Surgical treatment of obesity
Type of bariatric surgery
There are two types of surgical procedures for obesity performed at UC Davis Medical Center. Roux-en-Y gastric bypass, vertical sleeve gastrectomy. [Click here for more information about each type of surgery]
All bariatric surgeries are laparoscopically done, also known as Minimally Invasive Surgery. Several one-half inch incisions are made on the abdomen. The surgeon then performs the operation by inserting a camera and instruments through ports in these incisions. This style of surgery allows for a quicker recovery and much smaller scars.
- The program involves at least three pre-operative interviews with each patient in order to review medical, surgical and psychosocial history. The patient's understanding of the method of operation, possible complications, and post operative diet and exercise requirements is also assessed
- Candidates for surgery are chosen based on clear information that the medical indications for bariatric surgery are met as well as the patient’s candidacy for major surgery as determined by our team.
- A medical evaluation by the patient’s primary-care provider, including laboratory work, should accompany the patient to their visit with our team. Other medical tests such as a colonoscopy, upper endoscopy, and sleep study may be ordered based on a patient's medical history.
- Psychological assessment is required and will be done by the bariatric psychologist who will be available for the patient post-operatively, if needed.
Once a patient is medically, psychologically, and nutritionally cleared for surgery, insurance authorization is requested and must be received prior to scheduling surgery.
In general, patients seeking bariatric surgery for weight loss must be at least 100 pounds overweight and have failed prior medically supervised attempts at weight loss. Documentation of such attempts will need to be provided at the time of consultation. If this is not available, we may recommend a medically supervised weight-reduction program prior to further consideration.
The method of weight loss is the restriction of oral intake because the stomach becomes full with small amounts of food. In order to successfully lose and maintain a lower weight, the patient must adhere to a lifelong low-fat, low-calorie diet and exercise routine. The rate of success with this surgery varies; approximately 30% to 40% of the patients lose at least 100 pounds of their excess weight and are able to maintain this loss for years. Approximately 50% to 60% lose 100 or more pounds and then regain some of the weight. Approximately 10% to 20% lose less than a desired amount of weight or regain a great deal of their weight. The successful patient is one who is able to maintain a low-calorie diet and consistent exercise. Our dietitian is available to all post-operative patients to assist with dietary and behavior changes.
Most insurance companies require some kind of weight documentation prior to Bariatric Surgery. Listed are the common insurances we deal with and the months required in order for the procedure to be authorized.
|UCD Blue Shield||(3 months)|
|UFCW Blue Shield||(3 months)|
|UCD HealthNet||(3 months)|
|Health Net PPO||(3 months)|
|UFCW Blue Cross||(3months)|
|Blue Cross||(6 months)|
|United Health Care||(6 months)|
|UCD WHA||(No Weight Documentation Required)|
- The PRIMARY DIAGNOSES MUST say the one of the following, otherwise the visit is not considered for weight management.
- Morbid Obesity
- Weight Management
- The patient MUST have a Weight documented at the visit.
- The visit MUST be specifically for the discussion of the patients
issues they are having related to their Obesity, a plan should also
be discussed, for the following months.
- All weight management visits need to be CONSECUTIVE MONTHS
** If a patient misses a month, the last visit will not be counted and the patient
will have to restart his visits.
We have provided some EXAMPLES of how the documentation should look like.
Following the surgery, patients are in the hospital for a minimum of 2 to 10 days if there are no major complications. The status of the patient’s lungs prior to surgery is important to know, as those with prior lung disease are more likely to require mechanical ventilation for longer periods after surgery.
Your activity will be restricted to no strenuous activity for six weeks after the operation. You may walk, use a stationary bike, and perform light household duties as tolerated upon your return home. Most patients remain off work for six weeks to allow enough time to heal and work on new lifestyle changes.
After surgery, patients will be seen in bariatric clinic at 2 weeks post-op, 2 months, 6 months, and 1 year. We then continue to follow our patients at least one time per year, with no end date. Patients may be seen by the nurse practitioner, nurse, dietitian, and surgeon at each visit.