Filters..

What determines whether a patient who is going to have RNY will/will not get a filter placed within? Are the filters inserted and always still in you? The reason I ask is... when I told surgeon #1 I had a couple venous stasis/leg ulcers in the past(due sto excessive weight in my legs and lack of exercise), that she may insert one in me...when I told surgeon #2(who will be doing my surgery) he did't mention inserting one. I will be sure to ask him if he feels that I should have one when I get my second appt and get my surgery date...   I was just wondering if someone out there may help clear up my confusion as to why certain people have them inserted and why certain people don't...

Rhino, I had spoken to my first vascular surgeon that my Primary Care Physician sent me to about the filter. He actually was the one that brought it up to me, and that I should consider having one placed to prevent any blood clots if present that dislodged from traveling to my heart or lungs. It's about two inches long and looks like some kind of sci-fi fishing lure. When I had my consultation with my surgeon, I had talked with him about the filter, and the fact that the vascular doc had me wearing compression stockings due to the swelling in my lower extremities. Mainly my KANKLES, or now lack there of. I consulted with my surgeons vascular specialist from his team and he concurred that it would be in my best onterest to have one placed. No it's not permanent. My was inserted through the groin area, up into the vein with a catheter on May 21. I just had mine taken back out on July 2. It comes out through the neck, outta your jugular vein. In and out procedure for the retrieval. The insertion I stayed over night since I was scheduled to have my gastric bypass on May 22. Didn't happen till May 29. Doc got sick during a procedure and had to cancel, so I had to wait another week. No biggie. I've already lost 50+ lbs. If you have a second surgeon, and severe to moderate swelling in your legs you might want to have the filter placed. It's worth it since your doing this I would assume to get back into a healthier lifestyle. No sense having complications from a blood clot. Good luck on your journey.

My surgeon has told me I am going to have to have a screen placed before my surgery. I have had blood clots in my legs after a previous surgery. Better to be safe and cut the risk of complications down.

I'd get a second opinion on the Greenfield filter idea ..   although if your WLS surgeon is determined to use one, she probably will anyway (liability issues, otherwise) ..     Kinda odd though to use one just for VS ulcers ..  that doesn't necessarily mean that you have a clotting disorder, per se ..  It just means you have sluggish circulation in that area, although that does increase the risk for clots (as does MO itself, post op).   I had some VS ulcers pre-op and never had a clotting problem and my surgeon didn't even mention considering using a "Green screen" ..   I'd get tested for DVT (deep vein thrombosis) before your surgery, if you aren't going to be already, which makes it much more likely you could develop dangerous clots post-op.   The reason I suggest a second opinion is based on something a pair of local VBG and RNY surgeons told us a few years ago at one of their informational semnars ..  Someone in our group asked them near the end of their presentation whether they use the filters during WLS ..   The one surgeon replied that they did not, and, surprisingly and ironically, for the reason that the mere placement and/ or removal of the filter (yes, they are put in during the procedure and taken out later) into the blood vessel in their opinion can sometimes in and of itself trigger dangerous blood clots.  Apparently they felt the risks of doing that outweighed the dange of clots occuring w/o it.  WLS surgeons always give you a series of heprin injections after WLS anyway (or should!) to prevent post-op clot formation.   Quite often they also use the Venadyne "stockings" during surgery and during recovery in the hospital to also prevent such formation in the lower limbs.   

The second surgeon asked me if I ever had a clot and I have not, maybe that is why he didn't mention a filter...I wear compression stockings now. The last time I had an issue was like 2005 and after getting it corrected it was that doctor that stated that I should wear compression stockings and got fitted for them. I am hoping that after a significant weight loss that I will not have to wear them any longer... But again to give me a peace of mind...I will be sure to bring the topic up again when I meet with him to get my surgery date! 

My surgeon recommended that both me and my wife have the filters installed.  They told us that when they put the filters in, they are considered permenant.  They have not mentioned anything about taking the filters out.  They said you shouldn't notice anything after the filters are inserted.  I'm having no problems with my filter.  I consider it added protection if I were to somehow develop a clot somewhere down the road.

I've had my filter for almost two years and have had no problems with mine

My surgeon routinely places a vena-cava filter in his patients Who have a BMI of 50 or higher, One week before surgery. He made an exception with me Because I’m on Coumadin for a previous Heart Valve replacement. Several of the folks in my support group Have theirs still at 5 years+ out. Apparently, there is a type that is “left in.” They do greatly reduce the risk of issues Resulting from blood clots. If your doc decides for or against, Do ask “Why?” And pass on what you learned… Yes? Best Wishes- Dx

Not sure exactly what my BMI was but is was a lot more than 50! I was 740 pounds at surgery date,  and my Dr. wanted me to have a Greenfield filter due to my size alone. I never had any problems with clots before or after!