? Cost of Stomaphyx

Does anyone know the aprox cost of Stomaphyx surgery.  I couldn't get into a trial here in the northeast (MA) and my ins covers revisions only if there is a suture line disruption.  I have gained almost all my weight back after a RNY in 1999.  It also looks like I'll have to go out of state.

What I haveread on this forum anywhere from $8000-$12,000.

Mipo1 *LONG POST WARNING* I invite you to consider a few things, have you been evaluated for WLS failure. Meaning what are the contributing factors? Broken surgry, poor initial outcome, regain later due to tool issue, behavioral/emotional issues or lack of using the tool. Many of these factors are important in addressing the next step. IF the tool isnt used properly no revision will be helpful or successful longterm or may not even be needed. Without the lifestyle to support health any surgery can be defeated sadly. Having a good medical workup, knowing where you are at with using the tool, emotional eating issues that are or aren't addressed, upper GI workup (scope and or xrays) may all be a part of this workup. Stomaphyx may be just what you need or not! An experienced bariatric surgeon can assist inhelping you navigate this. Here are some resources and I hear as well Stomaphyx around $10,000. Closest to you may be Dr. Garber in NYC  http://www.stopobesityforlife.com/index.html http://www.stopobesityforlife.com/revision.html http://www.stopobesityforlife.com/StomaphyX.html I had emailed EndoGastric Solutions for local surgeons in NY area 12/6/07 this was their response, you could email them as well! from this link site: www.endogastricsolutions.com

https://forms.netsuite.com/app/site/crm/externalleadpage.nl? compid=635583&formid=68&h=8a5afd7b157693c35262 This was contact them form page! ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Thank you for contacting EndoGastric Solutions and your interest in our StomaphyX device. The StomaphyX device is cleared by the FDA for tissue approximation and/or ligation in the GI tract. Physicians under their medical license can use the product in a broad range of applications. We can not provide recommendations or information on medical conditions or the care of patients. Only a physician can provide this type of guidance in light of your specific medical history, current symptoms, and a full assessment of your situation. For medical recommendations and cost information, please contact a physician.

We are currently in the process of training physicians throughout the US. These doctors are better equipped to answer your questions and discuss whether your particular medical situation would be relevant for a StomaphyX procedure. The following doctors are closest to your location.

Arif Ahmad, MD John T. Mather Hospital 625 Belleterre Road, Suite 202 Port Jefferson, NY 11777 631-689-0220

Shawn M. Garber, MD Mercy Medical Center 3003 New Hyde Park Road, Suite 307 New Hyde Park, NY 11042 516-616-5500

Spencer A. Holover, MD Mercy Medical Center 3003 New Hyde Park Road, Suite 307 New Hyde Park, NY 11042 516-616-5500

Thank you very much for your interest in the StomaphyX device and EndoGastric Solutions' technology. We wish you the very best of health and success. ______________________ I received this 12/14/07 as well:

EndoGastric Solutions Opens Three Training Centers to Keep Up with Demand from Surgeons Wanting to Learn StomaphyX™ Procedures Redmond Washington, December 14, 2007: Incisionless surgery is the most significant advancement in surgical medicine in decades. It is being rapidly adopted by a wide variety of academic and private hospitals around the world, with over 700 StomaphyX™ and EsophyX™ procedures already performed globally. Despite the fact that both StomaphyX™ and EsophyX™ just obtained FDA clearance this year, over 50 U.S. centers have already been trained to perform these Natural Orifice Surgery (NOS) procedures and over 20 additional groups are scheduled to be trained in December.  Today, 3 training centers that have performed over 40 StomaphyX cases each and are starting to perform EsophyX cases are training surgeons in NOS technique. Courses are offered twice per month, with either academic or private setting options available. Current training centers include:          

• The Ohio State Medical Center in Columbus, Ohio
• Munroe Regional Health Systems in Ocala, Florida
• Mercy Medical Center in New York

Dr. Dean Mikami, Assistant Professor of Surgery at Ohio State University (OSU) who performed the first StomaphyX™ procedure in the U.S., started the first StomaphyX™ training center, and has trained the majority of surgeons states, “I have been very impressed with the performance of the StomaphyX™ device and the evolution of the procedure. Before StomaphyX, I had very few options to offer my patients. We have been performing a wide variety of procedures with StomaphyX and are able to address multiple medical conditions with one procedure. It is clear that transoral surgery is the way of the future and we are pleased to be leading this medical advancement.”  “It was clear to me from the moment I first saw StomaphyX that these incisionless procedures offer tremendous advantages” reports Dr. Todd Overcash, of the Florida Bariatric Center who is one of the original four surgeons trained in the U.S. and has personally performed over 60 StomaphyX and 10 EsophyX procedures. “With no scars, little recovery time, and significantly better safety, patients from all over the U.S. are contacting me seeking these procedures. Surgeons interested in developing their practice should not hesitate to adopt transoral surgical products.” Surgeons coming to the training course in Ocala can observe how both StomaphyX™ and EsophyX™ fit in a busy private practice and can observe the live procedures from state-of-the-art observation facilities. “This is the future of surgery and greatly reduces invasiveness and complications,” said Dr. Shawn Garber, Chief of Bariatric Surgery at Mercy Medical Center. “EndoGastric Solutions is leading the way with by far the most advanced instrumentation that moves us many leaps less invasive than laparoscopy, since it eliminates both internal and external incisions. Now we can offer patients the substantive anatomical change of surgery without even a scar. Patients can go back to work as early as the next day and no one can tell they have had a procedure.” Thierry Thaure, Chief Executive Officer of EndoGastric Solutions stated, “StomaphyX is a product that every surgeon doing Laparoscopic GI Surgery should have in their armamentarium. Interest in these products and procedures is tremendous and we now have 15-20 surgeons attending each training course. The technology is safe, easy to learn, and offers clinical benefits in solving the complications that can occur from surgery. We are enthusiastic that the strong response of our surgeons demonstrates that the surgical market is ready for Natural Orifice Surgery products such as StomaphyX™ and EsophyX™.” The Ohio State University Medical Center will be offering a Continuing Medical Education (CME) certified live case course on February 29th 2008 entitled Leap into the Future with Advances in Transoral Foregut Surgery that will highlight the EsophyX device, a live case TIF procedure, and StomaphyX procedures. Dr. Scott Melvin, Director of the Center for Minimally Invasive Surgery and chairman of the course says, “EsophyX has the potential to significantly change the treatment algorithm for reflux disease. EsophyX allows for earlier treatment because of the reduced procedural risk and offers the solution patients and physicians have been waiting for.” About EndoGastric Solutions   EndoGastric Solutions (EGS) is a privately held corporation located in Redmond, Washington and Redwood City, California. EGS is a pioneer in developing incisionless transoral procedures for the treatment of upper gastrointestinal diseases, including gastroesophageal reflux disease (GERD), obesity and other GI conditions. EsophyX and StomaphyX are cleared by the FDA, CE marked, and available for sale in the U.S. and Europe. For more information about EndoGastric Solutions, Inc., EsophyX™ and StomaphyX™, please visit: In the US: www.endogastricsolutions.com In the EU: www.egseurope.eu Other locations throughout the globe: www.egsglobal.net For more information about the Ohio State University Medical Center Leap into the Future with Advances in Transoral Foregut Surgery course please visit: www.cmis.ohio-state.edu Lisa Yeater 614-293-9072 [email protected] ***** Contact Information: Press Contact: Adrianna Tozzi 650-610-9250 x232 [email protected] U.S. Physician Contact: Larry K. Fulton Senior Director of U.S. Sales EndoGastric Solutions, Inc. [email protected] European Customer Contact: Karl Blohm General Manager, Europe [email protected] +33 6 7525 8382

EndoGastric Solutions Opens Three Training Centers to Keep Up with Demand from Surgeons Wanting to Learn StomaphyX™ Procedures Redmond Washington, December 14, 2007: Incisionless surgery is the most significant advancement in surgical medicine in decades. It is being rapidly adopted by a wide variety of academic and private hospitals around the world, with over 700 StomaphyX™ and EsophyX™ procedures already performed globally. Despite the fact that both StomaphyX™ and EsophyX™ just obtained FDA clearance this year, over 50 U.S. centers have already been trained to perform these Natural Orifice Surgery (NOS) procedures and over 20 additional groups are scheduled to be trained in December.  Today, 3 training centers that have performed over 40 StomaphyX cases each and are starting to perform EsophyX cases are training surgeons in NOS technique. Courses are offered twice per month, with either academic or private setting options available. Current training centers include:          

• The Ohio State Medical Center in Columbus, Ohio
• Munroe Regional Health Systems in Ocala, Florida
• Mercy Medical Center in New York

Dr. Dean Mikami, Assistant Professor of Surgery at Ohio State University (OSU) who performed the first StomaphyX™ procedure in the U.S., started the first StomaphyX™ training center, and has trained the majority of surgeons states, “I have been very impressed with the performance of the StomaphyX™ device and the evolution of the procedure. Before StomaphyX, I had very few options to offer my patients. We have been performing a wide variety of procedures with StomaphyX and are able to address multiple medical conditions with one procedure. It is clear that transoral surgery is the way of the future and we are pleased to be leading this medical advancement.”  “It was clear to me from the moment I first saw StomaphyX that these incisionless procedures offer tremendous advantages” reports Dr. Todd Overcash, of the Florida Bariatric Center who is one of the original four surgeons trained in the U.S. and has personally performed over 60 StomaphyX and 10 EsophyX procedures. “With no scars, little recovery time, and significantly better safety, patients from all over the U.S. are contacting me seeking these procedures. Surgeons interested in developing their practice should not hesitate to adopt transoral surgical products.” Surgeons coming to the training course in Ocala can observe how both StomaphyX™ and EsophyX™ fit in a busy private practice and can observe the live procedures from state-of-the-art observation facilities. “This is the future of surgery and greatly reduces invasiveness and complications,” said Dr. Shawn Garber, Chief of Bariatric Surgery at Mercy Medical Center. “EndoGastric Solutions is leading the way with by far the most advanced instrumentation that moves us many leaps less invasive than laparoscopy, since it eliminates both internal and external incisions. Now we can offer patients the substantive anatomical change of surgery without even a scar. Patients can go back to work as early as the next day and no one can tell they have had a procedure.” Thierry Thaure, Chief Executive Officer of EndoGastric Solutions stated, “StomaphyX is a product that every surgeon doing Laparoscopic GI Surgery should have in their armamentarium. Interest in these products and procedures is tremendous and we now have 15-20 surgeons attending each training course. The technology is safe, easy to learn, and offers clinical benefits in solving the complications that can occur from surgery. We are enthusiastic that the strong response of our surgeons demonstrates that the surgical market is ready for Natural Orifice Surgery products such as StomaphyX™ and EsophyX™.” The Ohio State University Medical Center will be offering a Continuing Medical Education (CME) certified live case course on February 29th 2008 entitled Leap into the Future with Advances in Transoral Foregut Surgery that will highlight the EsophyX device, a live case TIF procedure, and StomaphyX procedures. Dr. Scott Melvin, Director of the Center for Minimally Invasive Surgery and chairman of the course says, “EsophyX has the potential to significantly change the treatment algorithm for reflux disease. EsophyX allows for earlier treatment because of the reduced procedural risk and offers the solution patients and physicians have been waiting for.” About EndoGastric Solutions   EndoGastric Solutions (EGS) is a privately held corporation located in Redmond, Washington and Redwood City, California. EGS is a pioneer in developing incisionless transoral procedures for the treatment of upper gastrointestinal diseases, including gastroesophageal reflux disease (GERD), obesity and other GI conditions. EsophyX and StomaphyX are cleared by the FDA, CE marked, and available for sale in the U.S. and Europe. For more information about EndoGastric Solutions, Inc., EsophyX™ and StomaphyX™, please visit: In the US: www.endogastricsolutions.com In the EU: www.egseurope.eu Other locations throughout the globe: www.egsglobal.net For more information about the Ohio State University Medical Center Leap into the Future with Advances in Transoral Foregut Surgery course please visit: www.cmis.ohio-state.edu Lisa Yeater 614-293-9072 [email protected] ***** Contact Information: Press Contact: Adrianna Tozzi 650-610-9250 x232 [email protected] U.S. Physician Contact: Larry K. Fulton Senior Director of U.S. Sales EndoGastric Solutions, Inc. [email protected] European Customer Contact: Karl Blohm General Manager, Europe [email protected] +33 6 7525 8382

++++++++++++++++ http://www.bariatrictimes.com/displayArticle.cfm?articleID=a rticle207

Revisional Surgery Article: Bariatric Revisional Surgery - by Rodrigo Gonzalez, MD; Scott F. Gallagher, MD; and Michel M. Murr, MD, FACS

EVALUATION FOR WEIGHT LOSS FAILURE http://home.comcast.net/~muzicluvr777/Eval.htm

 DO I NEED A REVISION? What are your issues/ideas/thoughts on why insufficient wt loss or regain?

 

Solution/recommendations may be different depending on answers.... Three things may be happening independent or together:

ü      Broken Surgery (tool)

 

ü      Behavioral issues (not using tool)

 

ü      Wrong tool/surgery

 

 

 

1. BROKEN SURGERY:

    

1. WERE YOU Open or Lap?

    

2. Were you transected (pouch and distal unused stomach severed by staples and cut by space?) IF not maybe the issue is a staple line disruption/failure (AKA SLD)...food is going into the old tummy and no malabsorption is happening. Or a fistula ("A gastro-gastric fistula is simply a communication between the new "pouch" and the "old" stomach.)*Same as SLD your getting food into distal stomach and it avoids the bypass. Have you had an upper GI endoscopy? (Scope down throat) to see if pouch is intact and how large your stoma is (connection of pouch and intestines). Did a little more research on the Upper GI stuff....(scope vs xray with contrast) Upper GI endosopy can see at least 3x more pathology than upper GI radiographic series Upper GI contrast radiography can however best detect small gastro-gastric fistulas which can often be missed with an upper GI endoscopy. Also it can be extremely helpful to radiologically study the anatomic upper GI configuration of potential re-operative bariatric surgery candidates, as these films provide a "road-map" prior to operation which can be particularly valuable. An upper GI radiologic study often misses several 'culprits' responsible for wt regain after bariatric surgery such as: SLD (pouch reunion with stomach), partially or total eroded gastric ring or band, dilated stoma or enlarged gastric pouch. So both studies (scope and x-rays) are important in investigating bariatric surgical patients complaints of excessive wt regain. There are exceptions to every rule and it is preferable that each patient is evaluated independently, using sensible clinical judgment. So depends what is being sought/presenting problem as to what is done.From UPDATE: SURGERY FOR THE MORBIDLY OBESE PATIENT by: Mervyn Deitel ISBN 0-9684426-1-7 ©2000
3. Many have an enlarged stoma allowing them to eat larger quantities w/o feeling full, kind of like a chute. This is usually not patients or surgeons fault but many patients stomas relax on them...Some possible fixes:A lap band may help,or a surgical revision of stoma or a fixed silastic ring, but it isn’t always possible. Also many are using sclerotherapy and now stomaphyx http://www.stopobesityforlife.com/StomaphyX.html or http://www.endogastricsolutions.com http://www.ingentaconnect.com/content/fd/os/2003/00000013/00 000002/art00006 or http://www.drsimpson.com/chattranscript-08-13-2004.php for info. They say for this (inject substance thru upper GI scope into tissue to produce scarring) and there is a new procedure in Boston being done called: Endoscopic pouch repair. http://community.nursingspectrum.com/MagazineArticles/articl e.cfm?AID=14602

    

4. Do you get full? How much food? Have you done the cottage cheese test?  http://www.digitalhorsewoman.com/pouchrules.htm

    

 

 

2. BEHAVIORAL (not using tool to potential):I am not saying it is behavioral just asking a few questions:

    

1. What do you eat in a given day? Calories track on www.fitday.com % fat/protein/carbs.

    

2. Do you drink with meals?

    

3. Drink calories?

    

4. Soda?

    

5. Do you do protein shakes? (type/number)

    

6. Do you do vitamins? Which ones? Types/amounts/when do you take them?

    

7. When were your last full set of labs/Dexascan?

    

8. Do you exercise? How often? Amount? Type?

    

9. What other meds are you on? Medcial conditions?

    

10. Age, Height? Starting BMI Current BMI. (Basically looking for % of excess you lost)

     

11. Do you follow pouch rules? http://www.digitalhorsewoman.com/pouchrules.htm

     

 

 

We can eat more at ~6 months out (quantity/variety), it is also time malabsorbtion of calories decreases for many as body adapts. (intestines can elongate/grow more villi/folds to increase absorbtion)

 

 

 

OKAY the above questions are just to help us figure out some potential behavioral issues. Again I am NOT saying the failure of you or anyone is strictly behavioral. It is just one thing. Any surgery can be defeated if the tool isn't used, BUT if the tool is used reasonably it may be broke or may of been the wrong tool (surgery) for you! IF YOU DID NOT CHANGE YOUR LIFESTYLE THER IS NO TOOL THAT WILL WORK!

 

 

 

3        WRONG SURGERY: We do not always know this until after. Some surgeons realize the higher the BMI of the patient the more distal bypassed they should be. Or the type of eater someone is may lend itself to one surgery over another. Some fail to lose wt with a VBG or lap band only to lose well with a RNY or many with a proximal RNY fail to lose wt and do great with a distal RNY or others don’t do well with RNY and do fantastic with a BPD/DS...you get my point. One surgeon had this to say about choosing your surgery type for you. (*I am not sure there is any real one size fits all though on deciding!) http://www.alagsa.com/Bariatric_Surgery.htm Some surgeons do a very short 40CM bypass (not near long enough for most of us MO)! Get a copy of your surgical report from the hospital medical records so you KNOW what you have! It is yours according to law!

 

 

 

They say 50% of excess wt lost is a ‘successful surgery’. I agree *but why accept this? when others lose 75, 80, 90, 100%? I know everyone is different but if there are means to allow most to lost 80+ % why shouldn’t everyone have the opportunity? We all have to weigh the pros and cons. Going BPD/DS or more distal has risks, a lap band has risks etc. Many lose 80%+ and regain after 1, 2, 3,5 yrs. Not always behavioral or mechanical,,,,so their body is real good at adapting and hence they probably had wrong surgery....

 

 

 

I hope this helps some and doesn’t really confuse you. I have to add, I haven't had a revision. I am here learning with everyone "IN CASE" (I think education is key to success and all I can arm myself with!). It (regain) scares me too! I see/read/hear about wt regain more and more online and read more about revisions. WLS has come a long way, but maybe just maybe some day we'll get the right surgery the first time! One that we can behaviorally adapt to and use and that won’t break! ONE CAN DREAM! I think a good revision surgeon is key to lower risks, I wouldn't go to just anyone! And I know many on the group could help u with someone good! Dr Fox and Oh in Washington State.

 

http://www.aboutmso.com/pp/prospectivepatients.cfm

 

http://www.ohtobethin.com/

 

Dr. Gagner in NYC: http://www.cornellweightlosssurgery.org/

 

This is a great group http://groups.yahoo.com/group/WLSrevisionsupport/  of people who can definately lead u in the right direction! I also know OH has a different Revision Forum.

 

http://www.obesityhelp.com/forums/revision/ * you are here!*

Hello I, too, have gained back 90% of the weight that I lost after a 1999 RNY.  Does anyone have information about what doctors in Massachusetts are doing this procedure, the Stomaphyx?  How about any other type of 'revision' procedure? I would appreciate any help, and thank you.

I have been waiting for this surgery for some time.  My stoma is enlarged and i gained a lot of weight. Is there any more info out there about insurance covering it or is there anyone in MA or close by in CT. doing this?
thanks

Mehta Baraitric Center www.mehtaobesitycenter.com in NJ got my insurance to cover my StomaPhyx surgery. You can read about my surgery and get all kinds of information on StomaPhyx here http://survivingchubby.blogspot.com . Good luck!

If your insurance doesn't cover it, MBC charges $7000.