Lapband revision to sleeve in one or two surgeries

My doctor suggested having my lapband removed first and then doing my sleeve revision because there is less of a chance of a leak.  I'd like to hear from people who had the lapband revision in one or two surgeries and the outcome.  Thanks

I'm having the revision done in one surgery. Being from the medical field (I'm a retired RN), I know that sometimes doctors push two surgeries for maximum reimbursement. Currently there is not a billing code for a revision so the doctor has to bill for the sleeve with a modifier for extended OR time to get some type of reimbursement for taking the band out. Insurance companies are rejecting claims for a lap band removal with a sleeve gastrectomy performed at the same time because there are too many shared costs. They insist on billing for one surgery with the modifier to cover the time it takes to remove the band which isn't as profitable for the doctor. The doctors get maximum reimbursement when they can bill for two separate surgeries billed on different days. Now, with that said, not all surgeons are doing this. Some people have damage done by their lap-bands that would make it necessary to do the procedure in two surgeries; however, this has to be weighed against the risk of going under anesthesia twice and having a invasive procedure done twice whi*****reases your post-op complication risks dramatically, especially if you are not healthy. I just read a blog entry from a lady who was told she needed to have her revision done in 2 surgeries to find out after having the lap band removed her insurance company will not pay for the sleeve now because they have a policy of paying for only one bariatric procedure for the term of the policy. She is devastated because the insurance company told her that her physician should have done the surgery in one procedure. Communicating with your doctor is key in understanding justification for two surgeries.

Thank you for your post, it explains so much.  My dr will only do mine separately also.  He did say he has done it in one but prefers yo do it in 2.  $ makes more sense than any of the other explanations.  My removal is scheduled for tomorrow so I guess I will go this route.  

How was your recovery? how many days u were off work after the lap band removal?

I work from home so I was back to work the next day.  I could very well have gone back to an office though, the removal was easy but then I went shopping in Mexico the day after I got the band so i think the recovery for this type of surgery is not bad at all.  It's so nice to have it gone but beware if not careful weight will come back quickly even if you have been without a fill for a while and old eating habits also start to slip back.  Good luck hope this was helpful.  My sleeve surgery is 2 weeks away I'm so excited, I really hated the band.

I have the band and am scheduled for revision to RNY on the 25th. My original doctor said it would take two surgeries due to risks. I later found out that isn't the case at all. Basically it all depends on the doctors insurance and the how the hospital has its policy setup. So I didn't trust them anymore and decided to go with a more top rated Texas doctor in Dallas. I didn't want to take the risk with insurance not approving the revision. I initially wanted to have the sleeve but my doc explained that the lapband and sleeve are virtually the same thing - only restriction and that if I didn't lose weight with the lapband I probably wouldn't with the sleeve either so he recommended that I have the bypass since I have a slow metabolism. The malabsorbtion and restriction should work better for me. 

I don't believe they do it in two because of insurance.  As my insurance was going to OK the two at once but not the two separately, my surgeon said due to the increase risk he wouldn't do it even if the insurance Ok'ed it.

The band and sleeve are both restriction only but are NOT virtually the same thing.  I have a very slow metabolism (post menopausal, now even worse) didn't lose much with the band gained it all back at one point.

With the sleeve I am below goal with a 125 pound loss and loving life.  I can eat like a normal person just less.

My former doctors nurse said it was due to hospitals insurance policy on the doc, plus doing it in two surgeries they recoup more money. That's just what my docs nurse told me and while I appreciated her honesty that totally put me off.

I just had a revision on August 13th, my doctor said depending on the scar tissue he may have to do it in 2 surgeries, but he was able to do it all in one surgery.  That being said I was under anestisia for 5 hrs and because of the amount of work he did I had to go home from the hospital with a drain still in other than that I don't really have a lot of pain and I am doing well my dr feels why put you thru 2 surgeries 2x the chance of complications if he doesn't have to.  Hope all goes well for you

Kim

Because of complications I had my band out, Y done all last Weds. I have to admit if I knew now I would have still done it all in one surgery. It was a bit rough during hospital stay but not sure if I would go back if it had been this rough of a recovery and I had split into two surgeries. Do what is best for you. One size does not fit all. Good Luck