Guidance

The National Institute for Health and Care Excellence (NICE) issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Implantation of a duodenal-jejunal bypass sleeve for managing obesity in November, 2013.

January 2018: The device used in this procedure (EndoBarrier) no longer has a current CE mark. The CE mark is necessary for medical devices to be marketed in the European Union. A non CE marked device can only be used in the context of clinical investigations with MHRA and research ethical approval.

Description

Obesity is defined as a body mass index (BMI) of 30 kg/m2 or more. It is a risk factor for comorbidities such as type 2 diabetes, coronary heart disease and hypertension. Weight loss reduces the risks of comorbidities and improves long-term survival.

Obesity is managed by dietary advice, exercise, lifestyle changes and medication. Bariatric surgery is considered as a treatment option in selected patients whose BMI is over 40 kg/m2, or over 35 kg/m2 for patients with other significant comorbidities, if they have not lost enough weight using non‑surgical measures.

Surgical procedures aim to help patients lose weight by restricting the size of the stomach (for example, gastric banding or sleeve gastrectomy) and/or by decreasing the patient’s capacity to absorb food (for example, Roux-en-Y gastric bypass or biliopancreatic diversion).

Coding recommendations

G54.3 Endoscopic insertion of tubal prosthesis into duodenum

Y70.5 Temporary operations

Endorsing bodies

This interventional procedures guidance is endorsed by Healthcare Improvement Scotland as required by the Health and Social Care Act (2012).

  • National Institute for Health and Care Excellence (NICE)