NEW & TONS OF QUESTIONS - PLEASE REPLY!

I had my original WLS 5/1998 (SRVG-a modified VGB) all went well... for a while.  I lost weight and felt like I had a life.  In 2005 I had a tummy tuck - 20 lbs ecxess skin removed. Since then I have gained ALL THE WEIGHT BACK plus (for a total of 100 lbs).

My Insurance is Aetna and I've already talked to physcians in Louisiana and told that my insurance COVERS REVISION.  But from what I understand it has to be a revision of the SAME surgery.  Anyone ever hear of this? 

From what I have read I was thinking the RNY or DS would be better.  Just anyone who has had any type revision from stapling procedure I would really appreciate your thoughts and experiences.

Also, I have read the mortality rate is VERY high! (1 in 100 !!!)   I am however about at the point I'd rather be dead than this fat because I don't enjoy anything anymore.

I also suffer from SEVERE dumping.  I haven't been to doc yet, I have one apt set up for Oct 1 consult.

FIrst thing first if you are considering the DS then research I believe it's www.dsfacts.com or go over to the DS forum to get a SUPER qualified DS surgeon who does revisions.  You won't truly know what your insurance covers until you find your surgeon and submit for approval.

Much success.

Ms Shell

Check out My Story on my profile page. I have Just won a revision with my insurance from VBG to DS. My surgery date is 10/08/10.
Barb

The Aetna coverage may depend on your plan. I have Aetna PPO and had no trouble being approved or covered for Lapband to RNY and it was less than 2 yr.s between surgeries and it wasn;t because of a problem just no weight loss. Good Luck!

From Aetna's website:

1. Repeat Bariatric Surgery:

   Aetna considers medically necessary surgery to correct complications from bariatric surgery, such as obstruction, stricture, erosion, or band slippage.

   Aetna considers repeat bariatric surgery medically necessary for members whose initial bariatric surgery was medically necessary (i.e., who met medical necessity criteria for their initial bariatric surgery), and who meet either of the following medical necessity criteria:

   1. Conversion to a RYGB or BPD/DS may be considered medically necessary for members who have not had adequate success (defined as loss of more than 50 percent of excess body weight) two years following the primary bariatric surgery procedure and the member has been compliant with a prescribed nutrition and exercise program following the procedure; or
   2. Revision of a primary bariatric surgery procedure that has failed due to dilation of the gastric pouch is considered medically necessary if the primary procedure was successful in inducing weight loss prior to the pouch dilation, and the member has been compliant with a prescribed nutrition and exercise program following the procedure; or

   3. Replacement of an adjustable band due to complications (e.g., port leakage, slippage) that cannot be corrected with band manipulation or adjustments.