ASMBS Revision Task Force Established To Close Gaps In Care And Understanding


Published in August 2013 Issue             


In May 2013, ASMBS President Dr. Jaime Ponce, recognizing a need for the society to have a unified, consistent and scientific policy for revisional bariatric surgery, called for the establishment of a task force to review the topic and provide recommendations. Dr. John Morton, ASMBS Secretary-Treasurer, was charged with forming the "Revision Task Force," which includes the following leaders in bariatric surgery:

Stacy Brethauer, MD (Writing Chair), Matthew Brengman, MD (Coding Chair), Wayne English, MD/Brandon Williams, MD (Access Chairs), Matt Hutter, MD/Ranjan Sudan, MD (Data Chairs), and Marina Kurian, MD, Lloyd Stegemann, MD and Shanu Kothari, MD.

The objectives of the Revision Task Force include:

1) Definition of Revisions

2) Nomenclature-types of revisions

3) Indications

4) Coding/lack of coding

5) Evidence in the literature

6) Addressing access: "insurance paying for one procedure only"

"As more bariatric surgeries are done, there will be more opportunities for revisions. We, like cardiac or orthopedic surgeons, need to have access to care for patients who require revisions. Obesity is a chronic disease and, as such, we need to have opportunities for beneficial intervention for our patients. The Revision Task Force will provide a blueprint for revisional bariatric surgery to help patients, surgeons and payors alike," said Dr. Morton.

The Revision Task Force meets bi-weekly by phone and has met in person twice, most recently in Chicago this August. To date, Dr. Brengman has prepared a revision nomenclature and an insurance medical director’s sample workflow for revisions.

In preparation for a Systematic Review and Societal Recommendation led by Dr. Brethauer, the Revision Task Force has already selected and reviewed over 400 articles on revisional bariatric surgery. The Access Group, chaired by Dr. English and Dr. Williams, has found profound gaps in care for revisional bariatric surgery based upon representative reviews of medical insurance policies from around the country. Finally, Dr. Sudan and Dr. Hutter have examined the BOLD and MBSAQIP databases and have found that revisions are growly annually and are currently about 5 percent of all bariatric surgeries.

The Revision Task Force will present its findings at the Revisional Surgery Course during ObesityWeek 2013.

The Revision Task Force has plans to publish articles on:

1) Systematic Review and ASMBS Position Statement for Revisional Bariatric Surgery

2) State of Access for Revisional Bariatric Surgery

3) Revisional Bariatric Surgery: Demographic, Practice Patterns and Outcomes from
    MBSAQIP and BOLD

For any questions or comments, please contact Dr. John Morton, morton@stanford.edu