I had a lapband placed four years ago and had good success. Steadily lost weight and went from 275 pounds to 155 pounds. About four months ago, I was so happy with my band and the progress that I'd made. I felt like I was at my goal and the whole process had been wonderful. Then I realized that I'd been having problems for the past 8 weeks, which helped me lose that last 15 pounds. I was to the point that I could barely sip water. Barium XRay confirmed that I was almost completely blocked.

Since I'd recently moved across the country, I didn't have a surgeon, and since I live in a remote area, the closest weightloss surgeon was 2 1/2 hours away. After a frantic few days of trying to find a surgeon that would see me before taking a few weeks to evaluate my records, and more importantly evaluating my insurance, I went to an emergency room three hours away. The ER doctor removed the fluid from my band and I was able to drink again. When the surgeon saw me the next day, he was concerned that the ER doctor had punctured my band - my stomach looked like sausage after all the times he poked me trying to find my port.

I've been going back every 4 weeks to get my band filled back. I gained 30 pounds almost immediately but have gotten to the point that I am no longer gaining. From the beginning, this surgeon has wanted to do a revision. He thinks my band slipped and it will happen again, so he is afraid to fill my band to where it was before. Furthermore, we just realized that my band is leaking. So, something needs to be done. Since my original surgery, I have gone off my blood pressure meds (blood pressure was really high even the highest doses of meds that I could take) and the pre-diabetic issues (insulan resistance) have gone away. However, my blood pressure has shot up over the last few months and I'm going to have to go back on meds soon if something doesn't happen.

I talked briefly with my surgeon this week about where to go. He is talking about RNY or a sleeve and would prefer RNY. He feels RNY would be safer to let my stomach heel after surgery. I am just not feeling the RNY and am leaning towards a sleeve.

At this point, we are trying to figure out my insurance because my (new) primary covers surgery, but only if it is the original surgery and I've gone through the whole approval process with them. My secondary, which I used before, does not have the hospital that I'd have to use for this surgeon in their network. So, I have some time to think about where to go. If my primary won't cover the revision, I have two options. The first is to pay some out of pocket. The second is to find another surgeon that does practice at a network hospital. I like the surgeon that I'm going to now, mostly because he spends a lot of time with me discussing concerns and options. But, I'm sure there are lots of other good surgeons out there.

So, questions that I have: Maybe it's safer to have the RNY rather than having my stomach sleeved during a revision, but is that a real concern? I think I'd rather go through the tedious process of liquid/soft diet for the weeks/months than to have the issues involved with RNY. I'm just not feeling good about the RNY. Next question - if I do have a sleeve, what can I expect as far as pre-surgery diet, time in the hospital and overall recovery time, and diet once I am recovered - i.e. I've seen discussions about alcohol, carbonation, not using straws, etc....

I've read through the website, but would appreciate any information and advice I can get.

If your insurance covers VSG, but your surgeon does not have admission rights at any network hospitals, you can ask your insurance for an exception. They may pay for you to get it done at that hospital. It's worth asking.

Be sure you choose your surgeon with care. Revisions are no joke, and you want a surgeon who's been vetted and is experienced with good outcomes. Obesityhelp.com is a good first resource for that IME.

A DS (duodenal switch) is not like an RNY, BTW. Your pyloric valve remains intact, and you don't have a pouch, you have a stomach. A DS involves the same stomach reduction as a VSG, but they do re-route your intestines. It's the heavy duty WLS. VSG is often stage 1 of 2 for DS patients.

Thanks Pinkpeony. The surgeon's office is working on my insurance right now, so I suspect they know about the exception.

I believe I have decided to get a second opinion before proceeding. I'll pick that surgeon with care too because I may decide to use the new one.

I'll check out the obesity website for surgeons again - that is where I researched initially. I see many members from Washington State. My current surgeon is at Overlake and my thought is to find one that practices at the Swedish Hospital. Any thoughts would be appreciated.

You're in WA too? Awesome! OK, seriously, you need to see Srikanth. He's the best we've got for revisions (and that's not a backhanded compliment, he really is great and the best!). Everyone on OH will tell you to see Srikanth anyway. lol

He's based in Federal Way, but also practices at Evergreen in Kirkland.

Thanks! I see that he also has an office in Federal Way which would be very convenient for me as far as appointments. I am out on the peninsula and it's a long drive to get to Seattle.

Darn it. Dr. Srikanth is not in my insurance network. Any other suggestions out there for the Seattle area?

My revision was done by Dr Landerholm in Edmonds. No complications and success beyond my wildest dreams!

Thanks Jane. I will see if he is in the TriCare network. Looks like you have had incredible success!

Darn it. Dr. Srikanth is not in my insurance network. Any other suggestions out there for the Seattle area?

Dr Srikanth did my last band removal and he was great, but Dr Kelly Clinch did my first emergency band removal and is a super dr too. Wonderful mannerism and great guy.