Agreement expands beneficiaries' access to bariatric surgery

  • Published
  • By Sue Campbell
  • 59th Medical Wing Public Affairs
LACKLAND AIR FORCE BASE, Texas (AFNS) --  A resource sharing agreement between the Nix Health Care System in San Antonio and Wilford Hall Medical Center doctors here will provide increased services to bariatric patients. 

The agreement allows Wilford Hall providers to perform surgeries at the Nix Hospital using Nix equipment and support staff, and the agreement was modified to include bariatric surgeries in December 2008. 

In December, Wilford Hall doctors performed six bariatric surgeries at the Nix Hospital.
"The Nix Hospital is a Center of Excellence for bariatric surgery," said Maj. (Dr.) Richard Peterson, the Wilford Hall Bariatric Clinic chief. "They meet requirements established by the American Society for Metabolic and Bariatric Surgery that sets certain benchmarks such as high volume of surgeries, a dedicated bariatric unit and specialized equipment, such as large-sized CT scans and beds."

Two-thirds of all Americans are overweight or obese, according to the Centers for Disease Control.

For individuals who have been unable to achieve significant weight loss through diet modifications and exercise programs alone, bariatric surgery may help to attain a more healthy body weight. Gastric bypass surgery has been performed in the U.S. for about 40 years. Laparoscopic gastric bypass surgery has been performed since 1993.
"We usually see a patient after they have been through six months of supervised weight loss through a physician or dietitian," said Maj. (Dr.) Joshua Alley, a Wilford Hall bariatric surgeon. "Their body mass index must be at least 40, or 35 to 40 with an obesity-related health problem, such as Type 2 diabetes, hypertension or sleep apnea."

Wilford Hall officials offer three types of laparoscopic bariatric surgery for military dependents and retired military members.

Laparoscopic gastric bypass surgery, commonly known as stomach stapling, creates a small, thumb-sized pouch from the upper stomach, accompanied by bypass of the remaining stomach. This restricts the volume of food that can be eaten. The surgery normally requires two to four weeks of recovery and is approved by Tricare.

Laparoscopic adjustable gastric banding, commonly known as lap-band surgery, creates a small pouch in the upper part of the stomach with a controlled and adjustable opening, limiting food intake. Recovery averages one to two weeks and the surgery is also approved by Tricare.

Laparoscopic sleeve gastrectomy, or vertical sleeve gastrectomy, removes approximately 85 percent of the stomach, leaving a stomach with a much smaller capacity. Unlike other bariatric surgeries, this procedure is not reversible. Recovery averages one to two weeks, but the surgery is not approved by Tricare at this time, so it must be performed at Wilford Hall.

"We want to spread the word that these bariatric services are available to our beneficiaries," Dr. Peterson said. "Although surgery should be a last resort, it can significantly improve an individual's overall health and quality of life."

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