Gastric sleeve in Ontario, will Ohip say no.

hi I am new to all of this!!! I have a question and it's probably not the first time asked. But with my knee problems and being over weight at a bmi of 36, I am looking to get gastric sleeve done. I know wait times are long and I  have no problem doing the waiting. But I was told that they probably won't do it for me. That they will tell me that my only option is by-pass. Is this true. I only want the sleeve. The by-pass freakes me out ..

i guess if I want this done I have to pay right.?

kari. 

When I was going through my process my surgeon told me that RNY is considered the gold weight loss surgery in Ontario and they always do the RNY unless there is a health reason that would prevent the RNY being done and then they would result to the sleeve. He also mentioned if once inside and doing the RNY if they ran into any concerns and the sleeve would turn out to be safer they would do it then. He told me the reason for this is because the government has to approve the sleeve and the surgeon must present the cir****tances to them before the funding would be approved. I hope this helps and it could very well be different at each centre I was through Humber River Regional Hospital.

Hi Kari, about a year ago I would have said exactly the same thing.  It took me a long time, much research, and the many appointments required by the bariatric registry to wrap my head around the reasoning for why OHIP funds RNY as the first option and only covers the sleeve in exceptional cir****tances.  At the end of this, I'm glad I took the time to get used to the idea and learn as much as I could about this surgery because ultimately the stats prove that RNY has the best outcome for the most people in terms of percentage of excess weight lost.  My surgery is scheduled in January, and while looking at the diagram of what they are going to do still skeeves me out, I've come to trust that the OHIP funding structure that emphasizes RNY over the sleeve is sound, at least for me.  I hope this is helpful, I understand that others may feel differently, but what you have said reminded me so much of my own feelings on this a year ago that I thought I'd provide my two cents worth.  Best of luck with your process and welcome to the community!

Keep in mind that I am in Ottawa, and this is my experience here at OWMC:

While the RNY is still considered (and anciently so...) the "gold standard" here, it has been proven time and time again that at two years post-op, weight loss results for RNY and VSG (aka the Sleeve) are exactly the same. And with the added bit that Sleevers do not have the rerouting of the intestines, the remenant stomach, or the temporary malabsorption issues that RNYers have.

There are excellent reasons for both surgeries. However, from what I know, if you want the sleeve and do not have medical rationale for requiring it, then the RNY it shall be... at least here in Ottawa. They are notoriously difficult to convince for sleeve surgery here, while other centres are much more approachable, depending on the centre where you will be.

So keeping this in mind, do you have any health issues that would necessitate the sleeve? Or on the flip side, any health issues that would preclude you from having a sleeve and thus needing RNY?

If this truly is what you want, and your centre will not do it and you have no health rationale for requiring the sleeve, then yes, you may have to pay out of pocket.

I wish you luck in finding the right path for you.

Malabsorption with the RNY is not an "issue". It is a planned and desired outcome from the surgery, working together with high restriction, to assist morbidly obese people to lose excess weight. It allows a "re-set" to the body and its' metabolism, and is a desired "outcome" from the surgery.

Hey, I'm new here to the community. I live in Montreal Quebec, and have been approved for bariatric surgery by my doctor. We have decided that the sleeve is the best option for me, I have a genetic disorder making me prone to blood clots so the less invasive the better. MY wait time here in QC is looking like it will be 5 years! its a 12 month wait just to have the initial consultation. My doctor suggested that i look into having surgery in Ottawa because they accept medicare from Quebec, and then to check in Toronto if I can get in there. I really need advice on how to do this. I have no contact information for surgeons in Ottawa or how to go about gathering information.

Not to burst your bubble, but it's a lengthy process here in Ontario too. And rightly so; they need to ensure patients are ready for surgery, both physically and mentally. It took me 10 months from my referral to SEE my surgeon and a couple of more months to get my surgery. But I used that time wisely by researching these forums and reading EVERYTHING I could get my hands on. That prepared me for what lay ahead. I'm in Ottawa though and I know the process is faster in Toronto... depending on your health and preparedness. Be prepared to travel for a LOT of appointments if you are coming from QC. Hmm, then again, some might be able to be teleconference appointments (nut, psych, dietitian, etc.). 

That said, I cannot tell you for certain what the process might be if you are from Quebec but wanting surgery in Ontario. I am not sure if your doctor in QC needs to refer you to the Bariatric Registry in Ontario or not. Maybe you could contact the Registry to see what the process is if you are from out-of-province? http://www.ontariobariatricnetwork.ca/

Thank you for your replies. I talked to a dr. Orzeck and he says I'm approved. So I guess I'm paying. 

Paying for what?? If you are approved to have sleeve surgery, OHIP is paying.

That dr. Is from a private clinic. I was going to go thorugh the program, but from my understanding if I request a sleeve they won't do it because I have to meet a  strict  criteria to get it. I just feel safer with sleeve surgery.