Make a Run for the Border!

February 22, 2008 7:46 PM

Any info about lap-band surgery in Mexico?

A close family member is considering having lap-band surgery in Mexico. They've done the research, the surgeon is qualified, we know three people who have used him and sing his praises. Web research on the surgeon and the center seems positive and every question we have asked has been answered to our satisfaction. I just can't seem to get over the weird feeling I get about crossing over the border in a van to have surgery (yes, that's how this group does it). Am I being crazy? The family member feels like this is not a very invasive proceedure so it will be fine, I'm not so calm about it. I guess I am a product of my Americanized health care system and I'm having a hard time seeing past that. This is where I need the green's help. Does anyone have any experience with this sort of thing? Can you recommend a surgeon that we may not have researched? Should I have this weird feeling or am I being paranoid? More info: My family member has considered getting it done in the states but it is not covered and the cost will be half in Mexico. They have been to several doctors and had all the proper tests and clearances done. They are considered a good candidate for this surgery. Thanks for any advice or help you can give.

posted by anonymous to health (9 comments total)

No, you're not being crazy. The monetary cost is half. The life cost might be greater, might not be. My n=1 experience was a woman who got a lap-banding in Mexico and by the time she was back in the US was pretty damn sick and required an open revision for a perforation I believe. (It was a few years ago that I recall this happening.)
posted by gramcracker at 8:05 PM on February 22

The thing with lapband surgery is that it's not a one shot deal. It requires significant maintenance and follow up.

Lap band patients need regular monitoring to ensure that the band hasn't slipped, that they're following the proper diet, that they're not losing weight too quickly/slowly, etc. How is all that going to happen if they're not in the same country as her doctor?

Where is this family member going to go for their fills (when you go to have the band tightened with saline). The 'old school' method was to do fills right in the office, but you wouldn't know if it was too tight until you tried to eat and couldn't - you'd just throw up. So, more recently, doctors are preferring to do fills under fluoroscopy so that there are no surprises.

Are you sure it's not covered? Many insurance companies will cover it, but there are contingencies, such as a mandatory six month supervised waiting period. Also, if there are other co-morbidities involved, the family member may be able to file an appeal under medical necessity.

I would be VERY loathe to do something like this out of the country. JMO.
posted by dancinglamb at 8:56 PM on February 22

As dancinglamb suggested, the followup is critical. If you've done alot of research, I'm sure that you've come across ObesityHelp. Just anecdotally from the boards there, when people move, they can have significant issues finding a surgeon who is willing to do followup care for them. And that's for people who had the surgery performed by an American doctor. I would suggest lining up a local surgeon who would be willing to do followup before I went through with it. That may be impossible...and there's your answer.
posted by cabingirl at 11:19 PM on February 22

I got this back in germany when I lived there in the late nineties and already then it was rather cheap. I think my insurance (yeah) paid 8k then. so why cross the border for it now? don't the travel cost alone annihilate the savings?
posted by krautland at 6:42 AM on February 23

One of my best friends actually had the same surgery in Mexico about a year and a half ago. She lives in southern CA, and the hospital she went to is in Tijuana, so the distance was less of an issue for her (I think she still goes down there a couple of times a year for maintainance / follow-up). Also, her US insurance didn't cover lap banding at all... they would only cover gastric bypass, which she wasn't interested in. I was fairly skeptical at the outset, but FWIW, she was really happy with the surgeon she chose, had no complications and was back to work three days after surgery. Her surgeon was called Dr. Ortiz.

After watching her go through this, it seems to me that this type of surgery is "big business" in Mexico. The surgeon she went to does something like 4 lap band surgeries a day, 5 days a week, all year round. This could be considered a positive or a negative, but it does seem that a doctor working in this type of environment would have a lot of experience with any potential complications that could come up.
posted by OrlandoFurioso at 7:20 AM on February 23

I didn't have the lap band surgery, but I did have the duodenal switch in Brazil with a doctor and at a hospital with impeccable recommendations, both professional (US doctors) and anecdotal (patients). My experience was better than I hoped for, in fact my hospital care in Brazil was far better than the hospital care I have received in the US in the past. If I had to do it again, I would do it without a second thought and for those of us whose insurance doesn't cover weight loss surgery, I'd highly recommend exploring out-of-country options any day, just do your homework. For the record, from airline tickets to the hotel room, from the surgeons fees, hospital stay, food, souvenirs, visas, passports to having two friends fly in and stay with me for a week post-surgery, I was out a total of around $17,000. To have it locally, it would have cost around $40,000.

Having said that, for me personally, I don't think I would go out of country for the LapBand because of the long-term maintenance that it requires. Yes, it's a less evasive surgery, but fills and refills need to be taken into consideration and cabingirl is right, many doctors are unwilling to do that kind of follow-up care. My surgery was a one shot deal and my local PCP helps manage my progress with labs and check-ups as needed. I also make every effort to ensure my surgeon in Brazil is kept up to date with my progress and that he and my PCP are in communication.

Your family member can definitely be successful, but they absolutely have to be advocates for their health and they absolutely have to have good local follow-up care.
posted by SoulOnIce at 8:39 AM on February 23

What concerns me, aside from the obvious surgery complications, is how sterile are their instruments. Are they *really* autoclaving their surgical instruments the way they say they are? The people that are singing his praises now may be cussing him later if they eventually find out his unsterilized equipment infected them with HIV or hepatitis.
posted by GlowWyrm at 8:39 AM on February 23

I know someone very well who flew to Puerto Vallarta to get a lap band. (She's in BC.) Aside from the hassle of finding a local doctor willing to do the fills, she has had an amazing experience. It isn't a back-room affair: the doctors are very professional.
posted by ms.v. at 8:41 AM on February 23

GlowWyrm, I think that's a valid point and one that leads to the fact that people have to do their due diligence. Unfortunately, a lot of people just read a surgeon's website and consider that research or in the case of the LapBand, read their marketing material and consider that objective investigation. Whatever anyone decides, they need to talk to current and former patients.

Although ObesityHelp.com is a good starting point, they tend to censor their members when it comes to criticizing doctors and hospitals. I'd find Yahoo groups (many are doctor-specific) or other surgery specific forums where you can connect with people who are a few months to a few years out from their surgery and they should be able to tell you the good and the bad.
posted by SoulOnIce at 10:56 AM on February 23