Question:
Should I get GYN surgery before or after WLS? Advise appreciated.

During the long process of being screened for WLS I had to have a pelvic ultrasound. The US showed that I have a dermoid on my ovary. I went to see the GYN and he said it should be taken out, but it is not an emergency. I didn't want it to mess up my approval for WLS, so I elected to wait. Also I was told that maybe I could have it taken out at the same time. Well since then, the surgeon informally told me that HE could not do it at the same time, but I could get a GYN to come and do it at the surgery - NOT feasible. If I don't get it out, the surgeon was concerned and wanted something in writing saying that it did not need to come out. My GYN will give me that. So here are my choices: Do it now - what are the risks? Well apparently the recovery from this is quick, and the way I'm waiting now, there probably isn't really any big crunch... it's not like I can have the WLS tomorrow, or even in the next three months. Wait until later. To me this seems like it might smooth over the insurance issue - but actually I think my GYN already submitted me for approval since I was scheduled for a date to do this in April... so they probably have this in my records anyway. According to the GYN, he can do it either way, but after WLS it might be more complicated since I might have more scarring and then he won't be able to remove my dermoid lap but open, and I'll be stuck with a scar and recovery will be worse. Well, I can live with that. The scar may be a non issue since I'm already pretty sure I'll need a TT after all of this. I am really confused and would appreciate any advise? Anyone have a similar problem?    — w8free (posted on June 5, 2003)

June 5, 2003
I had a dermoid in 91, removed with a lap procedure but an 3" excision to remove the dermoid. lower quad of abdomen. I personally don't understand why they can't do it together. Many people I know have their tubes tied, appendix removed, I even knew a girl who's appendix was on the opposite side and was removed all during wls....anyway, I don't see where you would have so much scarring after wls, it is a lower surgery for the dermoid and upper for the wls. So, my opinion is have the wls, this has so much red tape, just get it over with. I would get a couple opinions on the dermoid removal, as not all doctors might have the same opinion on how to tackle it. Best of Luck!
   — ZZ S.

June 5, 2003
I would do it now! I am 4 months post op from open RYN, and now I am needing to have LAP GYN surgery, the GYN wanted to do this last month, although I have had a very good and very uneventful recovery, WLS not only takes it's physical toll, it's very emotionally. I cancelled my GYN surgery, emotionally I could not handle another surgery so soon, so I am going to wait a few months.
   — mildstorm

June 5, 2003
If you know you'll be waiting a few months for WLS, I would definitely have your GYN surgery now (they can do it lap, right?)....My surgeon for WLS also said he would not do two procedures, only the WLS and suggested having my lap endometriosis removal two or three months prior to WLS....(I have chosen to not have it, but the only risk is more pain, nothing serious) His reasoning for having one first was as you said, you'd be in better shape physically, and it was better to do the more minor surgery first. GOod luck whatever you choose, and hope you're feeling better soon.
   — Kelly B.

June 5, 2003
I know that some surgeons prefer to not combine procedures - and if I was a doctor and worried about a patient having complications from a major surgery at the same time, I probably wouldn't want to compound the risk by doing it together, one reason being longer anesthesia time. However, I'd ask your WLS surgeon how he feels about a combined procedure. If he feels it is no problem, I'd ask him for a referral to a GYN that he thinks might be more willing to combine the two. If you just can't combine the two, or don't know how long it will be for your WLS, I'd definitely do the GYN and get that behind you.
   — bethybb

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