These publications evaluated a patient educational tools available for the purposes of total of seven educational tools. Among them were educating women about postmastectomy breast reconstruc- employed various mediums including written, visual, and tion. A systematic review of the English language literature audio materials. Detailed review revealed that the develop- was conducted between the years and of all ment of only one educational program included an educational studies pertaining to the use of educational materials for needs assessment.
Weight-related arthropathies that impair physical activity; or Obesity-related psychosocial distress. Physician-supervised nutrition and exercise program: Member has participated in physician-supervised nutrition and exercise program including dietician consultation, low calorie diet, increased physical activity, and behavioral modificationdocumented in the medical record at each visit.
The nutrition and exercise program may be administered as part of the surgical preparative regimen, and participation in the nutrition and exercise program may be supervised by the surgeon who will perform the surgery or by some other physician.
For members who participate in a physician-administered nutrition and exercise program e. Records must document compliance with the program; the member must not have a net gain in weight during the program.
The presence of depression due to obesity is not normally considered a contraindication to obesity surgery.
Aetna considers open or laparoscopic vertical banded gastroplasty VBG medically necessary for members who meet the selection criteria for obesity surgery and who are at increased risk of adverse consequences of a RYGB due to the presence of any of the following co-morbid medical conditions: Aetna considers VBG experimental and investigational when medical necessity criteria are not met.
Aetna considers surgery to correct complications from bariatric surgery medically necessary, such as obstruction, stricture, erosion, or band slippage.
Aetna considers repeat bariatric surgery medically necessary for members whose initial bariatric surgery was medically necessary i.
Experimental and Investigational Bariatric Surgical Procedures: Aetna considers each of the following procedures experimental and investigational because the peer-reviewed medical literature shows them to be either unsafe or inadequately studied: Gastrointestinal liners endoscopic duodenal-jejunal bypass, endoscopic gastrointestinal bypass devices; e.
Background These criteria were adapted from the NIH Consensus Conference on Surgical Treatment of Morbid Obesity which state that obesity surgery should be reserved only for patients who have first attempted medical therapy: Therefore, the appropriateness of obesity surgery in non-compliant patients should be questioned.
The patient must be committed to the appropriate work-up for the procedure and for continuing long-term post-operative medical management, and must understand and be adequately prepared for the potential complications of the procedure. There is rarely a good reason why obese patients even super obese patients can not delay surgery in order to undergo behavioral modification to improve their dietary and exercise habits in order to reduce surgical risks and improve surgical outcomes.
The patient may be able to lose significant weight prior to surgery in order to improve the outcome of surgery. Obesity makes many types of surgery more technically difficult to perform and hazardous.
Weight loss prior to surgery makes the procedure easier to perform. Weight reduction reduces the size of the liver, making surgical access to the stomach easier. By contrast, the liver enlarges and becomes increasingly infiltrated with fat when weight is gained prior to surgery.
A fatty liver is heavy, brittle, and more likely to suffer injury during surgery. Moreover, following surgery, patients have to follow a careful diet of nutritious, high-fiber foods in order to avoid nutritional deficiencies, dumping syndrome, and other complications.
The total weight loss from surgery can be enhanced if it is combined with a low-calorie diet. For these reasons, it is therefore best for patients to develop good eating and exercise habits before they undergo surgery.
The pre-operative surgical preparatory regimen should include cessation counseling for smokers. The National Institutes of Health Consensus Statement states that all smokers should be encouraged to quit, regardless of weight.
Smoking cessation is especially important in obese persons, as obesity places them at increased risk for cardiovascular disease. Severely obese persons are at increased risk of surgical complications. Smoking cessation reduces the risk of pulmonary complications from surgery.
Ideally, the surgical center where surgery is to be performed should be accomplished in bariatric surgery with a demonstrated commitment to provide adequate facilities and equipment, as well as a properly trained and funded appropriate bariatric surgery support staff.
Minimal standards in these areas are set by the institution and maintained under the direction of a qualified surgeon who is in charge of an experienced and comprehensive bariatric surgery team.
This team should include experienced surgeons and physicians, skilled nurses, specialty-educated nutritionists, experienced anesthesiologists, and, as needed, cardiologists, pulmonologists, rehabilitation therapists, and psychiatric staff.
The American College of Surgeons ACS has stated that the surgeon performing the bariatric surgery be committed to the multidisciplinary management of the patient, both before and after surgery.
There is active collaboration with multiple patient care disciplines including nutrition, anesthesiology, cardiology, pulmonary medicine, orthopedic surgery, diabetology, psychiatry, and rehabilitation medicine.Dr.
Colleen McCarthy is a plastic surgeon in New York, New York. a systematic review of patient-reported outcomes. Preoperative patient education for breast reconstruction: a systematic.
Feb 10, · Preoperative CT-angiography has been shown to reduce operative time, and can help to avoid injuries of the vulnerable pedicle Preoperative patient education for breast reconstruction: a systematic review of the literature.
J Cancer Educ.
|Obesity Surgery - Medical Clinical Policy Bulletins | Aetna||What is a SR?|
|Key Steps Towards a Successful SR||This article has been cited by other articles in PMC.|
|Early Invasive Breast Cancer (T1T2; N0N1; T3N0)||Bacterial decontamination of surgical wounds treated with Lavasept.|
; – 6. Find the sessions of your interest in the schedule below. During the conference there are almost sessions spread over 10 rounds of 1 hour each that you can choose from. Assessing the effectiveness of interventions to support patient decision making about breast reconstruction: A systematic review.
conducted a systematic review of preoperative patient education aids for BR. They found few interventions, all of which were of limited methodological quality.
a systematic review of the literature. J Canc. Surgical Wounds. Local surgical factors such as infection, edema, seroma and hematoma formation, wound tension, wound trauma, wound drainage, the presence of drainage devices, muscle spasticity, and wound dressings all .
A An anomalous accessory flexor digitorum profundus muscle to the ring finger originating from the flexor pollicis longus tendon: A case report.