revisions surgery and kaiser
People typically report that they lose weight on the post op diet, about 20# and then they go on to gain it all back as soon as they start solids.
If the goal is to lose weight and it doesn't help them lose weight, it stands to reason that it doesn't work.
"Gastric leaks represent serious complications of bariatric surgery. With the increasing popularity and performance of bariatric procedures, the incidence of leaks and associated complications are expected to increase. Minimally invasive natural orifice surgery represents a novel and promising approach to gastric leak management, especially for morbidly obese patients who are at much higher risk from open or laparoscopic surgical procedures. The present article reports two cases of the safe and successful use of the EndoGastric Solutions StomaphyX™ device to alter the flow of gastric contents and repair gastric leaks resulting from bariatric revision surgery. Both patients were at a high risk and could not undergo another open or laparoscopic surgery to correct the leaks that were not healing. The StomaphyX procedures lasted approximately 30 min, were performed without any complications, and resulted in the resolution of the gastric leaks in both patients."
Bariatrics Munroe Regional Medical Center, Suite 603, 150 S.E. 17th st, Ocala, FL 34471 USA
I would just be a little more educated before you start stating that procedure or devices "don't work." I know many people who have benefited from the StomaphyX device. Just my opinion...
"Gastric leaks represent serious complications of bariatric surgery. With the increasing popularity and performance of bariatric procedures, the incidence of leaks and associated complications are expected to increase. Minimally invasive natural orifice surgery represents a novel and promising approach to gastric leak management, especially for morbidly obese patients who are at much higher risk from open or laparoscopic surgical procedures. The present article reports two cases of the safe and successful use of the EndoGastric Solutions StomaphyX™ device to alter the flow of gastric contents and repair gastric leaks resulting from bariatric revision surgery. Both patients were at a high risk and could not undergo another open or laparoscopic surgery to correct the leaks that were not healing. The StomaphyX procedures lasted approximately 30 min, were performed without any complications, and resulted in the resolution of the gastric leaks in both patients."
Bariatrics Munroe Regional Medical Center, Suite 603, 150 S.E. 17th st, Ocala, FL 34471 USA
I would just be a little more educated before you start stating that procedure or devices "don't work." I know many people who have benefited from the StomaphyX device. Just my opinion...
You have a right to your opinion just as others have a right to theirs.
People are not just getting stomaphyx to prevent weight gain, they are getting it for weight loss and that is not proving successful. It isn't even advertised as a great tool, it's advertised as a short term weight loss method in motivated people. If it is so great why is it considered a short term weight loss method? If it actually worked and did reduce pouch size people would be losing weight. They aren't. Many are gaining.
The fasteners they are using do not appear to be holding well at all. Perhaps this is why the "better" doctors are not doing this procedure. It's wasting the patient's money and performing a procedure that simply "does not work" is unethical at best on the part of the doctor.
We'll see...again, for a certain patient population, this device is the only one of its kind. Wait another year or two and then you'll see. This is an early generation of the device and it is improving as well as surgeon technique.
Perhaps they can improve on it, lord knows it needs help since it is not working. Currently it's just taking money out of the patient's pocket and putting it in the surgeon's pocket and no true results are being seen.
Look at the lap band. They have been trying for 40 years to make that one work and over time all it has done is fail and cause misery for a great number of people. There comes a time where you just have to move on and realize a given idea does not work.
To do this procedure currently on a patient and charge around $10K for it knowing results will be poor... the value of this is what? So you can tell them thay future generations of this product *might* be better? Are you serious?
Why not poll people here and on every revision board you can find and see for yourself just how well Stomaphyx works. Then come back and tell us how great it is.
BTW, are you a patient? A doctor? Have you had GB? Have you had stomaphyx?
MWG:
You took the words right out of my mouth, I was getting ready to type this as I was reading your post here about the fasteners.
They are plastic, and they break, pull out, are not heavy duty, when you are dealing with people who, duh? overeat and duh? have been unsuccessful with one surgery already. You better get fasteners made out of surgical steel. Or do they make them out of plastic so a patient will come back and do it again? Makes you wonder.
My Surgeon has basically stopped doing this procedure as he admits even though he has taken a more aggressive approach to the pleating process, even that is not real successful.
I think if you take a group of patients and throw them into a high protein liquid, 1000 cal per day diet. They are all going to lose weight. But as you said, as soon as you go off the liquid protein...the weight comes back on, the stoma, pouch streches again, and the fasteners break...
I'm with you MWG....Poll several on this board...I've only seen one person on here so far that sung praises for the Stomaphyx....I've seen a few more who were happy with Sclerotherapy....and I don't think I've seen anyone happy with the Rose...
Glad I saved my $8,000 out of pocket I was going to spend 1.5 years ago when they were only taking about 4 pleats instead of 4-6 rows of pleats. I would have been pretty ticked off to have blown that much dough....
Sorry FSU....that's my story and I'm sticking to it....I do believe you though when they say better things are coming in the next few years...I believe I'll wait those years out until they get it perfected and I see at least 50 lb maintained loss for over 5 years. Especially when insurance for the most part doesn't cover yet.
JRolfson
Dear Guerita:
I think MWG covered the options very well...
There is Vergito a new procedure Dr. Husted is doing haven't seen any results on that yet but he did tell me he was revising some RNY'ers to it.
Sclerotherapy is endoscopic means of actually scarring the stoma and creating a smaller opening. I have heard of a few people on here who have had minimal success with it. It is a lower risk procedure although I just read on another post a few minutes ago of someone who had that and had a bunch a problems. But I believe you take risks on any type of revision...you don't ever know for sure....we all differ and have different risk factors.
If we can be of any additional help, feel free to PM anytime.
Good Luck,
Janie
Perhaps my post to her might have some utility for you. It reads as follows:
Your post here really saddens me greatly. Sheesh, girl, please don’t be so dismissive of possible and likely options before you. I GET THE DESPERATION for a fix. It's bad enough we all fail with dieting all are lives only to seek a surgical remedy to have that fail, too. What appeals process might be available to you within the confines of your insurance policy and/ or through the state via oversight in regards to external appeals?
Your post below alludes to a number of bandsters you know personally, who, like you- are struggling and you state they all are still quite overweight. The very best (ultraconservative peer reviewed studies) puts the band at a 25% failure rate defined as losing less than 50% of your excess body weight. Yeah, you read that right- Losing a mere 50% or more of your excess body weight is the DEFINED STANDARD AS A WLS SUCCESS STORY. Well, not in my playbook, deary! And I would argue those same (ultraconservative peer reviewed studies) putting the RNY failure rate at 20 % doesn’t fair much better. Fully one in five having the RNY out long-term will fail to achieve the diminimus of losing ONLY HALF THEIR EXCESS BODY WEIGHT. Truly HONEST practicing RNY surgeons and their staff privately tell me fully a 3rd of their patients fail to meet the 50% test out longer-term to rate a success. And said RNY procedure DEMANDS you diet for life. Yes, DIET FOR LIFE limiting your carb and fat intake.
So, I ask you Ca-girl, how has DIETING worked out for "you" to date?
But, hey- don't take my word for it. Ever been to an OH convention or just a RNY support group??? Look at the long-termers attending in lager sample groups. Nearly all the ones I have come across are still quite OBESE.
Back to my point at hand. I had the DS to kiss the DIETING concept sayonara forever. I eat normally, albeit, smaller meals without any fear of anything but expected marginal regain. 5 to 7 lbs., Indeed, it's still hard for me to believe life can be this easy. A big Mac and fries are hardly off limits, nor, are rich deserts within reason now and then, but frankly, I'm still easily satiated with any of my choices. And therein lies my REAL POINT. Choices and a full universe of foods are not OFF limits for me anymore. Dumping as a control too should you are so blessed is simply medieval in my opinion.
Clearly your a light-weight now by virtue of your posted BMI and maybe a VSG might well be appropriate. But the private -not yet published small sample stats on this procedure out longer term ( what little we see still at this EARLY date) are not boding as well as I would hope, but at least with this procedure a conversion to a DS by an experienced DS surgeon is much more easily doable baring some unusual sequella you might present with. RNY to DS revisions, however, are vastly MORE complex and FAR riskier.
Your at a precipice here.
Understandable desperation aside to run to a fix, any fix afforded you easily; this is ultimately YOUR decision and should be a well considered and a thoughtful one. You sure don't want to be in the same place 4 or 5 years out asking in the SAME sort of desperation for yett ANOTHER surgical alternative.
As my DS compadres and renegades like to say...
"Think twice and cut once!"
Rock
Kaiser will almost certainly not tell you ANYTHING about the duodenal switch (DS) as a revision option, and even if by chance they do, they will tell you it is a terrible surgery and Kaiser doesn't cover it. They LIE.
Kaiser can be forced to cover a revision to a DS -- come over to the DS forum and learn how. There are people who will walk you through the complex and frustrating process, but you CAN have the DS if you want it.
You have NO IDEA how fortunate you are to live in California, where the CA Dept. of Managed Health Care will FORCE Kaiser to cover the DS if that's what you want. NorCal Kaiser even has a contract with Dr. Rabkin (paclap.com), one of, if not THE most skilled DS and DS revision surgeons in the world, because they CONSISTENTLY lose when Kaiser patients appeal denials of requests for the DS. But they won't tell you about that until you win your appeal.
