2 revision surgery's-is this possible?

I had RNY about 7 years ago, lost about 80# and put it all plus some back on.  Last year I had a revision to the intestinal portion of the DS.  My stomach was never re-operated on so I have a hard time getting full and/or satisfied.  My doctor thought this surgery would be a good option for me and for the most part it has.  I have lost about 70# in almost a year which is slow but I knew it would be being a revision.  I have now not lost anything for about 4 months and I am sure it is mostly because I eat a lot of food because of the lack of feeling full/satisfied.  I really wish I would have pushed for my pouch to be made into a sleeve like the full DS but I didn't.  Now I am wondering if it is possible, surgically and insurance wise to have the pouch redone.  I am not sure if my insurance will pay for a 3rd WLS.  Any thoughts from anyone?

Thanks,
 Lori

Unfortunately yes. I think it will become more and more common as the surgeries improve and more people have WLS. The few that I have known have gone from VGB or Band to RNY to DS or ERNY. Of course, with each revision... the risks of surgery are increased; so, doctors are reluctant to perform them unless there is a clear mechanical failure of the surgery or prevalent medical issues.

As for insurance coverage, it depends too. There are different diagnosis codes for different medical conditions. And different procedure codes for different surgery types. For example, a few years ago (I'm not sure if this is still the case) a person with severe reflux (who may not even be overweight at all) may need a partial gastrectomy or Roux-en-Y to address the reflux. An insurance company may have an "exclusion" on weight loss surgery however, the procedure (gastrectomy or RNY) wasn't excluded IF that procedure was also commonly used to treat the particular diagnosis (in this case reflux).

In my case, I had a Molina band in 1997. The band "eroded" and had to be removed. So, the diagnosis was not Morbid Obesity it was band erosion. Then the insurance company looks at the appropriate  treatment for the diagnosis. The appropriate treatment for band erosion was band removal (NOT RNY). So, I had to meet the additional criteria for WLS established by the insurance company which I did so they were able to remove the band and convert to RNY. Some insurance companies also have one per lifetime exclusions. I definitely can't decipher the insureance industry!

I am just starting on my 3rd WLS-related surgery. So, we will see how this all shakes out. This time I do not meet any of the WLS criteria for BMI, etc. (yet). It is purely because I am having issues with hypoglycemia causing seizures. I see a surgeon on Monday for recommendations. So, we will see.

Good Luck to you!

Jackie

Thanks for your post.  I guess just putting feelers out to see if anyone else has had similiar situation.  You are going for your 3rd WLS, which one are you pursueing now?

I'm not really pursuing any just yet. I will see a surgeon on Monday that will look at my EGD and hopefully be able to talk about some solutions. From my research it looks like the options are to 1) Put a band around where the stoma is, 2)Convert to DS, or 3) Re-make the stoma. However... there may be more options or it might even be a different problem than the stoma altogether. I'll post after my doc appt.

Take Care,

Jackie

I have had 3 revisional surgeries... Lapband in 2001; replaced lapband with another lapband in 2009; RNY gastric bypass in august 2009; got it right on try #3 ... insurance paid for all 3

 

good luck

maryjo

Wow, good to know...maybe there is hope for me then.  Thanks, Lori

 Hi Lori,

Just a question, which I am not trying to talk anyone into or out of anything. Have you been back to to your surgeon's office to check to make sure that everything is stll ok? Sometimes they can check the opening of the stoma and "shrink" it down by an endoscopic techniqe to help people have a better sense of fullness(sclerotherapy). Sounds like losing 70 pounds after your new surgery showa that you have had success- It is tough I know. Maybe something to pursue before another major surgery is done,
And no, I am not against the DS, just trying to mention alternatives. Have a great day.

wigglypoo(AmyH)

Thanks for the reply.  I have had the testing done and my stoma is just allowing the food to go right through.  I also had the sclerotherapy done and that didn't help a bit but thanks for the thoughts.  Lori