Mini gastric Bypass- does OHIP cover this?

Has anyone out there been involved in this new procedure? I am looking into this with my family physician. Does OHIP cover this?

Some of the people on this site and OSSG at Yahoo have had this procedure and have been happy with their results...however, you really need to investigate it thoroughly....and yes, OHIP does cover it. It's still lap RNY. There is an article that is in the files on OSSG and it's a bit long but here it is. After I read this I decided to go with regular lap RNY. I was concerned about the fact that Dr. Rutledge, along with the handful of surgeons he has trained, are the only ones out of hundreds in the States that are doing this procedure. If it's so good, why aren't there more doing it? Anyway, it's a personal decision that we each have to make for ourselves. Good luck with your research! Staple Diet: A Doctor's Version Of Obesity Surgery Raises Some Bile In Surging Field, 'Minigastric' Is Simpler and Quicker, But Critics See Safety Risk Burning 'Like Battery Acid' By David Armstrong, The Wall Street Journal, 2269 words Jan 14, 2005 Document Text Copyright (c) 2005, Dow Jones & Company Inc. Reproduced with permission of copyright owner. Further reproduction or distribution is prohibited without permission. In a nation of epidemic obesity, weight-loss surgery is booming. The number of such procedures, almost all of them stomach reductions, rose 36% last year to 141,000, five times the 1999 level, according to the American Society for Bariatric Surgery. One of the field's busiest practitioners is Robert Rutledge. Garnering patients via his Web site and local seminars, the 53-year- old surgeon charges $17,000 for his version of the surgery, undercutting the $25,000 to $30,000 typically charged for the standard procedure, known as a "gastric bypass." Dr. Rutledge calls his variation, which is briefer and involves a shorter hospital stay, the "minigastric bypass." In the past two years, he has opened minigastric programs at hospitals in Florida, Michigan, North Carolina, California, Missouri and Arkansas. Doctors at these sites receive training from Dr. Rutledge, *****ceives a portion of the fees for each surgery they do. He says about 50 minigastrics are being performed each month, with about 3,000 done since he began using the technique in 1997. Dr. Rutledge promotes the minigastric as a safer alternative to conventional stomach reduction. Many doctors, however, say the minigastric is nearly identical to a form of weight-loss surgery that was abandoned in the 1970s because of concerns about cancer risk and the churning up of intestinal bile into the esophagus and stomach. The "reflux" of bile, an alkaline liquid secreted into the intestine that the body uses to break down fat, can produce burning chest pain and gagging and also lead to serious irritation of the esophagus. As with the earlier surgery, Dr. Rutledge uses a type of hookup between the intestines and the stomach called the Billroth II. A 1985 study of 28 patients published in the journal Surgery found that those *****ceived the Billroth II hookup had 13 times as much bile in their stomachs as patients who had conventional stomach reductions. A 2002 study of 91 patients by Japanese researchers found 31% of Billroth II patients suffered from bile refluxing into the esophagus, compared with 1.6% of patients with conventional surgery. The study appeared in the World Journal of Surgery. Dr. Rutledge says he reduces the stomach's size in a different way than the discredited 1970s surgery, one that reduces bile-reflux risk. He says only about 6% of his patients experience bile reflux and the problem can almost always be treated with drugs. He says the increased stomach-cancer risk, which some doctors think might be related to bile reflux, is minimal. Complicating the debate is a shortage of safety data about Dr. Rutledge's procedure. He says he tries to follow up regularly with all the patients *****ceive operations from him or a doctor he has trained by sending them written or e-mail questionnaires. But these methods are open to bias: People might not accurately self-report their weight or other data, and those with bad experiences might not respond to the requests for information. Dr. Rutledge hasn't carried out any studies comparing his surgery to other procedures; he says that's because other surgeons have a vested interest in the status quo and refuse to participate. He has published only one article for a medical journal about his procedure. It appeared in June 2001 in Obesity Surgery and was based on data from his questionnaires. Dr. Rutledge "may be right, but I don't know and he can't say," says Alan Wittgrove, a San Diego surgeon who performed a conventional gastric bypass on the singer Carnie Wilson. "This hasn't been effectively studied for long-term safety." Dr. Rutledge is one of a growing number of doctor-entrepreneurs who have harnessed the Internet to attract patients in a fast-growing field. Among the most active Web marketers are hospitals that specialize in lucrative areas such as back and heart surgery. Although new drugs and medical devices must go through lengthy testing to gain the necessary approval from the Food and Drug Administration, a surgeon can conceive of a new procedure one day and try it out the next -- as Dr. Rutledge did with his minigastric bypass. Two minigastric patients have died within 30 days of surgery, or about one in 1,500, according to Dr. Rutledge's data. The 30-day mortality rate for all stomach reductions is about one in 200, according to a recent analysis led by a University of Minnesota surgeon that covered 22,000 patients and was published in the Journal of the American Medical Association. That analysis included the patients reported in Dr. Rutledge's June 2001 article. Other obesity doctors say Dr. Rutledge may see fewer near-term deaths because he restricts the minigastric to patients weighing less than 350 pounds. Five doctors who practice near Dr. Rutledge's clinics say that collectively they have treated 50 patients over the past six years for side effects from the operation. "That is why no one believes his data," says one of the five, Adolfo Fernandez Jr., a professor of surgery at Wake Forest University School of Medicine. In about two dozen cases, these doctors say the patients had to have corrective surgery to undo the operations that Dr. Rutledge or one of his followers performed. About a dozen patients who have had the minigastric procedure said in interviews they suffered from bile reflux bad enough to lead to serious symptoms. Mark Ferguson, the head of thoracic surgery at the University of Chicago Medical Center, says the minigastric as described by Dr. Rutledge is a "set-up for bile reflux." He says the operation could also bring on Barrett's esophagus, a condition in which the tissue lining the esophagus becomes malformed and can turn cancerous. Dr. Rutledge asks his patients to pay cash for their operations. Some can get reimbursement from their insurers afterward, but many health insurers won't pay. Blue Cross and Blue Shield of North Carolina covers other weight-loss surgery but not the minigastric. "It may be a simpler surgery to perform," says senior medical director Don Bradley. "But if you get 15 years down the road and because of bile reflux you end up with strictures in your esophagus or esophageal cancer, there is no way to say that getting out of the hospital a day earlier was worth it." In both conventional gastric bypass and Dr. Rutledge's minigastric bypass, the stomach is radically reduced in size using surgical stapling and the intestines are shortened. People lose weight afterward because their stomachs hold less food and the shorter intestinal tract gives the food less chance of being absorbed into the body. In the conventional operation, the intestine is first severed about 2 feet downstream of the stomach, and the lower end is attached to the new, smaller stomach pouch. This step leaves 2 feet of intestines dangling from the bottom of the unused portion of the stomach. So doctors make a hole in the remaining part of the intestines and attach this "limb" to it. (See diagram.) The conventional intestinal connection is called a "Roux-en-y," after a 19th-century French surgeon named Roux and the connection's resemblance to the letter Y. In Dr. Rutledge's minigastric, the intestine is looped upward, and the bottom of the new stomach is attached directly into a new hole in the intestinal sidewall. The procedure takes less time because it doesn't involve any clipping of the intestines or leave any dangling part that requires reattachment. Dr. Rutledge says his procedure differs in two important ways from the older "Mason Loop," the stomach-reduction surgery employing the Billroth II connection that was largely abandoned in the 1970s. He says the attachment he makes to the small intestine is lower on the newly created stomach pouch than the discredited procedure and further away from the esophagus. He says he also creates a longer stomach pouch that makes it more difficult for stomach contents to back up into the esophagus. Dr. Rutledge has a following of former patients *****fer to him in reverential terms. Randall Edwards, a lawyer from Reno, Nev., started doing some legal work for Dr. Rutledge after having the minigastric procedure. He says he lost 158 pounds following the surgery in December 2003 and is no longer plagued by sleep apnea and other health problems from his obesity. "This guy can save your life," he tells a group of patients awaiting surgery by Dr. Rutledge and a trainee surgeon one recent morning at the Chino Valley Medical Center, outside Los Angeles. Another proponent is Henry Fiala, a Toronto physician who lost 117 pounds after a minigastric performed by Dr. Rutledge in 2003. Dr. Fiala has sent 20 of his patients to the U.S. for the operation, which is paid for by the government of Ontario. He is impressed by the low mortality rate reported in Dr. Rutledge's self-collected data and the quick operating time. As for bile reflux, he says: "I have a lot of patients with bile reflux and it hasn't killed them. Of all the things that go wrong, that is not the worst thing to happen." Some patients and doctors tell a different story. Teresa Hanson of Fincastle, Va., turned to Dr. Rutledge after her blood pressure soared to dangerous levels while she was giving birth to her son. Peaking at 400 pounds, Ms. Hanson worried her weight could be deadly. She tried and failed to shed pounds using diet pills, injections, exercise and dieting. Ms. Hanson considered the standard gastric bypass, but after finding Dr. Rutledge's Web site she decided she preferred his approach because it was less invasive. She traveled to Durham Regional Hospital in North Carolina, where Dr. Rutledge was then operating, and underwent the procedure in January 2000. It took a little under an hour, and she left the hospital two days later. At first, "it was a dream come true," says Ms. Hanson. She says she quickly lost about 100 pounds, but within a year began to have attacks that started with a cold sweat followed by pain in her lower back. It felt "like someone was taking a hot dagger and just stabbing me," she says. The only relief came when she involuntarily vomited bile. Other surgeons diagnosed the pain as bile reflux and told Ms. Hanson she needed to undergo new surgery to replace Dr. Rutledge's intestinal routing with the standard hookup. She did so in 2001 and says she hasn't had attacks since. Dr. Rutledge says he doesn't remember Ms. Hanson's case but says many doctors perform repair surgery when medication to treat the symptoms would also be effective. He says some doctors are jealous of his success and averse to innovation. Dr. Rutledge performed a minigastric on Beth McFarling of Raleigh, N.C., in 2000. She says she soon developed bile reflux that burned "like battery acid" and was unable to control bile vomiting, which occurred while she slept. She too underwent corrective surgery and saw the problem disappear. Mrs. McFarling and other patients say they weren't warned of a bile- reflux ris****il at least 2001, Dr. Rutledge acknowledges, his Web site said there was no risk of bile reflux, which he says was "a mistake." Mrs. McFarling said when she began to detail her problems to other patients on a Web discussion group moderated by Dr. Rutledge, the surgeon cut off her access to the group. Dr. Rutledge says he doesn't remember cutting her off but has denied access in the past to "two or three" people who told "fibs" or swore. Dr. Rutledge graduated in 1978 from the University of Florida medical school and joined the staff of North Carolina Memorial Hospital in Chapel Hill, where he remained for 20 years. In 1997, while he was working an emergency-room shift, a patient with multiple gunshot wounds suffered injuries that required Dr. Rutledge to cut away part of his stomach and reconnect it to the intestine. He says he used the Billroth II procedure. After the surgery, Dr. Rutledge says he realized that same connection would offer a shortcut from the traditional Roux-en-y procedure that he had been using for obesity patients. He decided to try the Billroth hookup in a gastric-bypass surgery he had scheduled for the next morning. With the patient's permission, he says, the minigastric procedure was born. The following year, he moved to nearby Durham Regional Hospital and started a company, the Center for Laparoscopic Obesity Surgery, to focus on the new method. Dr. Rutledge says he stopped performing the surgery for several months in 2001 after some patients in North Carolina complained about complications, and Durham Regional suspended its minigastric program. The North Carolina Medical Board says it investigated the complaints, but never took disciplinary action against Dr. Rutledge. He began operating again at a different hospital in Statesville, N.C., and in 2003 began his expansion into other states. He recently moved to Las Vegas, where he is opening a center later this month, but spends much of his time on the road. Aside from bile reflux, some doctors say their chief concern about the minigastric is the potential for raising cancer risk, which has been well-documented in patients receiving the Billroth II hookup. On his Web site, Dr. Rutledge says the risk of developing stomach cancer from his surgery is equivalent to that of a diet heavy in foods with nitrates, such as hot dogs and bologna. He says those who eat a proper diet after the minigastric are unlikely to develop stomach cancer. David Hargroder, a Joplin, Mo., surgeon in Dr. Rutledge's program, says the stomach-cancer concerns are theoretical. "To me, we will worry about that 20 years from now," he says. Patients who need the minigastric, he says, "won't live 20 years if we don't do something right now." Reproduced with permission of the copyright owner. Further reproduction or distribution is prohibited without permission.

I've e-mailed you the e-mail address to a lady that lives on Niagara On The Lake that had the mini gastric bypass and had OHIP pay for it. She's a lovely person and I'm sure she'd be happy to tell you more about it! Cheers! Lorraine

Can you please send me the Niagara contact for mini gastric bypass