Andrew M Ibrahim, Jyothi Thumma, MPH, Justin B Dimick. University of Michigan
Introduction: Reported rates of reoperation to revise or remove the gastric bands range anywhere from 3% to 40% in small series or reports, with no long term population estimates in the United States. In addition to the uncertainty about the long term rate of reoperation after laparoscopic gastric band placement, the associated costs to Medicare are also unknown.
Methods: A retrospective review of 19,905 Medicare beneficiaries who underwent gastric band placement between 2006 and 2012 was performed. Our primary outcomes were the proportion of patients who subsequently required gastric band related reoperation including gastric band removal, replacement or revision to a different bariatric procedure (roux-en-y gastric bypass or sleeve gastrectomy.) For each patient, we calculated the 30-day total episode payment for the index operation and any subsequent reoperations. All amounts were price-standardized, risk-adjusted and reported in 2012 dollar amounts.
Results: Reoperation after laparoscopic gastric band placement was common and costly. With an average of 3.5 years of follow-up, 3,662 (18.4%) required at least one reoperation. Among patients requiring reoperation, they on average required 3.95 reoperations. The mean payment was $11,890 for the index operation and $16,283 for each reoperation. During the study period, Medicare paid $448 million for laparoscopic gastric band associated procedures, of which $211 million (47.2%) of the payments were for reoperations.
Conclusions: Reoperation after laparoscopic gastric band placement is common and accounts for nearly half of Medicare spending associated with this procedure. Reducing or eliminating the use of laparoscopic gastric band placement operations may be an effective patient safety and cost-saving strategy for healthcare payers.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 78811
Program Number: S131
Presentation Session: Bariatric surgery – Sleeves, Conversions and More
Presentation Type: Podium