Question:
I am tentatively scheduled in Sept for an open RNY, but have some problems

surrounding the issue. The last, intact, supple skin on my 350 lb frame is the flesh on my abdomen - I've always had my heart set on a Lap procedure. Now, I learn that the Fobi pouch has a greater loss result, and greater probablity of no regain. In my research, have found a Doc who comes very highly recommended who does the Fobi Lap, and I scheduled with him for July 31 (just a couple of weeks away). Now, after much effort, I find I can't muster the financing for the Fobi Lap (self pay, concrete written exclusion in employer's insurance policy). The cost of the open with the first Doc mentioned is $6900.00, the cost of the Fobi lap with the second Doc $13,000. I want to see 140 lbs again, which would be a 210 lb loss, but have heard most people lose about 100 lbs with standard RNY, then, I have that thing about the incision. To turn the heat up more, the Doc that does the open is getting booked well into the future; moreover, in January his cost goes to $8000.00 from the $6900.00 he charges now. What to do, go ahead with the Doc I can probably afford, and deal with the scar (which I can hardly abide) and lose less weight, or cancel both for now and try for later for the Fobi Lap, my first choice. Scared both chances may pass me by. I'm 50 years, old, need to get some show on the road. Please Help.    — pam C. (posted on July 22, 2003)

July 22, 2003
Hi Pam. We have MANY patients who have lost in excess of 100 pounds with RNY and MANY of them are at goal. So, I'd say the RNY is a very good and valid procedure that can give you the means to reach your goal. However, if you feel committed to the Fobi pouch you may do better to wait and save a bit longer. I know I'm not helping you much with a decision. What I actually wanted to do was reassure you that you can get to goal with RNY. I believe the Fobi pouch is an excellent surgery, however, like all WLS procedures it has it's downfalls too. Roseanne Barr had the Fobi pouch and has experienced significant regain since her surgery. It just goes to show that WLS is a tool and not a miracle (although I consider it a pretty miraculous tool). As far as the scar goes - ask yourself how much time you plan to be either nude or showing your abdomen in the presence of others. Compare that to how much time you will spend fully clothed. For me it was an easy decision - I HAPPILY traded 115 pounds for the scar. I am happily married and, like anyone else, I would love to have a tummy with no scar so I could wear a two piece swimsuit or maybe even wear a belly button ring. BUT I am perfectly content being able to wear small, fashionable clothes while hiding that old scar underneath. Best wishes to you in making the decisions that will make you happy.
   — ronascott