Lap Band to DS Revision in Washington DC area

Hi all,

I got a lap band in Oct 2007 from George Fielding at NYU, went from 363 to 260 in about 18 months, then climbed to 280 where I remained until late 2010 when my band slipped, Got it unfilled and have gained back to 330. I've been looking into revising to DS and visited Dr Halmi here in Vienna, VA *****commended the Sleeve or RNY since he doesn't do the DS. I'm not interested in the RNY, not sure about the sleeve.

Met with Elariny, he was nice, seems to know what he's doing, he said that most folks that fail to lose weight with restrictive proedures like lap band shouldn't revise to another restrictive procedure like the sleeve. He basically left the choice up to me, even offered to perform a ds and leave the lap band in if I wanted to use it after the major weight loss was done after some time. He wanted to remove my appendix at the same time as the revision as a precautionary measure.

Elariny's staff told me it would be $20k cash upfront if insurance covers the rest. I have Bank of America - Aetna Total Comprehensive. There seemed to be some negotiation room, I just sat in silence and finally said I was thinking cash payment of $6k was more in my range and she said maybe if $20k was too much that they could do $12k, it was all as if she had to get it approved by some committee and had to check on it. Felt like negotiating a car purchase. Elariny's staff also said it was $70k if insurance didn't cover and that we may not know until after they submit for payment after the surgery.  

Looking for another option, locally first, or within a couple hundred miles at the max. I don't want to do another surgery in NYC.

I see Vanguri is in Baltimore, Greenbaum is in southern NJ, Elariny in Virginia. Is there anyone else within a couple hundred miles of DC? They need to have lap band to ds revision experience and hopefully not charge me upfront something dramatic.

You also might want to check out Dr Sudan at Duke or Dr Smith in Atlanta. Dr Elariny is well worth the money but if it is an issue, as it is with most of us, there are other options. I think what Dr E told you about following up a restrictive WLS with another restrictive WLS is spot on.

--gina

I wouldn't mess with Vanguri - I see VERY few of his DS patients at all, let alone revisions, so I'm assuming he's not very experienced in revisions, if at all.

Honestly, locally, it's Dr. E. If I had the $$, I would have gone to Dr. E first. It would have saved me from all of the drama and heartache I've had from my surgeon's office...

Greenbaum and Sudan both do revisions, I believe, though I know Greenbaum had stopped accepting revision patients at one time (not sure if that's been resolved). You might also check with Dr.s Bonani and G near Philadelphia - not sure of their experience with band-to-DS revisions, but I know they do DSes there.

I know the upfront expense with Dr. E is a lot to swallow. But if I needed a revision, I would absolutely trust him with my life.

And I agree completely that if the band was not successful for you as a restriction only procedure, I probably wouldn't revise to just a VSG. If you had been successful with the band and then had some sort of mechanical failure, that might be different.

Unfortunately, I had to delete this post due to privacy concerns.

Dr. Greenbaum has apparently stopped doing RNY to DS revisions, but lap band to DS is much, much easier and less risky and he's probably still doing them. He has an excellent reputation and I would recommend checking him out. As far as fees go, I have no idea.
    I agree with everyone else that going from one failed restrictive operation to another purely restrictive operation is not a good choice.

Larra

 Thanks all for your time and opinions, all very useful!

Did anyone else get their appendix out as a precautionary measure? The way Elariny added it to the revision was sort of dismissal as if it was always done.

It's a good idea IMHO because if you ever come to the ER with abdominal pain, it's one less potential diagnosis (and a common one). It will add about 5 minutes time to your operation and potentially save you a lot of misery in your future.
    My surgeon also removes the appendix, and also the gall bladder, routinely with the DS. Not all surgeons do this.

Larra

I didn't get mine out, but it is common.

More common, though, is gallbladder removal because so many people run into gallbladder problems post op from the rapid weight loss.

 I just had my DS done by Dr. E about 2 weeks ago, and I wouldn't go to anyone else.  He did my sleeve 2 years ago, and he's the one who discovered that the thing I had been calling a hernia for the last couple years was, in fact, a surgical sponge that was left in 10 (TEN!!) years ago and removed it.  It was a big surgery, because we did the DS at the same time, along with a few other minor things (including removing my appendix).  But he's great, and I wouldn't go to anyone else.  He is a fantastic surgeon and has a great bedside manner.    

Liz