2 surgery Lap band revision?

Hello All,

I'm hoping to find out from those who've already had consults for a lap band revision. I've already had one consult and to be honest walked away feeling like the office trying to money grab. By that I mean, they told me that there was no way for them to determine the condition of my band or any erosion etc in advance of surgery and therefore would have one surgery to remove the band. Then several months after recovery, I would then go in for a second surgery to revise. They then explained that they wanted to order an EGD, and ultrasound. I asked why, if the test won't help them gain information what was the point. They didn't really have an answer. Side note- I understand that those tests are routinely done to check the status of the band, I just found it interesting that when countered with their justification for two surgeries they didn't have a concrete answer. Then, I expressed how worried I was about the idea of 2 completely separate surgeries. Two times under anesthesia, 2 post-ops, 2 recoveries. The explanation they gave was that insurance approval rates for revision was 50/50. Okay. If the insurance gives specific parameters for revision surgery -mine does- why is there such a hard time getting it approved? I specifically asked if their practice required specific time frames for participation in diets/nutrition etc classes- my insurance does not require it for certain revisions, and was told no. But yet it seems that if I went with their plan I would have one surgery, recover, have to enroll has a new bariatric surgery patient and complete all of the required steps, which just means more expenses.

So that's my question: how many of you were required to have a band removal and then proceed as a new separate surgery?

I have a second opinion consult on Tuesday, so I'm hoping to get more info on everyone else's process.

Thanks!

TxNc

Hello. I'm sorry you're going through all of this. I had my band removed in November of last year. I had my fluid removed in June. I wanted it removed because I was having problems swallowing and even throwing up water. My bariatric doctor requires a waiting period of 3 months between surgeries for healing. My insurance required 6 months. Eek. I would ask for the endoscopy first! My endoscopy revealed that I had Barrett's Esophagus. Good luck!! I hope all goes well for you. I'm having gastric bypass on July 15th.

Just added: My insurance denied me. I had to fight tooth and nail for approval. If you have a good surgeon and team on your side, you will succeed!

Thanks for telling me your history. I'm hoping to have it revised to a bypass as well. I'm unfortunately on a tight time line. I go tomorrow and hopefully will have a better idea. Considering how long it's even taken to get an initial appointment, I'm not particularly optimistic. Fingers crossed though. Good luck in July!

From what I've seen on OH during the years, it is actually pretty common to have two surgeries. If there is a lot of scar tissue from the lap band or there were other complications, some surgeons prefer to let patients heal up a bit before performing a VSG or RNY.

I would suggest contacting your insurance company to find out what your specific plan requires for a revision surgery to be covered. You can present that to the doctor during your consultation and getting a plan for your specific situation.

Thanks for the reply. I preemptively contacted my insurance company and had them look up my plan and email me the coverage. Revision is covered and fairly strait forward. Hopefully tomorrow I'll get a better idea. Thanks again!

Update: I met with a different surgeon today and came away feeling very... dare I say, hopeful. It is not his usual practice to do revisions in 2 surgeries. ? He said that in essence what the first doc said was partially true, you don't ever 100% know what the outside of the stomach looks like with just imaging, ask any mom who was told she was having a girl but then delivered a boy. But you can get a pretty decent idea of what the surgeon will encounter. He fully expects there to be scar tissue, but that it just goes along with being a surgeon that does bariatric revisions. I go in for my EGD on Monday. Hopefully, we'll get a more concrete plan after it's complete. Fingers crossed!

I can't speak to what your second opinion surgeon said as I'm not a medical professional. My experience is as follows.

Liquid reduction in june 2017 for severe GERD.

esophageal manometry in June 2017

Liquid removal in Aug 2017

EGD in Aug 2017 to determine state of esophagus

Official diagnosis of moderate esophagitis, no Barret's

30lb weight gain with no restriction

Approval for band removal after results of studies

Band removed May 2018. 3 month wait required by surgeon

Severe stomach scarring from band. Low motility in esophageal sphincter

Prescribed PPI and Carafate to help with healing and reflux

Original revision approval expires (grrr)

Psych eval, appeal for approval

EGD + EGD Bravo study for a week with acid sensor

Barium and gas contrast study

VSG in Nov 2018 with hiatal hernia repair

Oh my goodness! That sounds overwhelming just reading it, I can't imagine how you managed it all. I had my EDG 2 weeks ago. The results showed chronic gastritis, no Barrett's or hernia. My hernia was repaired when my band was placed. The surgeon said that even without any fluid in my band that it seems tight to him. I'm not really sure what will happen next. My follow up with him is next week and we'll see where I go from here.

Crysharris: I'm just curious...do you know what your Demeester score was from your Bravo testing?

I dont recall but it was within normal range which is why I had VSG and not RNY