Stomaphyx is considered expiemental by insurance

HI, I have had RNY 10/2000 and just started gaining weight after giving birth to my first child in 2004. I went to Dr. Holover to get info on the Stomaphyx procedure and was ecxited about it until his office informed me to try back in 3 months because my insurance HIP is not approving it and is calling it experimental. I got disappointed and when I read some of the post here today about stomaphyx it did not look promising at all soI would like to know if anyone has had lap band as a revision procedure done.  Thanks

Hi there- Keep in mind that hundreds of people have had stomaphyx or a procedure similar to it all over the country.  We only have feedback here from a handful of people, some negative, some positive, some right in the middle.  We really don't have much information about whether it works or not for the majority....yet...gosh I'm hoping for some data soon.   As far as adding the lapband to the pouch-I looked into this and found a surgeon that would do it, but first, my insurance won't cover a revision unless it mechanically failed (staple line disrupture, fistula, etc).  My policy specifically states that it won't pay for a revision due to stoma dilation.  Secondly, an upper GI and an endoscopy confirmed that my pouch was normal but my stoma was over 3cm wide.  My pouch empties very rapidly and I can eat a considerable amount before feeling full and then I'm hungry again 2 hours later.  .  This is why I volunteered to be in a clinical trial that will do something very similar as stomaphyx in that the device goes down endoscopically but it only reduces the size of the stoma.  I'm having this procedure done on Nov 6 and I fully expect not  to magically drop pounds as with my first surgery.  I am committed to exercising and eating "right" and having this tool help me.  God give me strength!!   Best of luck with whatever you decide to do.  I know people here have posted about having had a lapband added to the pouch and many of them are having success.    If you scroll down this board in prior posts I know that there have been a few recently who have posted. 

Is that the procedure? 

Nobody has put a brand name on it for me but here is the link for the clinical trial.  I'm having it done at the Cleveland Clinic.  http://clinicaltrials.gov/ct/show/NCT00394212?order=1

Intersting, do they charge you to be in the trial? It looks like they are calling it RESTORe, it seems close to the one that endogastric solutions is offering, but I am not sure of the difference.  endogastricsolutions.com   This is what it said on the clinical trial site. Official Title: Randomized Evaluation of Endoscopic Suturing Transorally for Anastomotic Outlet Reduction (RESTORe) for Patients With Inadequate Weight Loss Following Roux-en-Y Gastric Bypass Surgery

No you do not get charged for anything-in fact-after the procedure they pay YOU when you come back for each appt...I forget how many times (maybe 3 or 4 in 6 months) and you either get $60 or $80 each time you come in.  At the end I think you get $250.  Anyone reading this, please don't quote me on it-I'm going on memory here.   They ask you a bunch of questions to make sure you qualify and you have to have an upper endoscopy so they can determine if your stoma is dilated enough.  The only catch here is because it's a TRIAL, there are people who will not actually have this procedure-they're like a placebo.  Everyone goes under anesthesia and will be scoped but you won't know until the end of 6 months if you actually had the procedure.  One in 3 people will not actually have the procedure.  At the end of 6 months they will tell you if you did or did not get sutured.  If you did NOT have it done then they will give you the option of having it done for free.   I think there are a lot of companies out there producing similar types of equipment that are designed to perform similar outcomes.  They all need the clinical trial backings to get their product out there.   I'm just hoping this will help me get back on track, if not now then in 6 months-lol.  Since insurance paying is not an option for any revision for me and I really cannot afford to pay out of pocket for stomaphyx, I'm going to try this route.  They're doing this at 12 different hospitals across the country-the Cleveland Clinic is just one of them. I just got a phone call earlier today confirming that my preops are Oct 31 and my surgery is Nov 6. 

My mom too had her original RNY in 1998.  She proceded to gain 100 lbs back and looked into the stomaphyx with Dr. Garber.  She was also told it was not covered by insurance.  she then met with Dr. Overcash in Ocala, Florida and he said that he does a revision and as part of that revision he does the stomaphyx procedure.  This revision WAS covered by insurance, she had the revision/stomaphyx done in August!  Feel free to ask me any questions...hope I can help!

Hi.  I'm doing research on my revision and your Moms experience sounds promising. Do you have an email for this doctor in Flordia? Thanks,  Gail

Thanks for the information, I feel that the doctor's office of Dr. Holover and Dr. Garber do not really want to go through the hassle of getting people approved so they immediately just say know.  They just want you to pay out of pocket. They are not really into it for the health of the patients but for the dollars it brings in. This is sad and this is also why I am exploring other ways with other docotrs. Unfortunately for me the longer I wait the more I gain. I exercise at least 4 times a week and it is just not enough and it does not really heLp with the satiety issue I am going thoruhg. Thanks Again

My mother was very happy with Dr. Overcash and yes, he does believe that the Stomaphyx is not enough.  He told my mon  that the original RNY's did not bypass enough intestine and this is a problem.  His office was very helpful in getting her insurance done.  Here is the link to the site  http://www.floridabariatriccenter.org/.  I hope this helps.  My mom called to find out information and Dr. Overcash came to the phone.  He is very knowledgable.