High BMI Cases
"We're Not Afraid to Take on Extreme Cases"
"We take on very, very large people," said Gus J. Slotman, M.D., medical director of bariatric surgery program at Our Lady of Lourdes Medical Center, who has operated in an individuals weighing as much as 690 pounds. "And we've been blessed with success."
Some insurance companies are beginning to turn down for bariatric surgery coverage cases involving patients whose Body Mass Index (BMI) is higher than 60, he said. (The BMI is a popular index, using height and weight calculations, to estimate health risk related to weight. The upper limit normal BMI is 25. (See a BMI calculator here.)
"Medical literature indicates that as the BMI goes above 50, the incidence of post-operative complications goes up significantly," said Dr. Slotman. "The cost of complications in a minority of cases can far exceed overall savings resulting from the surgery. If a gastric bypass leak creates an 8-month hospital stay, then that can cost $1 million."
But that has not been Dr. Slotman's experience in taking on very obese patients, he said.
"Most practices in New Jersey have an upper weight limit or they try to get patients to lose 100 pounds before they operate on them. Our attitude is, well, if they could lose 100 pounds they wouldn't be coming to see us."
To evaluate his practice's success with high BMI patients, Dr. Slotman reviewed 45 cases of his surgery patients with a BMI greater than 70.
"The only complications were two seromas (fluid pockets) and one wound infection," he said. "Twenty percent of them did develop an incisional hernia, which had to be repaired later, but there were no leaks and no deaths.
"These were the kind of cases nobody else would touch and they came to us," said the surgeon.
He ended on a lighter note:
"Why do you think I have my practice at Lourdes, It's because Lourdes has this huge chapel where I can go in, look up and say 'OK you gave me these patients. Now please get us through it."
To locate a Lourdes Health System bariatric surgeon by phone, call 1-888-LOURDES.
