Hi everyone,

So I'm still in insurance appeal hell and trying to decide whether to just skip the months of fighting and go directly to self-pay with Dr. Aceves. (Skip to the last paragraph if you already know my story :-)). I need my lap band out and want to revise to a VSG but my insurance company is fighting me (I lost weight with the band and am under a 35 BMI). Odds are that I'll get the band removal covered but it won't save me much unless I can find a surgeon who'll do the revision as a single procedure and just charges me the difference. Dr. Cirangle said he would when I had my consult with him but darned if I can get anyone at his business office to return my calls.

At any rate, aside from the cost that only thing that holds me back from booking my surgery with Dr. Aceves now is the risk of any future complications happening that my insurance company would also refuse to cover. All things being equal, if I had no hope of insurance coverage or unlimited funds, Dr. Aceves would actually be my first choice. All I've heard is great feedback and he's one of the most experienced surgeons there is. Not to mention I really like the idea of a 3 day hospital stay.

So I'm hoping to finally make a decision (hang out in the hope of winning the appeal or just book my trip to Mexicali) this week. And I have a question on oversewing. I understand that Dr. Aceves uses a 34f boughie and then also oversews the staple line. Given that old VBS and stomach staplings had lots of problems with failed staple lines years later, it seems very wise to me to use this techique. The double-staples they now use for the VSG plus the oversew.

Does anyone in the U.S. do the oversew? Am I correct in my assumption that this adds a extra level of protection against leaks?

Thanks!

Britt

Dr. Pomp oversews the staple line.

Dr. Illan oversews.

I asked Dr. Elariny about this. He says he only oversews if it looks like a portion of the staple line might need it (i.e. some issue with staple line being imperfect)

Dr. Garth Davis in Houston does not over sews he feel it causes more leaks. I did not have a drain either!

My surgeon oversews. He's a 'belts and suspenders' type of guy. He's a MA surgeon. My husband (RN) works in the OR at a different hospital and the bariatric surgeons oversew there as well. I had no problems post-op at all.

According to his website, Dr Guillermo Alvarez also oversews.

yup. I can ask my friend who had hers done in the US, not sure if US doctors oversew.

I am aware that it would make your situation easier to have the band and sleeve in one surgery however it is my understanding that this seriously increases the complication of a leak. I would be very reluctant to have an all in one procedure.