Which revision is right for you?
mew6495
on 1/1/09 11:33 pm - MI
on 1/1/09 11:33 pm - MI
Hello Shawna,
I also had RNY in 2001. My revision was done Oct 2008. I would suggest working with your surgeon to determine what surgery would be best for you. But also understand what you personally want and can live with. Make the decision with your doctor as a "team" rather then just assuming he knows what is best for you. Each type of revision has its own set of good and bad points about it. Make sure your doctor understands the pros and cons of your choices and preferably has experience in more then one type of revision.
I chose the ERNY because 1st I did not want the complications that came with the band over RNY, fills, unfills, slippage etc. I considered the DS but I did not want to deal with the higher risk factor associated with the take down and the reconstruction of the pouch and stomach portion of it. But I liked the long term results that were currently being posted with the DS. If this were my original wls I would have probably went with that. So I opted for the ERNY where the doctors gave me a shorter intestinal common channel. This part of my wls is the same as the DS and in some cases my CC is a bit shorter. I just don't have the upper portion of the DS.
It's a tough decision. Only you can decide what you can live with and what you are most likely to stay compliant with.
Good luck.
I also had RNY in 2001. My revision was done Oct 2008. I would suggest working with your surgeon to determine what surgery would be best for you. But also understand what you personally want and can live with. Make the decision with your doctor as a "team" rather then just assuming he knows what is best for you. Each type of revision has its own set of good and bad points about it. Make sure your doctor understands the pros and cons of your choices and preferably has experience in more then one type of revision.
I chose the ERNY because 1st I did not want the complications that came with the band over RNY, fills, unfills, slippage etc. I considered the DS but I did not want to deal with the higher risk factor associated with the take down and the reconstruction of the pouch and stomach portion of it. But I liked the long term results that were currently being posted with the DS. If this were my original wls I would have probably went with that. So I opted for the ERNY where the doctors gave me a shorter intestinal common channel. This part of my wls is the same as the DS and in some cases my CC is a bit shorter. I just don't have the upper portion of the DS.
It's a tough decision. Only you can decide what you can live with and what you are most likely to stay compliant with.
Good luck.
I second what Mew said - talk to a good revision surgeon and see what they say. Talk to two or three even, until you get bored with the whole thing! Oh and slam the door on any surgeon who says its your fault. Post on the RNY and DS boards for revisioners - not all of them post on this forum, and it someone else's experience might 'click' with you.
DS revision from failed lapband
I think you have to decide what you can live with - each have their own + and - Also check with your insurance and see what's covered and what your surgeon does....Is the surgeon you are interested in experienced in revisions? how many RNY to DS or RNY to Distal RNY etc has he done.
In tandem, I looked at my insurance and worked out what was covered and what wasn't and how their appeals process worked and talked to 3 surgeons and what they would do for me. One was a total
, so I had many conversations with the other 2 and with my DH made a decision. I wanted a revision to a DS but it wasn't to be.
In tandem, I looked at my insurance and worked out what was covered and what wasn't and how their appeals process worked and talked to 3 surgeons and what they would do for me. One was a total
, so I had many conversations with the other 2 and with my DH made a decision. I wanted a revision to a DS but it wasn't to be. 2003 RNY, 2007 Revision Distal RNY
April 17, 2009 ~ fleur de lis TT w/Muscle Repair, Medial Thigh Lift, Ventral Hernia Repair
(deactivated member)
on 1/3/09 9:05 pm
on 1/3/09 9:05 pm
I'm very interested in the DS, but while looking into my insurance, I cant find that is says it covers or doesnt cover the DS, it lists several others as covered or not covered, but not the DS. Is it called something else?
Thanks for your input...I am sure I still have a long journey, but I am trying to get as much info as possible, I want this WLS to work for life this time around.
Thanks for your input...I am sure I still have a long journey, but I am trying to get as much info as possible, I want this WLS to work for life this time around.
Firstly, I applaud your interest in the DS. Smart girl!! 
The nomenclature can very some. The short version I've seen most often referred to is BPD/DS ( Biliopancreatic Diversion/ Duodenal Switch) NOT to be confused with the OLD BPD procedure which was severely problematical and almost never done any longer. This is precisely why BPD should no longer be attached the naming of the DS since insurance companies often use the old procudure and the morbidities attached as a reason to try and deny the DS.
I’ve sometimes also seen it referred to as Biliopancreatic Diversion with a Partial or Subtotal Sleeve Gastrectomy. Again, not to be confused with the stand alone VSG or Vertical Sleeve Gastrectomy which is restrictive only and to wit has not been blessed with the long-term studies to prove it's efficacy. Indeed, there are a fair number of VSG'rs over on the DS board seeking revisions to a full DS after inadequate weight loss and/or significant weight regain.This is unfortunate because to a degree these patients lose out somewhat on the wonderful synergistic metabolic dynamics of having the full DS done at the same time can achieve. Revisions can be a bit harder to get approved, not to mention the additional risks revisions present.
It might be enormously helpful if you posted what procedures your insurance company approves in their WRITTEN RECORD and what procedures in that same policy do they deny and the reasons given why... Often citing their nonapproved procedures as being "Experimental or Investigational" which is easily refuted with the data and studies existing today.
Rockne
The nomenclature can very some. The short version I've seen most often referred to is BPD/DS ( Biliopancreatic Diversion/ Duodenal Switch) NOT to be confused with the OLD BPD procedure which was severely problematical and almost never done any longer. This is precisely why BPD should no longer be attached the naming of the DS since insurance companies often use the old procudure and the morbidities attached as a reason to try and deny the DS.
I’ve sometimes also seen it referred to as Biliopancreatic Diversion with a Partial or Subtotal Sleeve Gastrectomy. Again, not to be confused with the stand alone VSG or Vertical Sleeve Gastrectomy which is restrictive only and to wit has not been blessed with the long-term studies to prove it's efficacy. Indeed, there are a fair number of VSG'rs over on the DS board seeking revisions to a full DS after inadequate weight loss and/or significant weight regain.This is unfortunate because to a degree these patients lose out somewhat on the wonderful synergistic metabolic dynamics of having the full DS done at the same time can achieve. Revisions can be a bit harder to get approved, not to mention the additional risks revisions present.
It might be enormously helpful if you posted what procedures your insurance company approves in their WRITTEN RECORD and what procedures in that same policy do they deny and the reasons given why... Often citing their nonapproved procedures as being "Experimental or Investigational" which is easily refuted with the data and studies existing today.
Rockne
(deactivated member)
on 1/4/09 4:09 am
on 1/4/09 4:09 am
OK,so the 2 yr old won for a while, but the laundry has yet to be touched...something tells me it'll still be there waiting on me tomorrow too!
Ok, so my insurance website states that the BPD/DS is one of the covered surgeries, of course, I have no clue if *My* policy covers it or not. Also, being a revision, I guess I have to just wait to see what the test results are. Anyone know what the cost of a self pay revision to DS would be? I read somewhere around $25K...sound right?
Ok, so my insurance website states that the BPD/DS is one of the covered surgeries, of course, I have no clue if *My* policy covers it or not. Also, being a revision, I guess I have to just wait to see what the test results are. Anyone know what the cost of a self pay revision to DS would be? I read somewhere around $25K...sound right?
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