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Obesity: Surgery

Volume 495: debated on Tuesday 30 June 2009

To ask the Secretary of State for Health how many people in each age category under the age of 18 years underwent surgery for obesity in each of the last three years; and what surgical treatments have been administered to treat the condition. (282484)

The requested data are not available. However, the following table provides data on the number of finished consultant episodes (FCEs) for patients under 18 year olds (0-17 years old) with a primary diagnosis of obesity1 and a main or secondary procedure of Bariatric Surgery2 for 2005-06, 2006-07 and 2007-08:

Total FCEs2005-0642006-0722007-086Notes:Finished Consultant Episode (FCE)A finished consultant episode (FCE) is defined as a continuous period of admitted patient care under one consultant within one healthcare provider. FCEs are counted against the year in which they end. The figures do not represent the number of different patients, as a person may have more than one episode of care within the same stay in hospital or in different stays in the same year.1 Primary diagnosisThe primary diagnosis is the first of up to 20 (14 from 2002-03 to 2006-07 and seven prior to 2002-03) diagnosis fields in the Hospital Episode Statistics (HES) data set and provides the main reason why the patient was admitted to hospital.The ICD-10 codes used to identify Obesity is as followsE66—ObesityMain procedureThe main procedure is the first recorded procedure or intervention in the HES data set and is usually the most resource intensive procedure or intervention performed during the episode. It is appropriate to use main procedure when looking at admission details, (e.g. time waited), but a more complete count of episodes with a particular procedure is obtained by looking at the main and the secondary procedure.Secondary procedureAs well as the main operative procedure, there are up to 23 (11 from 2002-03 to 2006-07 and three prior to 2002-03) secondary operative procedure fields in HES that show secondary or additional procedures performed on the patient during the episode of care. 2 Number of episodes with ‘Bariatric Surgery’ as a main or secondary procedureThese figures represent the number of episodes where the procedure (or intervention) was recorded in any of the 24 (12 from 2002-03 to 2006-07 and four prior to 2002-03) operative procedure fields in a HES record. A record is only included once in each count, even if the procedure is recorded in more than one operative procedure field of the record. It should be noted that more procedures are carried out than episodes with a main or secondary procedure. For example, patients under going a ‘cataract operation’ would tend to have at least two procedures—removal of the faulty lens and the fitting of a new one—counted in a single episode.The OPCS-4.2 procedure codes for bariatric surgery in years 2005-06 to 2007-08 are:G01.2 Oesophagogastrectomy and anastomosis of oesophagus to transposed jejunumG01.3 Oesophagogastrectomy and anastomosis of oesophagus to jejunum necG27.1 Total gastrectomy and excision of surrounding tissueG27.2 Total gastrectomy and anastomosis of oesophagus to duodenumG27.3 Total gastrectomy and interposition of jejunumG27.4 Total gastrectomy and anastomosis of oesophagus to transposed jejunumG27.5 Total gastrectomy and anastomosis of oesophagus to jejunum necG27.8 Other specified total excision of stomachG27.9 Unspecified total excision of stomachG28.1 Partial gastrectomy and anastomosis of stomach to duodenumG28.2 Partial gastrectomy and anastomosis of stomach to transposed jejunumG28.3 Partial gastrectomy and anastomosis of stomach jejunum necG28.8 Other specific partial excision of stomachG28.9 Unspecified partial excision of stomachG30.1 Gastroplasty necG30.2 Partitioning of stomach necG30.8 Other specified plastic operations on stomachG30.9 Unspecified plastic operations on stomachG31.1 Bypass of stomach by anastomosis of oesophagus to duodenumG31.2 Bypass of stomach by anastomosis of stomach to duodenumG31.3 Revision of anastomosis of stomach to duodenumG31.4 Conversion to anastomosis of stomach to duodenumG31.8 Other specified connection of stomach to duodenumG31.9 Unspecified connection of stomach to duodenumG31.0 Conversion from previous anastomosis of stomach to duodenum G32.1 Bypass of stomach by anastomosis of stomach to transposed jejunumG32.2 Revision of anastomosis of stomach to transposed jejunumG32.3 Conversion to anastomosis of stomach to transposed jejunumG32.8 Other specified connection of stomach to transposed jejunumG32.9 Unspecified connection of stomach to transposed jejunumG32.0 Conversion from previous anastomosis of stomach to transposed jejunumG33.1 Bypass of stomach by anastomosis of stomach to jejunum necG33.2 Revision of anastomosis of stomach to jejunum necG33.3 Conversion of anastomosis of stomach to jejunum necG33.8 Other specified other connection of stomach to jejunumG33.9 Unspecified other connection of stomach to jejunumG33.0 Conversion from previous anastomosis of stomach to jejunum necG38.8 Other specified other open operations on stomachG48.1 Insertion of gastric bubbleG48.2 Attention to gastric bubbleThe following additional four digit OPCS-4.3 and OPCS-4.4 codes are used in the 2006-07 and 2007-08 data (these are in addition to the OPCS 4.2 codes listed above):G28.4 Sleeve gastrectomy and duodenal switchG28.5 Sleeve gastrectomy necG30.3 Partitioning of stomach using bandG30.4 Partitioning of stomach using staplesG31.5 Closure of connection of stomach and duodenumG31.6 Attention to connection of stomach and duodenumG32.4 Closure of connection of stomach to transposed jejunumG32.5 Attention to connection of stomach to transposed jejunumG33.5 Closure of connection of stomach to jejunum necG33.6 Attention to connection of stomach to jejunumG38.7 Removal of gastric bandG71.6 Duodenal switchThe term “bariatric surgery” is often used to define a group of procedures that can be performed to facilitate weight loss although these procedures can be performed for conditions other than weight loss.Data qualityHES are compiled from data sent by more than 300 national health service trusts and primary care trusts (PCTs) in England. Data are also received from a number of independent sector organisations for activity commissioned by the English NHS. The NHS Information Centre for health and social care liaises closely with these organisations to encourage submission of complete and valid data and seeks to minimise inaccuracies and the effect of missing and invalid data via HES processes. While this brings about improvement over time, some shortcomings remain.Assessing growth through timeHES figures are available from 1989-90 onwards. The quality and coverage of the data have improved over time. These improvements in information submitted by the NHS have been particularly marked in the earlier years and need to be borne in mind when analysing time series.Some of the increase in figures for later years (particularly 2006-07 onwards) may be due to the improvement in the coverage of independent sector activity.Changes in NHS practice also need to be borne in mind when analysing time series. For example, a number of procedures may now be undertaken in outpatient settings and may no longer be accounted for in the HES data. This may account for any reductions in activity over time.Ungrossed dataFigures have not been adjusted for shortfalls in the data, i.e. the data are ungrossed.Source:Hospital Episode Statistics (HES), The NHS Information Centre for health and social care