RNY revision with Hernia repair

RNY 2004 with SW of 280.  Lowest weight in 2006 of 200 and maintained that until 2010 when I had abrupt changes in my job.  CW 278.  Inquired about revision in 2011 but was told I had a "significant hiatal hernia that needs repaired".  My pouch is definitely stretched and I can eat an entire meal and not feel full.  Original surgeon won't take my insurance so I'm researching for a new surgeon (not easy to do).   Wondering if the surgeon has to call it a revision if he were to make my pouch smaller when he repairs my hernia?  Also, is this hernia repair enough of a reason to approve the revision (Illinois Medicaid, insurance)?  Thanks!

I don't know whether the surgeon has to call making your pouch smaller a revision or not. He has to call it something for the insurance,to cover the extra time in the OR and his time spent doing it. Or he won't get paid. I can't imagine he wouldn't want to get paid for his work. 

Gl

Hiatal hernias are very, very common, especially in heavy people. Did you have one at the time of your original WLS? Was it repaired? Check your surgical notes---it should say.

As for a revision---first you need to figure out WHY you've gained weight. Do you  measure and journal your food? If not, start. If you do, then post here what you're eating in an average day, and maybe we can give you some suggestions.

Have you been 'scoped to check your pouch and stoma? Are either of them significantly larger than they should be?

All of these are things you need to check out before you decide on a revision. Avoid surgery if you can, but if it turns out you have to have surgery, also research the possibility of revising your RNY to a DS. This is the most difficult revision, but also the most successful one for most people.