Geha insurance

[tmoog 2]

Has anyone had a revision from sleeve to a duodenal switch with GEHA insurance? I’m having terrible GERD. I had the sleeve 6 years ago and have been on nexium ever since. My GERD is getting worse. So I’m thinking about starting the process of having a revision. Not sure if GEHA would cover it or even where to start with the process.

[GreenTealael 25,383]

*Almost* no Surgeon will revise a VSG to a DS if GERD is a factor. Something to consider...

[RickM 1,747]

Have you had any medical evaluation of your GERD other than just what you are feeling - an upper GI or endoscopy to see whats going on in there to cause it? Self diagnosis is not a good start toward a revision.

The VSG has a predisposition toward GERD owing to the stomach volume being cut down much more than the acid production potential along with its high pressure character (much like the RNY is predisposed toward marginal ulcers, dumping and reactive hypoglycemia owing to its specific quirks.) If your GERD is a simple result of the above VSG factors, then revising to a DS won't help the situation; an RNY is the more typical solution. However, if your GERD is caused by a hiatal hernia or a malformed sleeve (strictures and the like) then it is not unreasonable for surgery to correct that particular problem will do the trick; a DS in itself will not do anything for GERD as it will use your existing VSG as a starting point - a re-sleeve may be done at the same time depending upon need. Revising to the DS will help some with losing some regain but mostly will help avoid future regain, but revisions in general are typically only marginally successful in treating regain.

I can't speak for your specific insurance, but generally insurance will cover any medically necessary revisions for treating complications.

[Postop 411]

2 hours ago, GreenTealael said:

*Almost* no Surgeon will revise a VSG to a DS if GERD is a factor. Something to consider...

Agreed.

I’d speak with Dr. Keshishian regarding a revision to the DS. He’d give you a fair opinion.