Revisional metabolic/bariatric surgery is a moral obligation; for not to perform revisional surgery is a denial of the precepts of our discipline and an abandonment of the underprivileged population who has placed its trust and future in our hands.
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The argument offered by this segment of the provider community is that the results of revisional surgery are not predictable in terms of hospitalization and follow-up care, that revisional surgery may have an increased complication rate compared to primary surgery and may be less successful than primary surgery, and, above all, that it may be financially disadvantageous. This negative response to revisional bariatric surgery is manifested at national, state, and local levels. There is a lack of conceptional support from the National Institutes of Health and a lack of critical financial support from the Affordable Care Act. On the state level, 28 states do not mandate or approve metabolic/bariatric procedures. Locally, the policies of some hospitals and departments of surgery, even in academic institutions, seek to eliminate or minimize revisional bariatric surgery. Yet, there are no papers in the medical literature that justify and support this perspective of denial.
© 2014, Springer Science+Business Media New York.
- Bariatric surgery
- Revisional metabolic/bariatric surgery