Endoscopic Overstitch Procedure

Helen_Anne
on 7/8/17 2:44 pm - Bremerton, WA

Hi... it's been years since I have been on OH! I had RNY in August 2008... lost about 135#. I kept most of it off for about 3 years.. then tragedy hit my family and I spent the next 3 years waiting for a court date for the woman charged in the death of my father. During that time I gained about 50#. Thankfully my weight has been stable for the past year or so! I went to see my Endocrinologist... because I calcium and Vit D issues. He suggested that I have an upper GI to see if my stoma had stretched and it had! It is now 35mm instead of the 10 to 12mm it should be.

I just found out last week I was approved for the endoscopic overstitch procedure. That was after it was denied by the insurance company twice... and finally overturned by an outside reviewer.

My procedure is on Aug 4! I have read the posts I found here about those of you who have had this procedure. I am excited and nervous about the post procedure liquid diet... but I am willing to do what ever it takes to stop the semi constant diarrhea because my food tends to go right through my pouch! I went on Qsymia about 2 months ago and lost about 22 pounds... so if I can lose 20 to 30 post procedure... I will be a very happy!

Consult W/Surgery W/Revision W/Goal W
332.5/302.6/231/200


Doriam R.
on 7/9/17 10:57 am - Austin, TX
VSG on 07/12/17

I am so glad you got approved. Wish you the very best. Keep us posted!!

mompowers
on 7/12/17 6:59 am

how did they determine if your stoma was stretched?
i am meeting with my GP end of Aug, and i need relief.

i had a RNY in 2013, at 356lbs (i am 5-11) and have since had a baby. ever since my pregnancy i have bad reactive hypoglycemia.. i am now 248lbs and i think it is to a stretched stoma, from drinking and eating when i was pregnant. i am gaining weight slowly due to constantly eating to cure the low blood sugars. and its not from carbs either, even white milk will send me plummeting into the low 2's.

i am just wondering what tests they did to show that your stoma is stretched.

i am in Canada, so there is a process about going to see Surgeons.. its free, however its not as easy as in the US. lots of hoops to jump in before you see them.

Helen_Anne
on 7/12/17 7:34 am - Bremerton, WA

Hi... I had an Upper GI exam done... where they stuck a tube/camera down my throat and he could measure the size of my pouch and the size of my outlet.

i am sorry that you are struggling with hypoglycemia!

Consult W/Surgery W/Revision W/Goal W
332.5/302.6/231/200


mompowers
on 7/12/17 7:36 am

were you awake for that?

ohiomomx2
on 7/14/17 10:52 pm - West Chester, OH

What insurance do you have? I have BCBS Federal. Just starting the process of trying to get approval for a revision of my 2008 RNY.

 

Ohiomomx2
40 years old
6'3 (yep, I'm tall)
RNY 3/08
Starting weight 378
Current weight 198
Lowest weight 190
Helen_Anne
on 7/15/17 6:27 am - Bremerton, WA

I have First Choice... they denied the procedure twice stating that the Endo stitch procedure was Experimental. The Bariatric nurse coordinator and the Gastroenterologist who is doing the procedure requested an outside review with a Bariatric surgeon. I have the narrative whi*****ludes the studies that show this procedure works. Let me know if you would like me to scan and send you any of the information I have. It was the outside reviewer who overturned the denial!

Consult W/Surgery W/Revision W/Goal W
332.5/302.6/231/200


ohiomomx2
on 7/16/17 5:59 pm - West Chester, OH

I would appreciate any information you can share with me. My email is [email protected]

I have BC/BS Federal and they are great about covering all my "stuff". I had the RNY in 2008 and went from 378 to 193 (I didn't stay at that low weight for long. I was more in the 220 range). I've steadily been gaining the last 3 years and have put on 100 pounds. I'm a little different than most, I'm 6'3 so that makes a difference with my BMI etc. Here is the info listed for approval. The only one of these that concern me is the "lost less than 50% with the first weight loss surgery". If they stick to that criteria I'll be excluded. I'm not sure what information the doctor needs to send in, but I'm hoping we can make a case for me. I'm worried I'm going to end up back where I started.

I called and asked if the Overstitch procedure was an exclusion and the CS rep said they didn't have a list of any exclusions as far as what kind of weight loss surgery is requested....so I have no idea what's going to happen.

Any advice or information you can share with me would be great.

Thanks,

Jen

? Benefits for subsequent surgery for morbid obesity, performed on an inpatient or outpatient basis, are subject to the following additional pre-surgical requirements:

â?' All criteria listed above for the initial procedure must be met again

â?' Previous surgery for morbid obesity was at least 2 years prior to repeat procedure

â?' Weight loss from the initial procedure was less than 50% of the member's excess body weight at the time of the initial procedure

â?' Member complied with previously prescribed post-operative nutrition and exercise program

â?' Claims for the surgical treatment of morbid obesity must include documentation from the member's provider(s) that all pre-surgical requirements have been met

Helen_Anne
on 7/16/17 6:38 pm - Bremerton, WA

I am out of town until late Friday night.. and should be able to scan and email the narrative to you next weekend. I am not sure of all the reasons they do this procedure... but I know that I had to have the Upper GI procedure so that there was documentation on my current pouch and stoma size.

Consult W/Surgery W/Revision W/Goal W
332.5/302.6/231/200


T.K.68
on 4/27/19 7:00 pm, edited 4/29/19 1:02 pm

Hi There.....I have just joined the site in hopes of finding hep from someone who had the Overstitch Procedure denied. I am in the process of battling my insurance company because they are saying the Endo Overstitch Procedure my doctor has submitted for is experimental, investigational and unproven. I am in the process of requesting an outside review and can use all the help I can get. If you can kindly share the information that helped you, I will be very thankful.

Most Active
×