ESG Self-Pay - Questions

Michelle F · April 1, 2019

Hello everyone!

I've been trying to figure out everything about the ESG surgery. I went to a seminar last week for gastric bypass/sleeve, only to find out that my insurance doesn't cover it. In checking out my options, I found out about ESG and it sounds like a better fit for me. I'm waiting for a callback from the surgical office for my consultation appointment. I'll be self-pay (Care Credit & HSA), but I had some questions:

1. What kind of testing did you all have to go through prior to the surgery? I know insurance generally requires a lot of hoops for patients to go through, but I'm curious how that applies to self-pay patients.

2. I've read two different responses for the anesthesia - one that you're sedated (but not knocked out) and another says general anesthesia. What was your experience?

3. Did you have to do the 2 week liquid diet that most other bariatric surgeries require?

4. Have you had any complications?

Thanks in advance!

- Michelle

Hop_Scotch · April 1, 2019

In Australia (self pay too) it may be different than where you are but,

1. Standard blood tests to establish base points and any comorbities (not that I probably needed comorbities my weight was high enough), also need a test for H-pylori (negative for me), if positive would have needed a course of antibiotics.

2. General anesthesia

3. Yes, but this really depends on the doctor. Some doctors do it to ensure a pattern of compliance, if someone can't do two weeks pre -op liquid/shake diet how will someone be able to manage the post-op liquid diet? ?

4. None for me.

Some people for various reasons have lost restriction. Tests have revealed that the sutures have become lose or undone. Reason may include non-compliance with post op guidelines, doctor inexperienced with ESG and suture placement, some people who have had a gastric balloon prior to ESG have a higher failure rate, some people with severe vomiting (due to other illnesses) which has caused sutures to loosen...and then there are the people for some inexplicable reasons the ESG has failed even though they have followed all the insructions and they have experienced doctors etc.

Some points to bear in mind for ESG: weight loss will likely be slower and lower than the surgical options (average weight loss is 20% of excess weight, some people have lost a lot more, some people have lost less), adherance to post op guidelines is vital - it will help the suture anchor points heal which will help the restriction hold tight. Like the surgical options there is a weight loss sweet spot, for the ESG it is probably the first six months to 12 months. It's tool, we need to make it work to ensure the best weight loss, this means a compliance with post op guidelines for diet and exercise, will need to change all those not so healthy eating habits particularly emotional eating.

Generally the ESG is not reversible, and it has been said that for those who choose to have a revision (where the ESG has failed) that a VSG is not a safe option (though I have seen research where such revision has been successful) - i think it may be a chase of the suture anchor points may get in the way of a VSG. Bypass seems to be the surgeons' choice for ESG revision to surgical option. Another ESG is also a viable revision.

Edited April 1, 2019 by Hop_Scotch

Michelle F · April 1, 2019

Thanks so much for your response!

sandi56 · April 3, 2019

This just answered a lot of questions I had. I go tomorrow for my consultation and go from there. Wish me luck !

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Hop_Scotch · April 3, 2019

1 hour ago, sandi56 said:

This just answered a lot of questions I had. I go tomorrow for my consultation and go from there. Wish me luck !

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Hope it all goes well for you.

Some questions to ask should they not already be on your list of questions: how ESG has the doctor done? Success rate? Failure rate? What caused the failure? Anyone experience complications and what were they? Average excess weight loss of their ESG patients? Post op support program - is there one and what does it entail? What post-op medication is prescribed to help deal with initial pain?

sandi56 · April 29, 2019

I go May 10th for a scope then I go June 3rd and July 3rd. My insurance is making me go. So after the July meeting with the dietitian I will set my surgery date.Thank you Hop_Scotch for the questions I need to ask.

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