web.
http://wpsmedicare.com/j5macpartb/policy/active/national/_files/gsurg042_cbg.pdf
Picot, J et al. “The clinical effectiveness and cost-effectiveness of bariatric (weight loss)
surgery for obesity: a systematic review and economic evaluation.” Health Techonology Assessmen. 41.1 (2009): 215-357. Print.
