Rondônia, ParaÃba, Goias, Amazonas, Acre, Roraima and Piauà are the states that have not yet accredited hospitals to bariatric surgery by the Unified Health System (SUS). It is pointing survey of the Brazilian Society of Metabolic and Bariatric Surgery (SBCBM).
According to the Ministry of Health, there are 80 units authorized in the country, but has not indicated whether present in all states. Also according to the folder, to enable new services Assistance High Complexity Bearer of Severe Obesity, the local manager must organize and implement care line to the obese patient, a procedure which is under public consultation. Hospitals, including accredited, have one year to adapt to the new criteria.
For Irenaeus Rasera, surgeon and manager of the Hospital of Sugarcane Suppliers of Piracicaba and member of SBCBM, the government should create a single registry for candidates for bariatric surgery and also authorize videolabaroscopia, which is a less invasive intervention.
Currently, SUS authorizes three techniques: gastric bypass with intestinal gastrectomy with or without duodenal bypass, and vertical banded gastroplasty in banda, which will be replaced by new index present significant weight gain by the patient. In lieu of this procedure, is expected to include the vertical sleeve gastroplasty (sleeve).
For the new tests authorized by the ministry, Rasera believes will be beneficial only if they come as a possibility, but if required it is worrying. He explains that not all patients need to pass the new, which can delay the execution of the surgery.
The Ministry of Health has reduced from 18 to 16 the minimum age for surgery in public, where there is risk of death for the patient. According to a statement from the folder, the decision was made based on studies that link the rise in obesity among adolescents. Data from the Household Budget Survey of 2009 (POF) indicate that, in the range of 10 to 19 years, 21.7% of Brazilians are overweight. In 1970, the rate was 3.7%.
Rosana Radominski, endocrinologist of the Brazilian Association for the Study of Obesity and the Metabolic Syndrome (ABESO), believes that the change in the minimum age is positive. This change will make all the difference for teens. Where surgery, he will not have to wait two long years to get a considerable reduction in weight.
She alert for care in cases of teenagers. I think the group needs a multidisciplinary team, because he must have a good understanding of the procedure, need maturity to understand the post-surgery treatment. They have life ahead and have to understand, for example, the power restrictions.
Banning the sale and use of amphetamine appetite suppressants, Rosana Radominski believes that the withdrawal of these products from the market is because of the increase of obese, but emphasizes that the drugs are lacking for some groups of patients. In Brazil, there's that group of patients who lose weight with diet and physical activity, have one group that will make bariatric surgery and have that group in the middle who can not lose weight with diet and has no indication for surgery. These patients were left unattended. Those who had a good outcome with treatment [with banned drugs] with the suspension were without the remedy. Do not have another option for now. They took off and have not given another option, he said.
With information from the Agency Brazil
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