New w/ revision questions.

Hi....I had RNY on 12/19/06.  My stats are noted below in my signature...if it shows on this board. My lowest wt after WLS was 159.  I have now gained 20 pounds and it seems like no matter what I do the scale keeps climbing.  I have not lost any weight since my 6 month post op appointment.  I was at 252 when I started the WLS process at my first nutrition appointment.  I have lost a total of 73 pounds during the first 6 months post op, and the scale is going the wrong way. I'm wondering who has had a RNY revision to a DS??  If it was successful?  What is my first step in researching this?  Did you go to your original bariatric surgeon?  How long was it before the original and the revision?  How did you approach it from an insurance standpoint?

If you haven't already, you may want to post this on the DS board. I know there are a few on there who have had it done.

Usually a surgeon will not convert a RNYGB into a BPD-DS, claiming that you will have the worst of both worlds. Thinking that you'll get the best of both.  YOu could do a few things, get a UGI w/ SBFT, then possibly an EGD. Maybe you just need to have your pouch tightened and your limb lengthened. Or even better a band over bypass.  Make sure you keep all your LM appointments though, you will always need to make sure you haven't fallen back into old habits! Steff

A highly skilled surgeon CAN usually convert a RNY to the DS. There are more and more of these conversions taking  place and the number will continue to rise.

My problem with gettin a revision is that my insurance has an exclusion for weightloss surgery ...they did tell me that if it were coded for something other than for Obesity or weightloss ...it could be covered as medical neccessity ....but really dont thing a surgeon would code it like that ....right now I am gettin ready to have the ROSE procedure that is in Clinical Trial ....that will be the 23rd of this month ..... if for some reason this doesnt work then I will have to persue other ways of gettin my weight taken care of  Cheryl

What is the ROSE procedure? Jules

They use endoscopic equipment and go into the pouch and make it and the stoma the size it was when you first have your RNY ...its for RNY patients

Paula, the only surgeons in Mn doing the DS are at the U...(I think, but am fairly certain). the first steps to a revision are an endoscopy and upper GI to see if anything is wrong with your surgery. Your stoma might be enlarged, you might have a fistula etc. Insurance - it can be as simple (or as difficult) as having a look at your summary plan description or calling your customer service number and see if revisions are covered and under what cir****tances.  My insurance required me to be at least 2 years post op, have regular follow-up with a bariatric program, a few other things too, then I needed a psych eval, and  some have the same requirements as if it were a first surgery - BMI of 40, etc....BMI35+ with co-morbs etc....my new surgeon also made me do medical weight management.  The process took me about a year.  I am sure it's alot quicker for most people. good luck!

I had a RNY to DS revision in SF with Dr. Husted and Dr. R Rabkins.  It's an extremely complex surgery, but the best chance to get to goal and not regaining.

http://www.obesityhelp.com/forums/DS/a,messageboard/board_id ,5357/

I had the UGI and endoscopy when I had my consult with Dr. Husted.  One look and he told me he could help me because I had mechanical failure of my RNY.  Of course, I met all the criteria of 40 plus BMI with comorbids by the time I was able to have this consult, so don't know what criteria your insurance will require.  But, if I were you, I'd call them and ask if revisions are covered and what are their requirements.

edited to add:

Henry Buchwald, MD, PhD
E-mail: [email protected]
Phone: 612-625-8413
Fax: 612-625-3206
420 Delaware Street S.E., MMC 290
Minneapolis, MN 55455
Dr, Buchwald’s bio
http://www.uofmmedicalcenter.org/weight

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Paula - FYI Ikramuddin and  Kellogg do DS surgeries, but of course have no where near as much experience as Buchwald.  They do Lap.  Buchwald only does open.  Experience matters.  lap vs open matters to some people too good luck, feel free to PM me any time Paula