Lap band surgery overseas.

Question
I am 58, 6?? and weigh about 230.  I抳e tried eating less and exercise to lose weight for years with no success.  I would like to try lap band surgery.  I don抰 believe I would qualify for insurance reimbursement.  I抳e heard that overseas procedures, such as in India cost about 25% as much as having it done in the USA.  How can I determine the best place to have the procedure done where I will get good quality care at the lowest possible cost?


Answer
Dear Roger,

You are facing a few issues.

First is your weight.  At 6 feet tall and 230 pounds, you do not meet the criteria to have weight loss surgery, including the Lap Band.  In the US, you would need to have a BMI of 40 or a BMI 35 with serious health complications Your BMI is 31.5 - making you far from obese.

This said, if you have have struggled for a long time with your weight, you may be right to consider this as an option.

I generally do not advise foreign surgery for several reasons:
1) With a Lap Band, after care is very important and must be done on a regular basis to make the device effective.  When a band in placed, it is placed  open or unfilled and the first fill is not done for 6 week.  So unless you are going to spend a quite a while in India, this is not very convenient.

2) Bands then need to be adjusted on an ongoing basis.  As a medical device, anyone in the US who adjusts your device owns it - and this then becomes their medical liability.  For this reason, many US doctors will decline to adjust foreign-placed bands.  If you do choose to go overseas for surgery, it is critical, therefore, that you locate a surgeon here who will be willing to adjust you in the States.  This will not be free.  You may find, in fact, that it off-sets the overseas savings.  Some overseas programs include free adjustments, but you do have to travel back and forth to get them.  I have heard that in some facilities in Mexico, this is affordable, but I think the airfare alone to India would make this very hard.  You can look into a company called Fill Centers USA that has adjustment centers in various locations - if one is near you, you can look at their fee schedule for adjustments.

3) Make sure that if you are going to go over seas you get the right band.  In the US, only one device is approved - the Lap Band from Allergan (formerly Inamed).  In the rest of the world, other devices are used in addition to this one.  If you have an non-Allergan band placed, no US doctor will adjust it simply because they can't.

To me, the last question you ask here is the critical one.  You are in a situation where, since you will not meet insurance criteria, you would need to pay cash to a US surgeon for a Lap Band.  Even then, it might be harder to get the procedure done since many surgeons apply the same criteria regardless.  Still, I would start looking here before looking out of the country.  There are many US facilities that now offer lower-cost Lap Bands domestically - and by the time you factor in multiple plane tickets for adjustments, the cost is really not so different.  Plus you have the assurance of US-quality healthcare and you will know that you have a place to go in an emergency.  I might start by checking out Journey Lite, AIGB, and New Hope Bariatrics - they all have multiple outpatient centers her in the US placing bands.  One center I do know in Mexico that is well regarded is Obesity Control Center (Dr Ortiz).  They have been a long-time training center for US surgeons.

If you really are set on going abroad, get into some chat rooms on sites like Obesity Help and talk with some real patients about their experience, their surgeons, etc.  One of the best ways to know what you are getting into is to talk with people who have been there before.

I hope this is helpful.  Please let me know if you need more information.

In Health,

Dr. Jacques

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