Questions about bypass in Mexico?

[whitneyisfab 26]

Hi all! I was considering getting gastric surgery in Mexico. I currently live in the US, and my insurance does't cover anything related to gastric surgery here. I saw that Dr. Illan had good reviews and looks affordable so I was considering choosing him. I was unsure of whether I should choose gastric bypass or the mini bypass, I think the mini bypass would be better for me but from what I hear it is not a common procedure in the US, and I am concerned about finding a Dr. that can treat me here if something goes wrong. Also, has anyone had issues with their insurance once they got back not covering things related to having the surgery? From what I hear Mexico is very safe to have surgery but I can't help but be scared to do it. I am so afraid I'm gonna pop open on the plane or something. If anyone has any insight I would appreciate it.

[shannybananny71 106]

I think you should fill out the questionnaire for Dr. Illan and see what he recommends and why. I am choosing a sleeve over bypass because you cannot take NSAIDs after bypass (ibuprofen, Advil, Aleve, etc.). However, it is my understanding if you currently have really bad acid reflux, you should go with bypass over the sleeve.

My surgery with Dr. Illan is scheduled for March 6th. I have the same concerns about finding a doctor stateside and with insurance. It seems that the majority of people don't have problems with that and are able to find doctors to help them. My plan is to schedule a physical with my regular doctor three months after my surgery and then have the discussion with her then.

[RickM 1,747]

Finding doctors to provide post-op treatment as needed can sometimes be a problem as most docs are wary of taking on the liability of other doctors' patients (this can apply whether the original surgeon is in Mexico or the US). Routine follow up like labs and such are not usually a problem and can be done thru ones PCP and are usually covered by insurance as routine health care.

As to which procedure to get, do as much research as you can on them. I'm no expert on the bypass or mini, but there are reasons why the mini bypass has never been accepted by the ASMBS or the insurance industry in the US. It has been around for a long time - some docs were promoting it when my wife and I first got into the WLS game some fourteen years ago, and in the meantime both the DS and the VSG have been accepted as mainstream procedures, but the mini has not. This also plays into any "plan B" that one may have in that since it is not well known in the general bariatric community, this makes it more difficult to treat and/or revise in the future if such is necessary. I would certainly stick with a more mainstream procedure (though a case can be made for a newer procedure like the SIPS/SADI which hasn't gained acceptance due to its novelty and a track record hasn't been established, as opposed to the MGB that never gained traction despite it having been around for a while.)

[MissKay 329]

Dr. Illan is great! @Bill Yanez can help you get the questionnaire and even set up a Skype consultation (or phone) with Dr. Illan to figure out what's best for you. So far many don't have issues with PCP follow up with blood work, routine tests, etc. If something goes wonky (not typical, but also not guaranteed) down the road, then that might be where your insurance may get touchy. I know with mine they'd cover it because my coverage covers anything besides the actual surgery itself, go figure.

As for while you're in Mexico, the price only covers you for the tests, post-op prescriptions, and surgery itself (plus the hospital/hotel stay). If there are any complications you'd have to pay those costs. My suggestion is to get a travel health insurance coverage. I did that just to be safe. Paid $20 for 2 weeks of coverage. Once I was stateside, I wasn't worried. I talked to my PCP prior to surgery about getting it done in Mexico and she was supportive (she'd had 2 other patients who'd done it as well).

[GBLady41 393]

Actually, I had surgery in Mexico, and went through BariatricPal TeamMX and the price covers the surgery, tests, post-op prescriptions, hospital and hotel stay, AND if you have any complications either in the hospital or the hotel, it was covered. I emailed my question to Bill Yanez and he responded that any complications I have in the hospital or hotel is included in my price. Bill?

[Berry78 4,261]

I am also deciding between sleeve and bypass. (Don't want a mini since they aren't common in the US).

I'm pretty set on the sleeve because it can be converted later if necessary. The bypass is one and done, but what if it is more than I need? The sleeve has a pretty good weight loss to complication ratio, and I am willing to entertain the notion of a revision later.

The RYN bypass is definitely "one and done". I wouldn't entertain a revision later from that.

Good luck!

[RickM 1,747]

8 hours ago, Berry78 said:

I am also deciding between sleeve and bypass. (Don't want a mini since they aren't common in the US).

I'm pretty set on the sleeve because it can be converted later if necessary. The bypass is one and done, but what if it is more than I need? The sleeve has a pretty good weight loss to complication ratio, and I am willing to entertain the notion of a revision later.

The RYN bypass is definitely "one and done". I wouldn't entertain a revision later from that.

Good luck!

Indeed, the sleeve provides more options down the road if necessary, while the bypass's options are limited to minor tweaks within the basic bypass architecture. It can be revised to a DS, but that is a complex procedure that only a half dozen or so surgeons can be trusted to do.

One should be as certain as possible going in as to which procedure is the best fit for one's needs. Revisions typically don't work as well as a virgin procedure, so they should certainly be considered a "plan B" if other actions don't work out, but nothing that should be planned on "if I don't like" the first one. I know several who have gone the RNY to DS route and while they are generally doing better with the change, they would have done better still had they gone to the DS originally (most didn't know, or know enough about, the DS when they were sold the bypass in the first place.) Research, research, research. The sleeve can just as readily be revised to a DS as to an RNY but still usually has that performance deficit relative to a virgin procedure.