Lap vs open... price and difference.

[Guest guest]

Hi all.

Anyone know what the self pay price is for a lap DS with Rabikin?

Also, is the lap as effective as the open surgery?

Anyone know what the risks for lap are?

Feedback is appreciated.

Rosie

[Guest guest]

Hi Rosie,

I think that Dr. R's price is about $32,000, but that is old data.

Rabkin uses a lap assited technique, so there is still a 3 " incision

as well as several port incisions.

The procedure is equally effective. The risk of wound infection and

and hernia are reduced. There is a slight increase in the risk of a

leak. Recover time is slightly quicker, but not all that much.

Note that this is not the same as the fully laprascopic technique

developed by Gagner, Ren, and . The fully laprascopic

technique involves no vertical incision. The benfits have to be

weighed against the significant increase in complication rates,

especially for those with very high BMI (>65). Usually the appendix

and gall baldder are not removed in this operation. Often this

operation is done in two parts, as it takes so long. There clearly

is increased risk from being on the operating table for so long. The

shortend healing time of the wounds has to be weighed against the

effect of being under anestisa for so long, and the requirement (for

those with high BMI) to do the procedure in two parts. In addition,

because the gallbladder is not removed (to save time), patients with

a gallbladder at time of operation have a significant chance of

requiring an operation later for that.

Dr. Anthone feels that the fully-lap procedure is too risky at this

time. When I asked him about Dr. Rabkin's technique he stated that

he really dosen't see the point, since you still need a 3 inch

incision. Anthone also feels that a hernia is often a plus, as it

makes it easier to get insurance coverage when it is time for the

Panni.

Dr. K has just started doing the lap. He began with a technique

similar to Rabkin, but he also is going to try the fully laprascopic

technique. It is way to early to judge his resutls.

Hull

> Hi all.

> Anyone know what the self pay price is for a lap DS with Rabikin?

> Also, is the lap as effective as the open surgery?

> Anyone know what the risks for lap are?

> Feedback is appreciated.

> Rosie

[Guest guest]

I think you need to take a look at that old information of yours. Are

you including hospital costs in with that? If not, your number is

way to high, and if so, your number is way to low. Further, the

point of Rabkin doing lap with open assist is terribly important in

terms of comparing open to lap with open. Having had abdominal

surgery in the past, with a 12 inch incision, let me tell you, that

extra 9 inches is what kicks your arse!

Rabkins 3 inch incision, he uses as a safety guard in order to

increase his field of vision, and because he measures each patient

individually. this incision is dramitically less invasive than a

standard " open " procedure. Rabkin also always removes the gallbladder

and appendix, and his surgical times for the lap are very short.

Unfortunately, I can't put my finger on the exact time that doctor

Rabkin has gotten his surgery down to, but it is absolutely no more

risky than the open procedure as far as anesthesia time, and is

certainly much safer in regards to the points that you mentioned.

Personally, I don't think a hernia that might or might not afford me

a TT later on is side affect I want.

You always give such wonderful information. I hope you don't mind my

adding my .02 cents worth.

Theresa

> > Hi all.

> > Anyone know what the self pay price is for a lap DS with Rabikin?

> > Also, is the lap as effective as the open surgery?

> > Anyone know what the risks for lap are?

> > Feedback is appreciated.

> > Rosie

[Guest guest]

Teressa,

Thanks for the info. The $35,000 was a data point on a negotiated

package deal with Rabkin. More recently Robyn negotiated $42,500

with Anthone, but decided to go with Dr. K for $25,000.

The comments on operating time were for the " fully laprascopic

technique " , not Rabkin's technique.

Anthone's incision is 6 " , rather than the 12 " that you mentioned.

There has been a trend in open surgery towards smaller incisions. As

a result, sometimes the appendix is not accesable, and Anthone will

leave it in rather than increase the incision size.

The hernia situation is debatable. Even if insurance doesn't approve

the Panni, your hospitalization time is covered because of the

hernia, and the incremental costs of doing a Panni or other cosmetic

surgery are much smaller than if they were done in a separte

procedure. For those that don't think they will need any cosmetic

surgery, then avoiding a hernia is arguably a good thing.

If anybody has more recent experience with Dr. Rabkin and Self-pay,

please let us know.

Hull

> > > Hi all.

> > > Anyone know what the self pay price is for a lap DS with

Rabikin?

> > > Also, is the lap as effective as the open surgery?

> > > Anyone know what the risks for lap are?

> > > Feedback is appreciated.

> > > Rosie

[Guest guest]

If you are going self-pay, the hospital wants $18,000 up front. I was

approved out of network with Blue Shield PPO. So I had to pay Dr.

Rabkin up front, but not the hospital. My out of pocket with them will

be about $2,000. However, I have yet to receive a bill. They've put me

in collection and I get calls, but nothing in the mail. If I can't get

this straightened out soon, I'm going to have to go to the hospital in

person and say WAYMISH (why are you making it so hard) for me to pay

you? LOL

KathleenF

Open DGB/DS

Dr. Rabkin/Dr. Jossart

01/02/01: 374#

09/26/01: 247#

http://www.webniche.com/wls

> ..snip.. but don't forget about the hospital,

> that's the biggest charge. I don't know what it is, maybe someone who has had

> it done there will let you know.

> Sheryl