Over the last four years, the field of weight-loss surgery has grown at an exponential rate. As a result, I’m receiving an increasing number of questions about post-operative surgery. The sheer quantity of post-op patients is boosting the demand for these two sorts of post-op operations, whether it’s plastic surgery or a revision.
The word “revision” means “to change or amend” (for our purposes, it is to change or modify a prior bariatric surgery). Revisions are possible in a number of areas. A patient will either be undergoing a revision of a failed bariatric procedure or undergoing a revision to a new type of technique that was not approved or even available at the time of the original surgery.
This is a basic question with a more complicated answer. Insurance firms, as we all know, appear to make choices by tossing darts at a dartboard. As a result, it’s only normal to suppose that a supplier will respond differently to various people from different states.
To begin, a request for a revision based on a failed prior bariatric surgery would elicit a response from most insurance providers, who will query whether the earlier surgery genuinely failed or whether the patient was just not adhering to the initial operation’s guidelines. To put it another way, you’re eating past the pouch or band.
Similar questions will be asked about a revision from a previous treatment to a new type of procedure, as well as why the patient wants to transition from a Roux-en-Y to gastric banding or duodenal switch.
It’s critical that you and your surgeon are on the same page before making such a request. He or she should be aware of the specific reason for the operation, as well as any challenges you had with compliance during the initial process. Never wait for the insurance company to inquire about the matter. When your surgeon sends a request for authorization, respond to it.
If the pouch stretched, the staple line failed, the band slipped, or the bypass just didn’t work, you’ll need pre-op testing to back up your claims. You should obtain the results of an MRI, CT scan, or endoscopy before applying for certification. Similarly, you should give the surgeon a basic summary of your compliance throughout time, including a diet and exercise history.
It’s likely that your BMI has been low in the past and that you no longer have any substantial co-morbidities. In this situation, you’ll make sure the carrier understands that if the modification is denied, it’ll only be a matter of time before your BMI becomes even higher and your co-morbidities resurface. If you’re requesting a new type of surgery, one that didn’t exist when you last had one, make sure to highlight the reasons why this operation is suited for you in your surgery request. By answering the insurance company’s questions before they’re asked, these preemptive strikes may just gain you the clearance you need.
I’m sure you’re thinking something along those lines. Assume that my insurance company does not cover bariatric or weight-loss surgery, or that it does not cover it any longer. In such case, you’re going to dispute over two things. First, weight-loss surgery should be covered because it is used to treat co-morbidities such as diabetes and hypertension in addition to obesity. Second, this is a request to fix a failed procedure that may result in serious complications in the near future, not for obesity or weight loss. The latter is a more difficult argument to make, but one that has been effectively stated. Remember, just like with your original surgical request, you must document your claims. And, of course, never, ever, ever, ever, ever, ever, ever, ever, ever,
How do you qualify for gastric bypass revision?
Your body mass index, a numerical number of your weight in relation to your height, plays a role in determining your eligibility for bariatric surgery. The BMI range of 18-24.9 is seen as ideal. A BMI of 40 or higher is considered morbid obesity.
If you have a BMI of 35-39 with particular serious health concerns like Type 2 diabetes, sleep apnea, or high blood pressure, you may be a candidate for bariatric surgery. A BMI of 40 or more is also a requirement.
Can you get a revision on gastric bypass surgery?
The bariatric revision operation is only for those who have had gastric bypass surgery rather than a sleeve gastrectomy (often referred to as “the sleeve”) or an adjustable gastric band. Bariatric revision is usually done as an outpatient operation with minimal sedation.
Will insurance cover weight loss surgery twice?
- Conversion Surgery is a technique that allows you to go from one type of bariatric procedure to another. Lap band to gastric sleeve or gastric sleeve to gastric bypass are the only two treatments that can be converted. Both become permanent after that.
- Surgery to restore the effectiveness of the original bariatric treatment is known as revisional surgery. Revisional surgery is any operation used to treat failing weight reduction after a gastric bypass or gastric sleeve.
Insurance companies currently consider revisional surgery options to be experimental or investigational. The following are examples of revisional procedures:
Your insurance plan may not cover a second procedure. You’ll need to go over your plan to see what your coverage options are and what standards you’ll need to meet in order to be considered for another weight reduction procedure.
Laparoscopic Revision of Band to Laparoscopic Sleeve Gastrectomy
In a revision band to sleeve gastrectomy, the band and all surrounding scar tissue are removed first. The sleeve gastrectomy is performed after the band, port, and scar tissue have been removed. If a patient has a hiatal hernia, it will be repaired at the same time as the procedure. In most cases, patients can lose 65 percent of their excess body weight, or 65 pounds for every 100 pounds they are overweight. Patients might expect to be out of commission for 1 to 3 weeks. When compared to a simple sleeve gastrectomy, the complication rates are minimal and comparable.
Laparoscopic Revision of Band to Laparoscopic Roux-en-Y Gastric Bypass
According to studies, converting a band to a laparoscopic gastric bypass is the gold standard for a revision band operation. A band to gastric bypass, like other band revisions, is done in a single stage with only one operation. We remove the band, port, and scar tissue first, then proceed with our gastric bypass, similar to a band to sleeve revision. The risks of complications are the same as for a gastric bypass performed on someone who has never had surgery before, as is the recuperation time, which is 1 to 3 weeks. A normal patient can lose 75 percent of their excess body weight, or 75 pounds for every 100 pounds of excess body weight.
Is StomaphyX covered by insurance?
Depending on your surgeon and where you live in the country, the procedure might cost anywhere from $8,000 to $13,000.
Due to the scarcity of research documenting the procedure’s outcomes, insurance companies rarely pay it. There are, however, a number of viable bariatric surgery financing solutions available to help pay for some or all of the procedure.
As previously said, we highly advise against doing this operation until more data confirming its efficacy and safety is available.
How long does a gastric bypass revision take?
How long does bariatric surgery take? True You’s endoscopic gastric revision surgery is done as an outpatient procedure that takes around 30 minutes to complete under minimal anesthesia.
Can you have gastric bypass surgery twice?
Yes, you can have bariatric surgery twice; however, it’s crucial to keep in mind that the risks of complications are substantially higher. While you can have bariatric surgery twice, whether your surgeon recommends a revision depends on a number of factors, including the type of surgery you had, the complications that occurred, your weight, lifestyle behaviors, and whether they believe your personal circumstances are suitable for a second bariatric operation.
What does revision surgery mean?
You’ve visited this location before. This is an all-too-familiar scenario. The nagging discomfort that runs down your arm or leg, the incapacity to carry out simple chores.
You had hoped that the surgery would be the end-all solution after years of simply managing the discomfort. Nonetheless, you’re still here, with the same symptoms and little relief. The specialists have recommended revision surgery after months of pain management, rehabilitation, physical therapy, and reviews of your circumstances. But what is Revision Surgery, and how optimistic are you about your chances of recovery this time?
A revision surgery is a technique to rectify a previous operation that failed to cure pain from your initial ailment or produced further internal difficulties due to a misdiagnosis, surgeon error, lack of fusion, infection, hardware malfunction, or poor recovery after a previous surgery. With 33 little irregularly shaped bones protecting the crucial task of the spinal cord, the spine is one of the most complex elements of your body, affecting the functionality of both the skeletal and neural systems. This means that a spinal surgery problem is a difficult scenario that should be handled by a skilled revision surgery specialist.
A revision surgery specialist will decide the optimum course of diagnostic imaging and testing to correctly establish the source of your discomfort following surgery based on the type of initial surgery you had and your current symptoms. If another doctor has performed recent post-op imaging, the specialist may request to examine it, but he or she will almost certainly want to conduct his or her own diagnostic tests to have a complete picture of your previous operation and current symptoms. Some issues, such as loose screws or infection, may necessitate an immediate re-entry, which should be handled by a revision surgeon who is experienced in caring for a surgical site that is already sore.
Revision Diagnosis
A revision surgery diagnosis will seem similar to what you had before your initial surgery, and it may include a range of imaging dependent on your previous procedures. A second back surgery, for example, might start with a CT scan to look for a fracture or lack of fusion, followed by an MRI to look for nerve compression or the presence of a herniated disc, an X-ray to look at the alignment and hardware implant, a bone scan to look for an infection, and finally an EMG to check nerve functionality.
Once the surgeon has determined the source of your current discomfort, he or she may recommend revision surgery for one of the treatments listed below:
Revision Discectomy
A doctor may propose a revision discectomy if he or she thinks that more of the bone has to be shaved in order to entirely relieve your pain. For mild herniations, microdiscectomy, a minimally invasive procedure, is used to remove portions of a herniated disc to relieve compression on a nerve or spinal cord. According to a 2015 study on lumbar discectomy, while the initial revision surgery improved most people’s quality of life, the second back surgery revision had poor results. Depending on your doctor’s response, conservative treatment and pain management may be a better option if a secondary revision surgery is required. For a reoccurring herniation, a revision surgery specialist will be able to provide you with the best diagnosis and treatment options.
Revision Fusion
Unfortunately, due to degeneration or stenosis, a herniated disc is often beyond repair and unable to be treated with a revision discectomy. In this case, your doctor may discuss with you the possibility of a complete fusion of the painful area. If you’ve already had fusion surgery and your post-operative pain is due to pseudarthrosis (lack of appropriate fusion), your doctor may still prescribe a fusion revision. Fusion relies on the bones to spontaneously fuse and heal together, however failure to fuse on their own can be caused by a range of factors such as smoking, diabetes, obesity, age, nutrition, and hardware. Because pseudarthrosis accounts for 45-56 percent of revisions, it’s critical to follow your doctor’s detailed recovery recommendations to increase your chances of a successful fusion.
Epiduroscopy
This procedure involves removing scar tissue that has built up and is causing pain months after surgery. Scar tissue is an unavoidable side effect of surgery, but an excessive buildup can encircle and compress nearby nerves. Epiduroscopy allows the revision surgeon to see directly into the inflamed area, use a laser to remove adhesions and fibrosis, and use local steroids to reduce inflammation and separate the nerve from the scar tissue. The precision of this approach is its most advantageous feature. However, because an additional surgery increases the chance of scar tissue, it’s critical to have an expert do the procedure and educate you on how to avoid scar formation this time.
Foraminoplasty
In most cases, your doctor will do your revision surgery in the least intrusive manner feasible. A small incision and tiny surgical tools are used to reach a specific region of the spine with minimum damage on adjacent muscles and tissues in foraminoplasty, a surgery that is becoming increasingly popular. Depending on the severity of your symptoms and access to the cause, this strategy may be explored with you in the event of a herniation, bone spur, stenosis, or nerve compression. Foraminoplasty has a 90% success rate and is highly recommended for individuals over the age of 50.
Spinal Hardware Removal & Revision
You may have discomfort as a result of an infection if your body has reacted poorly to any hardware implanted during your previous operation. Screws may loosen as your body rejects the metal implant, requiring rapid attention. The hardware will be removed by a revision surgeon, and the infection will be treated with antibiotics. Additionally, during this revision surgery, prophylactic measures such as antimicrobial screw coating can be implemented to prevent infection.
Surgery is always a risky procedure with the potential for complications. Because each body is different and each surgery is different, it’s impossible to get a sense of the wide range of probable outcomes. Revisiting a surgical site where there is already pain and difficulties is a complicated and multi-faceted process that should only be performed by a specialist who is experienced in revision procedures. Some of the procedures listed above produce greater results than others. The effectiveness of revision surgery depends on a doctor who correctly identifies the reason of your pain and oversees your recovery. Schedule a consultation with Dr. PRPA before committing to revision surgery if you haven’t been diagnosed and evaluated by a revision surgery specialist.
What percent of gastric bypass patients gain the weight back?
Early weight loss after bariatric surgery is typically between 47 and 80 percent of extra weight. Weight return, on the other hand, is typically 1525% of lost weight. This can be quite discouraging for patients, so it’s critical to keep weight expectations in check after surgery.