2010; 252(2):319-324. // Hide post controls if empty Pediatrics. Endoscopic treatment of weight regain following Roux-En-Y gastric bypass: a systematic review and meta-analysis. Rockville, MD. The meta-analysis was limited by a number of factors, including high heterogeneity between the studies, including differences in follow-up time, type of surgery performed, type of biopsy method and degree of obesity. 2003; 38(9):1379-1382. 2017; 27(5):1358-1364. "author": { However, the OAGB group did report higher incidences of diarrhea, steatorrhoea, and nutritional adverse events. The mean age of the adolescent group (n=161) at baseline was 17 years. 2009; 361(5):445-454. Laparoscopic adjustable gastric banding in the treatment of obesity: a systematic literature review. Surgery. Biliopancreatic diversion with duodenal switch. 2014; 311(22):2297-2304. Arterburn (2013) noted that as the prevalence of severe comorbidities in this population is less, the evidence currently does not support that the benefit of preventing comorbidities in this population outweighs the risk. In eligible individuals under the age of 18 years, who are skeletally mature, it is the consensus in the practice community that potential candidates for surgery be evaluated for the following: Gastric bypass and gastric restrictive procedures. Obes Surg. Mortel KJ, Pattijn P, Mollet P, et al. Bariatric surgery: an IDF statement for obese Type 2 diabetes. There are two categories of bariatric surgery: restrictive procedures and malabsorptive procedures. "@type": "Person", Hypertension. Policy Alerts takes a client-focused hands-on approach and works hard to provide our customers with helpful insights and actionable analytics over raw data. Surg Obes Relat Dis. Very happy about the whole thing.\n\nI just wish the surgery was sooner now! J Pediatr Gastroenterol Nutr. Brethauer SA, Hammel JP, Schauer PR. Members have to be at least 18 years old at the time of the surgery. 2018; 56:7-14. Effect of laparoscopic Roux-en Y gastric bypass on type 2 diabetes mellitus. Courcoulas AP, Christian NJ, Belle SH, et al. Evans JD, Scott MH, Brown AS, Rogers J. Laparoscopic adjustable gastric banding for the treatment of morbid obesity. Comparison of weight loss and body composition changes with four surgical procedures. Vertical gastrectomy for morbid obesity in 216 patients: report of two-year results. A similar list can be found in the ConnectiCare section of this annual notice regarding ConnectiCare's Medical Policies. On February 16, 2011, the FDA approved an expanded indication for the Lap-Band device to include individuals with a BMI at least 30 kg/m2 with one or more obesity related comorbid conditions. A multidisciplinary approach to the adolescent bariatric surgery patient. Comparison of laparoscopic sleeve gastrectomy and laparoscopic greater curvature plication regarding efficacy and safety: a meta-analysis. Stop spending time searching for medical policy changes and let us do it for you! October 6, 2011. A total of 13 prospective and retrospective studies with 850 individuals were included in the analysis. Gangemi A, Russel S, Patel K, et al. Bariatric surgery can be expensive, even with insurance. Murr MM, Balsiger BM, Kennedy FP, et al. J Clin Endocrinol Metab. This system helps the person to eat less by limiting the amount of food that can be eaten at one time, and increasing the time it takes for food to be digested. $(".closeMessage").on('click', function(){ Ann Surg. 1987; 16(2):317-335. 2007; 21(10):1810-1816. "name": "BariatricPal", Detection, prevention and treatment of obesity. Biliopancreatic diversion. in Gastric Sleeve Surgery Forums, By } Radiology. Find our Quality Improvement programs and resources here. "streetAddress": "", 2018; 141(3):e20173459. Surg Endosc. Very happy about the whole thing. A. (Conditional recommendation, moderate level of evidence) A cardiac cause should be excluded in patients with chest pain before the commencement of a gastrointestinal evaluation (Strong recommendation, low level of evidence). Skinner AC, Ravanbakht SN, Skelton JA, et al. At 92-month follow-up, no significant difference in weight loss was found between the two study groups (59% for VBG and 62% for AGB, p=0.923). "@id": "https://www.bariatricpal.com/forum/1300-insurance-financing/", 2008; 18(5):560-565. Inge TH, Garcia V, Daniels S, et al. Hsu WC, Araneta MR, Kanaya AM, et al. 2002; 184(2):97-102. Available at: TransPyloric Shuttle/TransPyloric Shuttle Delivery Device. The ASMBS recommends that surgery be considered for the following: While the recommendations are in place for adolescents (defined as between the ages of 10 and 19 years), there may be children who should be considered for surgery prior to adolescence due to the presence of obesity related complications. If additional assistance is needed, please contact Healthplex at 888-468-2183, Monday to Friday from 8 a.m. to 5 p.m. Belachew M, Zimmermann JM. "dateCreated": "2012-01-03T00:03:20+0000", One-anastomosis gastric bypass as an alternative procedure of choice in morbidly obese patients. ] OBrien PE, Dixon JB. CMAJ. At 5 years, the OAGB group reported significantly greater remission rates for all three conditions when compared to both SG and RYGB. document,'script','https://connect.facebook.net/en_US/fbevents.js'); Gastric Band - bands are placed around the top portion of the stomach leaving only a small portion available for food. Consensus Development Conference Panel. 8.5 POST OP FROM GASTRIC BYPASS!!!!! Biertho L, Steffen R, Ricklin T, et al. Obes Surg. The FDA (2019) currently includes four categories of regulated devices which are intended for weight loss. In J Obes Relat Metab Disord. The investigators commented: Due to the dearth of long-term studies of bariatric surgery in this particular target population, few data exist about long-term adverse effects, and we found no evidence regarding major clinical endpoints, such as all-cause mortality, cardiovascular mortality and morbidity, and peripheral arterial disease. Approximately 30% to 53% of incident diabetes cases in the U.S can be attributed to obesity (Cameron, 2021). The effectiveness of surgery versus nonsurgical interventions in these populations was also compared. There are potential complications might be of particular concern in the pediatric population. 2002; 4(2):447-461. 2008; 158(2):135-145. Sugerman JH, Sugerman EL, DeMaria EJ, et al. Farrell TM, Haggerty SP, Overby DW, et al. Clinical UM Guidelines, which address medical efficacy, should be considered before utilizing medical opinion in adjudication. 2004; 188(6):659-662. Laursen TL, Hagemann CA, Wei C, et al. JAMA. Surg Obes Relat Dis. Two-stage laparoscopic biliopancreatic diversion with duodenal switch as treatment of high-risk super-obese patients: analysis of complications. Efficacy of transoral outlet reduction in Roux-en-Y gastric bypass patients to promote weight loss: a systematic review and meta-analysis. Obes Surg. Schauer PR, Ikramuddin S, Gourash W, et al. $(targetElement).removeClass(className); Gastrointest Endosc. Also the 6 month thing and psych evaluation. Insufficient weight loss or weight regain following RYGB can be the result of several factors, including the dilation of the gastrojejunal anastomosis. The use of bariatric surgery in children and adolescents has been limited (Shoar, 2017). My insurance has always been GHI - CBP for City of NY Employees. t.src=v;s=b.getElementsByTagName(e)[0];s.parentNode.insertBefore(t,s)}(window, Prompt reduction in use of medications for comorbid conditions after bariatric surgery. August 2022 Emblem Health Medical Policy Updates; Abdominoplasty Panniculectomy Acupuncture for Low Back Pain Medicare Amniotic Membrane Transplantation Ocular Reconstruction Autologous Chondrocyte Implantation Automatic External Defibrilators Bariatric Surgery Bavencio Biomagnetic Therapy Blepharoplasty Bone Density Studies a Botox Interventions included group counseling, individual counseling, classroom sessions and phone or web-based messaging. 2019; 2 5(12):1346-1359. Sjstrm L, Narbro K, Sjstrm CD, et al. Mason EE, Tang S, Renquist KE, et al. The studies cited by the ASMBS include retrospective studies, a case series, and a systematic review. } else if (modifyClass === 'remove'){ Catalano MF, Rudic G, Anderson AJ, Chua TY. 2013. 2014; 129(25 Suppl 2):S102-138. At 2 years, the mean percentage excess BMI loss in the RYGB group versus the OAGB group was -85.8% (SD 23.1) and -87.9% (SD 23.6) respectively. Updated Discussion and References sections. Programs which combined behavioral interventions and pharmacotherapy reported greater success. Randomized controlled trials are needed to determine whether MBS should be considered as a frontline therapy for NAFLD and NASH. var classModifiers = classContent.split(' '); Our Companies, Lines of Business, Networks, and Benefit Plans (PDF), Medicaid, HARP, and CHPlus (State-Sponsored Programs), Cultural Competency Continuing Education and Resources, Medicaid Cultural Competency Certification, Find a center near you, view classes and events, and more, EmblemHealth Neighborhood Care Physician Referral Form (PDF), Vendor-Managed Utilization Management Programs, Physical and Occupational Therapy Program, Radiology-Related Programs and Privileging Rules for Non-Radiologists, New Century Health Medical Oncology Policies, UM and Medical Management Pharmacy Services, COVID-19 Updates and Key Information You Need to Know, EmblemHealth Guide for Electronic Claims Submissions, Payment processes unique to our health plans, EmblemHealth Guide for NPIs and Taxonomy Codes, 2022 Provider Networks and Member Benefit Plans, EmblemHealth Spine Surgery and Pain Management Therapies Program, Outpatient Diagnostic Imaging Privileging, Benefits to Participation in Dental Network, Clinical Laboratory Improvement Amendment Waived Tests, Duplicate Claims from a Non-Physician Practitioner. JAMA. BMI 31 , 5 7 ft and 200 pounds. 2010; 303(6):519-526. 2018; 28(1):266-276. Adv Ther. { }, Surg Obes Relat Dis. While revision surgery is an option, revisions do not eliminate the potential mechanical complications as a result many VBG procedures are converted to a RYGB. Service codes 88304 through 88309 describe all other specimens requiring gross and microscopic examination and represent additional ascending levels of physician work. 2021b; 31(4):1438-1448. Endocr Pract. According to the AMA CPT Manual, A specimen is defined as tissue or tissues that is (are) submitted for individual and separate attention, requiring individual examination and pathologic diagnosis. 2004; 114(1):255-256. Download BariatricPal for your iPhone, iPad or iPod Touch! deployment. Results of laparoscopic sleeve gastrectomy: a prospective study in 135 patients with morbid obesity. Surg Endosc. Ikramuddin S, Blackstone RP, Brancatisano A, et al. Ann Surg. Is there a benefit to preoperative weight loss in gastric bypass patients? 2012; 307(1):56-65. Full-thickness suturing devices studies reported 20% excess weight loss at 1 year. "@type": "ListItem", While the procedure is considered less invasive than bariatric surgeries, weight loss does not appear to be as robust when compared to other therapies (Weiss, 2019). 3. F. LAP-BAND when BMI is 30 to 35 with or without comorbid conditions; G. AspireAssist; H. Endoscopic Suture Revisions post bariatric surgery; I. Longitudinal Assessment of Bariatric Surgery (LABS) Consortium; Flum DR, Belle SH, King WC, et al. You need to be a member in order to leave a comment. Medical Necessity Criteria For adults, bariatric surgery is generally considered for refractory morbid obesity that persists despite medical therapy. J Pediatr. Topical Oxygen Wound Therapy (Medicaid/FHP) Download (PDF) Torisel (temsirolimus) Download (PDF) Total Ankle Replacement. Patient must be 18 years of age or older. Revised not medically necessary indications to remove examples of devices which are no longer available. The USPSTF characterized the intensive behavioral weight loss programs included in their evaluation: Most of the intensive behavioral weight loss interventions considered by the USPSTF lasted for 1 to 2 years, and the majority had 12 or more sessions in the first year. Spear BA, Barlow SE, Ervin C, et al. 2006; 144(9):625-633. Purse-string transoral outlet reduction (TORe) is effective at inducing weight loss and improvement in metabolic comorbidities after Roux-en-Y gastric bypass. 2003; 13(6):861-864. 2009; 5(4):469-475. Ann Surg. This is an increase from 2011 when the revision rate was reported as 6%. 2010; 6(4):367-371. window.addEventListener('load', function() {viselyForumInit();}); Mittermair RP, Aigner F, Nehoda H. Results and complications after laparoscopic adjustable gastric banding in super-obese patients, using the Swedish band. Hospital complication rates with bariatric surgery in Michigan. Years ago I had looked into getting the surgery, but they didn't cover it at all then. DeMaria EJ. Clinical trials No. Obes Surg. Ann Surg. 2009; 17(5):901-910. Electrical Stimulation Systems - electrical stimulator is placed in the abdomen to block nerve activity between the brain and stomach (currently there are no marketed devices). Malabsorptive procedures divert food from the stomach to a lower part of the digestive tract where the normal mixing of digestive fluids and absorption of nutrients cannot occur. Late outcome of isolated gastric bypass. Laparoscopic gastric bypass is superior to adjustable gastric band in super morbidly obese patients. Biliopancreatic diversion for obesity at eighteen years. Sleep apnea: The temporary stoppage of breathing during sleep, often resulting in daytime sleepiness. // END Polyfill GERD with damage or erosions present on endoscopic exam is classified as erosions present or ERD. At 10 years post surgery, the reported cumulative incidence of major adverse liver outcomes was 2.3% (95% CI,0%-4.6%) in the bariatric surgery group and 9.6% (95% CI, 6.1%-12.9%) in the nonsurgical group; adjusted absolute risk difference, 12.4% [95% CI, 5.7%-19.7%]; adjusted HR, 0.12 [95% CI, 0.02-0.63], p= 0.01). "@context": "http://www.schema.org", A total of 4 of the individuals who initially underwent OAGB surgery later converted to RYGB due to anastomotic leak (1), Wernicke encephalopathy (1), and intractable severe biliary reflux (2). "dateCreated": "2011-09-20T19:56:07+0000", Ann Surg. Schok M, Geenen R, van Antwerpen T, et al. // Make hover navigation work with touch devices Laparoscopic gastric bypass versus laparoscopic adjustable gastric banding: a comparative study of 1,200 cases. The USPSTF noted that the interventionists collaborating with individuals varied across programs and included primary care physicians, lifestyle coaches, registered dietitians, behavioral therapists, psychologists, and exercise physiologists. 2002; 26(2):184-192. Pediatrics. The authors concluded: LRYGB is safe and effective for the treatment of morbid obesity. Increased BMI, waist circumference and weight gain are associated with the presence of GERD (Katz, 2013; Flores, 2019). Over the past several years, EmblemHealth has been implementing payment policies that reflect guidelines set forth by industry authorities. 2008; 4(1):33-38. Brolin RE. Individuals complaining of GERD following biliopancreatic diversion with duodenal switch and are initially treated with conservative measures such as behavioral or medical therapies, while a resleeve or fundectomy surgery is an option for those individuals with GERD refractory to conservative therapy. "name": "BariatricPal", Clients can access detailed coverage reports and medical policies on the interactive Dashboard portal. Updated the Background/Discussion section to clarify that there is sufficient evidence to support the use of BPD/DS in clinically severe obesity. And I was so happy with the whole process. mappingH1 = googletag.sizeMapping().addSize([1024, 768], [728, 90]).addSize([980, 690], [728, 90]).addSize([640, 480], [320, 50]).addSize([0, 0], [320, 50]).build(); Bariatric surgery as a treatment for idiopathic intracranial hypertension 2. Benotti PN, Still CD, Wood GC, et al. Treadwell JR, Sun F, Schoelles K. Systematic review and meta-analysis of bariatric surgery for pediatric obesity. While bariatric surgery has been shown to be an effective tool in treating the pediatric population with severe obesity, the AAP recommends that the pediatrician understand and communicate the efficacy, risks, benefits, and long-term health implications associated with bariatric surgery to the family when making decisions regarding surgical options. .cycle-3 img:nth-of-type(1) { -webkit-animation-delay: -3s; animation-delay: -3s; } 2022;1 8(5):577-580. I am a patient of Dr Cywes. .visely-recommendations-container .complete { min-height: 400px; } Copyright Policy Alerts 2021 - All Rights Reserved |Terms Of Service|Privacy Policy. 2019; 56(12):100692. When reviews occur out of cycle, they may go unnoticed. F. RELATED POLICIES/RULES Metabolic and Bariatric Surgery in Adolescents Metabolic and Bariatric Surgery: Revision Experimental and Investigational Item or Service G. REVIEW/REVISION HISTORY DATES ACTION Date Issued 09/21/2004 New Policy. var Shopify = Shopify || {}; Anyway, there requirements are BMI of 40 or 35 with a co-morbidity. "position": 1, Am J Surg. Preoperative predictors of weight loss following bariatric surgery: systematic review. Surg Obes Reatl Dis. Parikh MS, Ayoung-Chee P, Romanos E, et al. cookie_prefix: "ips4_", Treatment of mild to moderate obesity with laparoscopic adjustable gastric banding or an intensive medical program. Bariatric Surgery to Treat Indications Other than Obesity. Revisiting the 2011 FDA decision on laparoscopic adjustable gastric banding. NCT01479452. Her office accepts new patients. a Body Mass Index (BMI) greater than 40. Go now! Updated: Surg Endosc. The SADI-S group reported a higher incidence of GERD. These include, but are not limited to, cardiovascular disease, dyslipidemia, hypertension, insulin resistance, type 2 diabetes, obstructive sleep apnea, nonalcoholic fatty liver disease. 2012; 367(8):695-704. Endosc Int Open. The American Society for Metabolic and Bariatric Surgery (ASMBS) does not recommend OAGB as a primary weight loss procedure. Transoral outlet reduction with full thickness endoscopic suturing for weight regain after gastric bypass: a large multicenter international experience and meta-analysis. Complete either the bariatric surgery questionnaire for BCN commercial members ( PDF) or the bariatric surgery questionnaire for BCN Advantage members (PDF). "url": "https://www.bariatricpal.com/profile/115868-fusilli66/" The study included individuals with a BMI of up to 40 kg/m2, only 41% had a BMI of 3035 kg/m2. DeMaria EJ, Sugerman HJ, Meador JG, et al. 2. 2003; 13(4):265-270. 2014; (8):CD003641. There is sufficient evidence to support the use of the biliopancreatic bypass with duodenal switch (BPD/DS) for individuals who have clinically severe obesity. Obes Surg. Reformatted Not Medically Necessary section without change in intent. Ambulatory reflux monitoring is the only test that can assess reflux symptom association (Strong recommendation, low level of evidence). I thought they were nuts. messageDate.setTime(messageDate.getTime() + (126000000)); Bariatric Surgery Page 5 of 17 VI. }, Wolfe and associates (2016) note: The fundamental basis for bariatric surgery for the purpose of accomplishing weight loss is the determination that severe obesity is a disease associated with multiple adverse effects on health which can be reversed or improved by successful weight loss in patients who have been unable to sustain weight loss by non-surgical means. 2015;(6):CD011740. 2018; 14(7):882-901. MAESTRO provides vagal blocking (VBLOC) therapy by delivering intermittent, controllable, electrical blocking signals to the abdominal anterior and posterior nerve trunks of the vagus nerve. notification_imgURL: "", Reconstructive surgery does not mean "cosmetic surgery," which is surgery performed to alter or reshape normal structures of the body in order to improve appearance. Sjstrm CD, Peltonen M, Sjstrm L. Blood pressure and pulse pressure during long-term weight loss in the obese: the Swedish Obese Subjects (SOS) Intervention Study. // END Shopify Context These devices include: AGB is a restrictive procedure which involves surgically placing a gastric band around the exterior of the stomach; the stomach is not entered. "author": { 2021; 17(12):1956-1976. Letters to the Editor: Adolescent bariatric surgery: treatment delayed may be treatment denied. googletag.pubads().refresh(refresh_slots); Clinically severe obesity is a result of persistent and uncontrollable weight gain that constitutes a present or potential threat to life. }); Mognol P, Chosidow D, Marmuse JP. 2019; 380(22):2175-2177. The AHA concluded that severely obese youths are much more likely to become severely obese adults with commensurate risks and adverse outcomes. Included additional examples of potential complications. ] Circulation. A meta-analysis of short-term outcomes of patients with type 2 diabetes mellitus and BMI 35 kg/m2 undergoing Roux-en-Y gastric bypass. On October 6, 2011, the ASMBS issued a policy statement on laparoscopic gastric plication, also known as laparoscopic greater curvature plication (LGCP). Ann Surg. Deveney CW, MacCabee D, Marlink K, et al. The relevant InterQualSmartSheet for bariatric surgery should be filled and faxed to the Tufts Health Plan Precertification Department. J Surg Case Rep. 2017; 2017(11):rjx214. Evolution of paradigm for laparoscopic adjustable gastric banding. 2007; 357(8):753-761. Quickly understanding the changes Payers make can help you adjust reimbursement strategies impacting your business. This proprietary tool curates publicly available health plan information to track bariatric surgery policy changes, supporting advocacy and coverage. I am sooo disappointed. } Curr Probl Surg. J Am Coll Surg. Whenever changes occur, email notifications containing a summary of those changes are delivered to your inbox. Policy and Procedure Subject: Bariatric Surgery Policy Number: 106 Department: 5B Medicare Advantage Provision Effective Date: 2003. Endoscopy performed at 2 years showed the presence of bile in the gastric pouch in 9 individuals in the OAGB group and 1 individual having intestinal metaplasia compared to none of the individuals in the RYGB group having these issues. } else { Enochs P, Bull J, Surve A, et al. Bariatric Multivitamins! Well I was denied last week. \n\nOriginally my doctors office said they had to schedule surgery in order to submit it to the insurance company with a surgery date. Surg Endosc. Conversion bariatric surgery may be proposed when adequate weight loss has not occurred after 1 to 2 years following the initial surgery or weight loss has not been maintained. Obes Surg. General Surgery Policies Table of Contents Policy Title Policy Number Last Revised Autologous Fat Transfer (AFT) In Breast Reconstruction 507 12/06/21 Bariatric Surgery Guidelines 295 10/07/21 Coverage for Procedures Associated with Bariatric Surgery 122 04/09/18 Cryoablation for Desmoid Tumors 565 07/13/21 Gender Affirmation Surgery 386 07/20/22 Bariatric surgery represents a major and permanent cl1angc to the digestive system . 2005; 19(2):200-221. Pratt JS, Lenders CM, Dionne EA, et al. These services may or may not be covered by all Medica plans. They are a very busy office and have the process down to a science. Despite the limitations of this small study, safety and efficacy results for the stand-alone LSG-treated group appear to be equivalent to those obtained from other restrictive surgical techniques. var mappingH1; Arch Surg. var ViselyConfig = {"homePage":[{"type":"MOST_POPULAR","title":"Most Popular In Store","count":1,"totalCount":4,"order":[{"type":"Image","enabled":true,"priority":0},{"type":"Name","enabled":true,"priority":1},{"type":"Price","enabled":true,"priority":2}],"enabled":true,"recommendedByVisely":true},{"type":"TRENDING_NOW","title":"Trending Now In Store","count":5,"totalCount":15,"order":[{"type":"Image","enabled":true,"priority":0},{"type":"Name","enabled":true,"priority":1},{"type":"Price","enabled":true,"priority":2}],"enabled":true},{"type":"NEW_ARRIVALS","title":"New Arrivals","count":5,"totalCount":15,"order":[{"type":"Image","enabled":true,"priority":0},{"type":"Name","enabled":true,"priority":1},{"type":"Price","enabled":true,"priority":2}],"enabled":true,"recommendedByVisely":true}]}; Garcia VF, Langford L, Inge TH. Quality of life after laparoscopic adjustable gastric banding for severe obesity: postoperative and retrospective preoperative evaluations. ips.setSetting( 'date_format', jQuery.parseJSON('"mm\/dd\/yy"') ); Inabnet WB, Quinn T, Gagner M, et al. mappingT1P1 = googletag.sizeMapping().addSize([1024, 768], [468, 60]).addSize([980, 690], [468, 60]).addSize([640, 480], [320, 100]).addSize([0, 0], [320, 100]).build(); US experience with the LAP-BAND system. var _d_site = _d_site || '91477E68AE0F3B83C4E72821'; Consensus Conference Panel Consensus Statement: Bariatric surgery for morbid obesity: health implications for patients, health professionals and third-party payers. Obes Surg. Obes Surg. 2002; 194(3):367-375. KeCor87, October 24 Bariatric surgery in patients with diabetes and body mass index less than 35 kg/m. Surgical vs medical treatments for type 2 diabetes mellitus: a randomized clinical trial. Laparoscopic greater curvature plication: initial results of an alternative restrictive bariatric procedure. Early results in 120 morbidly obese patients. In order to be approved by Highmark Health for bariatric surgery in the United States, you must meet the following criteria: Be age 18 years or older. Anthem Blue Cross Georgia is the largest health insurer in the state with over 1,000,000 policies and over 30% market share. This can be accomplished by decreasing the calories ingested with some form of dietary restriction and by increasing the calories expended through increased physical activity. 2008; 299(3):316-323. Fielding GA, Allen JW. Laparoscopic sleeve gastrectomy for morbid obesity. In June 2001, the FDA cleared the Lap-Band System (Allergan, Inc., Irvine, CA and sold to Apollo Endosurgery, Inc., Austin, TX, in 2013 In 2007, the FDA approved a second gastric band device, (REALIZE Adjustable Gastric Band, Ethicon Endo-Surgery, Inc., Cincinnati, OH) to be used for weight reduction for morbidly obese patients and is indicated for individuals with a BMI of at least 40 kg/m2, or a BMI of at least 35 kg/m2 with one or more co-morbid conditions.

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