Question:
I've finally be approved for RNY!! Now I am trying to decide lap vs. open.
I've had two laparoscopic procedures in the past (gallbladder removal and spleen removal) and would prefer to go laparoscopic this time simply because of the quicker recovery time. However, I would like to have the pannulectomy/tummy tuck after the weight loss so I think I have to go open for that since (from my understanding) a hernia has to be involved for the insurance company to cover it. Have any of you had your insurance cover the pannulectomy after a laparoscopic procedure? Was it without a hernia? What type of procedure was it? All your experiences, ideas, and suggestions are appreciated. — [Anonymous] (posted on October 10, 2001)
October 10, 2001
my insurance co covers tummy tucks if they r MEDICALLY NECESSARY. a hernia
is one way to get it done but there r other conditions that r considered
medically nec. if ur apron hangs down low on ur thighs & u get rashes
or infections because of it is another way to get it done.
— sheryl titone
October 10, 2001
My insurance has approved my panniculectomy, and there is no known hernia.
If the surgeon finds that a hernia is present and has to change the surgery
to a slightly more involved abdominoplasty, the insurance will also cover
that. I submitted supporting letters from the plastic surgeon, my PCP, and
my bariatric surgeon to the insurance company, and the plastic surgeon
submitted pictures as well as a copy of the 1996 Position Paper from the
American Society of Plastic Surgeons which addresses "The Treatment of
Skin Redundancy Following Massive Weight Loss". Additional factors
included my Type II diabetes which predisposes patients to infection.
Although the diabetes has been "cured" since the day of surgery,
I still have recurrent skin irritation in the folds of the apron and the
MDs quoted that as a "risk factor" in their letters. I had a lap
RNY with six tiny incisions scattered across the upper abdomen...only two
of those are now visible at all. I have a lot of extra skin above the
belly button as well as the apron below. The plastic surgeon plans an
"inverted T incision (vertically from bra line to pubic area, and
horizontally in the bikini area from hip to hip). Whatever lap incision
lines I have will be gone after that. I had had 3 large vertical abdominal
incisions in the past due to 2 C-sections and a hysterectomy, so the idea
of another long incision doesn't bother me at all. It will be worth that
and more not to feel like a Shar-pei! Good luck!
— Diana T.
October 10, 2001
Why run a risk of a hernia? Tummy tucks are covered if medically necessary.
Lower back pain from all that excess skin weight, rashes, are just 2
medically necessary reasons. Go LAP, and save pain, hernias, and recovery
time.
— bob-haller
October 11, 2001
Go for the lap procedure!! You don't have to have a hernia to
get a approval for the pannu....you might not even need one.
Personally, I've lost 120lbs. and my boobs and my gut just melted
away. I have no excess skin on my stomach, it's flat and relatively
firm....and I had an open rny when I was pushing 50. Take things one
step at a time........
— [Anonymous]
October 11, 2001
Which one did your insurance company issue approval for? That's something
they should have known before approval, probably from your surgeon. A lot
of insurance companies won't pay the extra $ for a lap procedure. Before
you make a decision, call and make sure you do have the option of picking
lap or open. Good Luck!
— [Anonymous]
October 11, 2001
LAP, LAP LAP!!!!!!!!! I just had lap rny and my recovery has been
phenomenal!!!! I have six small puncture holes instead of a huge scar .
If you have a choice, I would definately go lap. I am walking 30 minutes
per day and feeling stronger every day. I had a stomach stapling 17 years
ago and it was open, so I know the difference. It took six weeks to
recover, and I had to have scar revision on my incision. Just make sure
your doc is reputable and has done several lap surgeries. I wish you the
best and will keep you in my prayers. Patti Meadows/ e-mail:
[email protected]
— peppermintp
October 11, 2001
I have a hernia and still can't get the TT approved. I'm getting still
getting the tummy tuck done with the hernia repair, since the anasthesia,
and the hospital, everything but the plastic surgeon's fee will be covered
by the insurance. It seems every insurance company is different on this
issue.
— Anne G.
October 12, 2001
I cannot answer any questions about plastic surgery. (Here's hoping that
at some future time, I'll have some expertise on that, too). In any event,
I am almost 10 weeks post-op and have definite opinions on lap vs open. I
was originally going after lap. The doctors told me to expect to be on the
table for about 3 hours. For a couple of reasons, I ended up going to a
different doctor. While there for my pre-op exam, he said expect to be on
the table for one hour. I asked why and he said he does it
"open". He is a very experienced and accomplished surgeon who
does gall bladders and other procedures lap but he said this (RNY)is just
too complicated to do lap and that "leaking" (the greatest
complication from the surgery) happens much more frequently with the lap
procedure. So, between that and the extra time under a general anesthetic,
I was very pleased to have the open. As far as the scar, he closed it the
way a plastic surgeion would and it's not bad at all. Whatever you decide,
I wish you the very best of luck.
— Nancy Z.
October 15, 2001
BE CAREFUL!! I am stuck in this insurance hole about this very thing!! My
insurance approved instantly my RNY... but has yet to approve my LAP RNY!!!
You better check with your insurance company before you get too excited and
end up paying for the surgery yourself!
— Sharon H.
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