Has Anyone Ever Heard Of This????
I tried to find out where she got her info but got called a pest and then blocked. I am just curous because I have never heard of this before.
RNY can be done as a two step procedure.
When someone is a massive BMI doing bypass is far too dangerous so they typically do RNY in a two step procedure. They'll sleeve the person and after they have lost enough weight to safely to the rest of the surgery then they will go back in and do RNY.
But, if the doctor knows full well the patient does not want RNY and he is submitting it as a two step procedure it is fraud. Not that I object, I don't. I think it's stupid people have to do this to get a sleeve. But if you want to get technical, it's fraud. The ins covers RNY and not VSG, it's a way of getting around their requirements.
Whoever the doc is, good for him. But I hope it doesn't catch up to him. Ins co's do track these stats and if he's doing a two step procedure on X number of people and never going back to do the RNY insurance co's have been known to come back and bill the doctors and patients for the VSG that was never a covered benefit.
Usually, the two part procedure is only done on people with BMIs over 60...and in general, the DS is a much more effective surgery for those patients. However, if there was a Doc who only did RNYs, he may do a staged RNY on a 60+ BMI patient. In the past, they've often done Band on those patients and then gone ahead and done the RNY. I think some of those surgeons who did Bands, may be doing sleeves today.
Lap-Band June 14, 2001. Dr. Rumbaut, Monterrey, Mexico.
Lap-Band removed after 7 years and converted to Sleeve Gastrectomy on July 7, 2008 by Dr. Roslin. I've had three happy healthy Lap-Band babies.... and one VSG baby. 5 years out from revision to VSG. Gained 55 pounds in past 5 months, now considering DS. :(
Usually, the two part procedure is only done on people with BMIs over 60...and in general, the DS is a much more effective surgery for those patients. However, if there was a Doc who only did RNYs, he may do a staged RNY on a 60+ BMI patient. In the past, they've often done Band on those patients and then gone ahead and done the RNY. I think some of those surgeons who did Bands, may be doing sleeves today.
My issue was with her saying the RNY was done in 2 stages with the sleeve being the first stage. I do not think the sleeve is done as the first part of the RNY and I also have not heard of the RNY typically being done in 2 stages in the same way the DS is.
Here's one journal article on it...
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Obes Surg. 2008 Dec;18(12):1575-80. Epub 2008 May 28.
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Staged laparoscopic sleeve gastrectomy followed by Roux-en-Y gastric bypass for morbidly obese patients: a risk reduction strategy.
Ou Yang O, Loi K, Liew V, Talbot M, Jorgensen J.Upper GI, Advanced Laparoscopic and Bariatric Surgery, St George Private Hospital, Sydney, Australia. [email protected]
BACKGROUND: In our centre laparoscopic Roux-en-Y gastric bypass (LRYGBP) is the most effective weight loss surgical procedure performed. However, LRYGBP may be associated with higher risk of peri- and postoperative complications in contrast to a purely restrictive procedure to justify this procedure on all comers. Laparoscopic sleeve gastrectomy (LSG) as a staged procedure may be an alternate risk reduction strategy. The aim of this study is to report on the short-term outcomes of LSG, the effect on operative risk reduction and resolution of comorbidities. METHODS: A prospective review of 138 patients who underwent consecutive LSG from November 2004 to November 2006 was performed. Data were collected on all patients who attended the three to six monthly clinical follow-up and/or the patient questionnaire. Data collection included demographics, degree of weight reduction, postoperative complications, and changes in comorbidities. RESULTS: Median BMI was 50.60 kg/m(2) (33-82). Of the patients, 46.38% had a BMI >or=50 kg/m(2). The overall median postoperative excess weight loss (EWL) was 43.26%, 31.08% at 6 months, 54.50% at 12 months, 51.47% at 18 months and 46.05% at 24 months. Of the patients, 39% had resolution of type 2 diabetes mellitus, 48% had resolution of dyslipidemia, 29% in hypertension, 52% in obstructive sleep apnea. Complication rate was 5.07% and four patients needed further surgical intervention. The mortality rate was zero. CONCLUSION: LSG does minimize postoperative complication rates significantly on high-risk patients and achieves effective short-term weight loss with resolutions in comorbidities. Additional studies are required to evaluate LSG as a stand-lone procedure.
Lap-Band June 14, 2001. Dr. Rumbaut, Monterrey, Mexico.
Lap-Band removed after 7 years and converted to Sleeve Gastrectomy on July 7, 2008 by Dr. Roslin. I've had three happy healthy Lap-Band babies.... and one VSG baby. 5 years out from revision to VSG. Gained 55 pounds in past 5 months, now considering DS. :(
Lap-Band June 14, 2001. Dr. Rumbaut, Monterrey, Mexico.
Lap-Band removed after 7 years and converted to Sleeve Gastrectomy on July 7, 2008 by Dr. Roslin. I've had three happy healthy Lap-Band babies.... and one VSG baby. 5 years out from revision to VSG. Gained 55 pounds in past 5 months, now considering DS. :(
