What made you pick RNY over DS?

[Onelastshot]

Just curious what made the final decision for you. I'm curious to see if there are any long term post-op people with feedback as well? If you had to do it all over again, would you choose the same?

 

[southernlady]

Not many RNY'ers here yet. And most of the RNY'ers we get are seeking revisions to the DS.

 

[Settledownnow]

I choose RNY in 2003 because at that time many insurance companies considered the DS experimental. I wanted the DS but it was not covered by my insurance. I revised to DS this month. Problems with my RNY included lack of weight loss and mechanical problems including ulcers, gastric fistula, dumping, and pain eating meat and other foods. As the number of years out from surgery increased, the number of supplements I took increased to manage the multiple vit/min deficiencies. I also needed to see the hematologist on a regular basis for iron infusions. I was taking a very similar amount of supplements to the DS schedule so that was no longer a sticking point for me with the DS. I was very naive early on with the RNY and thought only "noncompliant" people had problems with vit/min deficiencies ulcers, lack of weight loss and so on. Would I choose the RNY again? No way.

If you search the web you can find comparisons of the two surgeries and their outcomes. You may find more happy endings with the RNY on some of the other WLS boards, but you will also find many people who want to revise to another surgery type due to regain and other concerns.

 

[GrammyLuLu]

I too chose the RNY because of insurance. I am now seeking a revision to the DS which I wish I had been given that option in the first place. I have regained all the weight I lost and my stoma has stretched to over 3cm and I do have dumping but can control that with food choice. Would I do it again nope not at all the RNY has now in my opinion proven to not have been the best option for me. Have now talked to several surgeon's office staff and 2 surgeons in the waiting game to see when I can get a surgery date.

 

[Remingtonh]

The fact that I would have to pay $8K for DS up front, in case the insurance company denied it. Something about no codes for laparoscopic DS in the system. I wanted the DS but am scheduled for RNY on 7/30.

 

[southernlady]

The fact that I would have to pay $8K for DS up front, in case the insurance company denied it. Something about no codes for laparoscopic DS in the system. I wanted the DS but am scheduled for RNY on 7/30.

Then they aren’t looking for the code. It’s there. Unless they are trying to pass a SADI/SIPS/LoopDS as a DS.

DianaCox Larra

 

[hilary1617]

Hi and welcome Remingtonh ! If you want a DS, it is well worth pursuing, even if that means travelling to a different doctor. You're in the only body you'll get for this lifetime - and this may be your only chance at a bariatric surgery. *You* are worth it!

 

[Larra]

There is most definitely a code for the DS, either lap or open. DianaCox will have it for sure, wish I could remember it offhand. I agree with southernlady that they are either trying to pass off a SADI/SIPS as a DS (it isn't, but some surgeons are using the DS code, falsely, to get insurance to cover it) or they are extremely misinformed, as the DS has been a standard of care bariatric surgery since about 1991. Or they're lying, but I prefer to think misinformed, as sad as that is.

 

[Larra]

Found it! 43845

 

[DianaCox]

I had lap DS in 2003. The code is 43845, whether done lap or open, just as it was 15 years ago. So, they’ve lied to you. Strike one.

I suspect they’re trying to scam you. They don’t do a standard DS surgery or they’d know the code. Strike two. And 43845 requires TWO anastomoses, which means it can’t be used for SADI, SIPS or LoopDS, which are all single anastomosis procedures that are NOT standard of care and thus there is no code for them. Perhaps they’ve been previously caught in insurance fraud for using 43845 for a single anastomosis procedure, which is NOT a standard of care procedure - it is still experimental. No selective fat malabsorption and what fat malabsorption there is, disappears by a year out. Which they didn’t tell you. Strike three. I would run, not walk, away from that practice.

A standard two anastomosis DS is a standard of care procedure, and you are entitled to chose among standard of care procedures for your disease if morbid obesity. If there is nobody local and in-network who does it, you are in most cases entitled to have the procedure at an out of network facility and/or by an out of network surgeon, at in network cost to you.

We can help you fight for the procedure that is right for you. I would NEVER have agreed to an RNY.

 

[galaxygrrl]

Here is the comparison of the weight loss surgery. DS is the winner by far and no dumping. ;-)

 

[JackieOnLine]

I wanted the DS but am scheduled for RNY on 7/30.

don't settle - fight for the DS if that is what you want/need.

 

[Remingtonh]

My next appointment is on 7/11 so I'll bring it up again. I have had this conversation, after reading and discussing this issue with others on another board. The explanation the Doctor gave (Dr. Sashidhar V. Ganta, Austin Institute of Bariatrics and Laparoscopy) seemed to be reasonable- though it's been awhile and I can't remember exactly what that was.

 

[Larra]

two thoughts - first, it is very strange that someone at this practice would tell you there is no insurance code for lap DS when it is listed on their website as one of the operations Dr. Ganta performs. I checked. Does that not strike you as weird? As if they are trying, for some reason, to direct you (and possibly others) away from the most complex procedure into something that is quicker and easier for the surgeon (but not as effective for the patient). Of course I can't know the reason you were given the misinformation about the code, but something is off.

Next, and I apologize for the vagueness of this, but I've seen this surgeon's name before on another website, some years ago, and not in a positive light. I can't remember the details. Perhaps it's unfair for me to mention this when I can't be specific, but it's the best I can do. I think you need to be extremely cautious, and if you do decide to have a DS with him (which, remember, he claims he does on the website) you need to make it very clear that gastric bypass is unacceptable to you as a "fallback" in case he finds some reason during the surgery that he can't complete the DS (again, I'm not accusing him of having done this in the past) and even put on your surgical consent form "no gastric bypass".

 

[southernlady]

I would also state “no two stage” procedure. Unless you talk to him way before hand.