Guest guest Posted July 15, 2000 Report Share Posted July 15, 2000 In a message dated 7/15/00 6:30:06 PM Pacific Daylight Time, lindat@... writes: << Well, let me reiterate my comments, lest you apologize for them, because I was *not* pleased at the totally unprofessional and unsupported attack Lindstrom made publicly, in private emails, and in conversations with others, on the MGB, you, personally, and on the basic intellectual capacities of your potential, past, and present patients. When called upon to support his " opinions, " with some facts, he could not, did not and has not. >> Oh my God! Can we just give this a rest--PLEASE!! I am about to have a severe case of reflux myself and I haven't even had surgery yet!! LOL Regards, Debbie in IL Daughter MGB 8/9 Cigna (3rd appeal)--BMI 45 Counting on Cigna for Debbie (BMI 40) ins letter sent 7/14 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 15, 2000 Report Share Posted July 15, 2000 Thanks for the post, Dr. R.... I like those statistics! Deb in IL Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 15, 2000 Report Share Posted July 15, 2000 Hi Laurie in Ohio, Thanks for your nice post. I will summarize: No one now criticizes the MGB about weight loss, leak rates, pulmonary embolus rates, hospital stay, operative times, costs mortality rate... Let me tell you that in the beginning I was criticized for concerns about all of these things and we have now clearly demonstrated that in every case the MGB results are as good or better than any other operation. So what can an uninformed physician complain about? Well how about Bile reflux? First let me correct you we have, as far as I am aware, no patient that is over 3 months after surgery with any bile reflux esophagitis. In the old loop gastric bypass up to 40% of patients had bile reflux esophagitis soon after surgery. Mr. Lindstrom and I have been having a nice friendly dialog privately and here is some of what I wrote to him: **************************************************************************** ***** " Hi again Mr. Lindstrom, I just finished my print outs for tomorrow's surgery. 9 cases, yikes. Let me again try to apologize for the strong comments that have been directed at you from some of the people on my lists. I earnestly hope that you can find it in your heart to be forgiving. I think you are very right to do what you have done. You asked your trusted friends and colleagues their opinions about an area that is their expertise and they said that the MGB is bad. You did what can only seem to be right in your eyes. I honestly respect you for that. Now as to me. I could do a VBG or RNY or even a BPD if I wanted to. Why would I dare to do something different? What if I honestly felt it was better? Let's look at the concerns about the MGB. Short term, well since my people have done so well, the raft of short term complaints and concerns have been silenced. Long term, bariatric surgeons feel that the loop leads to bile reflux and esophagitis (inflammation and irritation of the esophagus) and this then leads to cancer! Sounds bad. They feel that they know this will happen because of the 20 year old experience of the Mason " Loop Gastric Bypass " as you heard at the meeting up to 40% of patients developed esophagitis. Hmmm... But None of my patients have esophagitis. None. But 40% of the old loop patients did. None of mine do. In fact many of my patients had severe esophagitis preop and it, the MGB, has cured their esophagitis. But how can that be? The obvious answer 1) I am fibbing (I am not, find one of my patients with esophagitis) or 2) the MGB is not the old loop. Now lets go at this same question from another tack. Billroth II, loop gastrojejunostomies are done at a rate of ~12,000 cases per year by general surgeons in America for ulcers, cancer and trauma. Is their a similar crusade by nonbariatirc General surgeons against this very high rate of Billroth II gastrojejunostomies? Are the bariatirc surgeons creating a petition to stop loop gastrojejunostomies? No of course not, but why not? If your colleagues were concerned about cancer why not get wound up and criticize all of these other surgeons? Basically there is a difference between the " old loop " gastric bypass and the Billroth II done by most general surgeons for ulcers etc. My MGB is designed to be like the usual Billroth II loop and to avoid the problems of the " Old Loop " gastric bypass. It is easy to do. The difference is that in the old loop bypass the loop was close to the esophagus and in the usual Billroth II loop gastrojejunontomy done by the average general surgeon the loop is placed far from the esophagus. In the MGB the loop is far away from the esophagus. It is not close to the esophagus it is far away. " **************************************************************************** ***** " Hi again Mr. Lindstrom, RE: your comments on my note. First I have only given you a very small part of the argument that makes me favor the MGB. There are at least 4 other major factors that I would be happy to detail for you more of the apologia for the MGB that I have in my mind. Briefly let me just say " failure " : i.e. what to do after any other surgery if the operation fails, to much to little or something else. In an MGB revision is a 60 minute laparoscopic procedure. That is not true with any other surgery as you well know. Also think about a 20-30 minute surgical cure of diabetes. On Wed. of this week I did 9 cases from 8:30 to 4:30. All had an overnight stay in the hospital... What if I were to be right? and there is more... Re: my colleagues, I do not think that they have had a chance to hear what I am saying.They " know " the Mason Loop was bad and it is hard to get over that " knowledge " . I think it will take time. There have been two surgeons here to visit and learn and watch the surgery. One has done 10-15 so far. Another has expressed an interest in coming down to spend the day. I think as you imply if a few people get to think about it I may get more of chance to explain my procedure. I think people are very right to be skeptical but look at the evidence that I have. I have almost 700 patients that I follow meticulously and are available for anyone else with any real interest to investigate themselves. Never in the history of Bariatric surgery has an operation appeared with such strong supporting data. Peace. " RR Rutledge, M.D., F.A.C.S. The Center for Laparoscopic Obesity Surgery 4301 Ben lin Blvd. Durham, N.C. 27704 Telephone #: Fax #: Email: DrR@... ************************************************ Please Visit our Web site: http://clos.net ************************************************ Durham Regional Hospital: Also, Please consider joining the Mini-Gastric Bypass Mailing List at http://www.onelist.com MiniGastricBypass is a general discussion of the Mini-Gastric Bypass ( http://www.onelist.com/community/MiniGastricBypass ) Talk with lots of other Pre and Post Op patients and friends. Keep up to date on the latest news about the Mini-Gastric Bypass. ----- Original Message ----- Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 15, 2000 Report Share Posted July 15, 2000 Hi Dr. Rutledge, Thanks for this post. I love reading all the information, here and on your web site. I am so glad to hear that other surgeons are learning to do the MGB! It is great to hear your comments about the concerns that some others have about the MGB. Each time I read new information about this, even the negative comments, I end up realizing that after I take everything into account, I continue to feel very comfortable with and sure of my decision to have the MGB. I look forward to meeting you and having the MGB. Hopefully at the beginning of August, if my insurance cooperates. Thanks, Sara Schutz " Rutledge, M.D., F.A.C.S. " wrote: > Hi Laurie in Ohio, > > Thanks for your nice post. > > I will summarize: > > No one now criticizes the MGB about weight loss, leak rates, pulmonary > embolus rates, hospital stay, operative times, costs mortality rate... > > Let me tell you that in the beginning I was criticized for concerns about > all of these things and we have now clearly demonstrated that in every case > the MGB results are as good or better than any other operation. > > So what can an uninformed physician complain about? > > Well how about Bile reflux? > > First let me correct you we have, as far as I am aware, no patient that is > over 3 months after surgery with any bile reflux esophagitis. > > In the old loop gastric bypass up to 40% of patients had bile reflux > esophagitis soon after surgery. > > Mr. Lindstrom and I have been having a nice friendly dialog privately and > here is some of what I wrote to him: > > **************************************************************************** > ***** > " Hi again Mr. Lindstrom, > > I just finished my print outs for tomorrow's surgery. 9 cases, yikes. > > Let me again try to apologize for the strong comments that have been > directed at you from some of the people on my lists. > > I earnestly hope that you can find it in your heart to be forgiving. > > I think you are very right to do what you have done. > > You asked your trusted friends and colleagues their opinions about an area > that is their expertise and they said that the MGB is bad. You > did what can only seem to be right in your eyes. > > I honestly respect you for that. > > Now as to me. > > I could do a VBG or RNY or even a BPD if I wanted to. > > Why would I dare to do something different? > > What if I honestly felt it was better? > > Let's look at the concerns about the MGB. > > Short term, well since my people have done so well, the raft of short term > complaints and concerns have been silenced. > > Long term, bariatric surgeons feel that the loop leads to bile reflux and > esophagitis (inflammation and irritation of the esophagus) and this then > leads to cancer! > > Sounds bad. > > They feel that they know this will happen because of the 20 year old > experience of the Mason " Loop Gastric Bypass " as you heard at the meeting up > to 40% of patients developed esophagitis. > > Hmmm... > > But None of my patients have esophagitis. None. > > But 40% of the old loop patients did. > > None of mine do. > > In fact many of my patients had severe esophagitis preop and it, the MGB, > has cured their esophagitis. > > But how can that be? > > The obvious answer 1) I am fibbing (I am not, find one of my patients with > esophagitis) or 2) the MGB is not the old loop. > > Now lets go at this same question from another tack. > > Billroth II, loop gastrojejunostomies are done at a rate of ~12,000 cases > per year by general surgeons in America for ulcers, cancer and trauma. > > Is their a similar crusade by nonbariatirc General surgeons against this > very high rate of Billroth II gastrojejunostomies? > > Are the bariatirc surgeons creating a petition to stop loop > gastrojejunostomies? > > No of course not, but why not? > > If your colleagues were concerned about cancer why not get wound up and > criticize all of these other surgeons? > > Basically there is a difference between the " old loop " gastric bypass and > the Billroth II done by most general surgeons for ulcers etc. > > My MGB is designed to be like the usual Billroth II loop and to avoid the > problems of the " Old Loop " gastric bypass. > > It is easy to do. > > The difference is that in the old loop bypass the loop was close to the > esophagus and in the usual Billroth II loop gastrojejunontomy done by the > average general surgeon the loop is placed far from the esophagus. > > In the MGB the loop is far away from the esophagus. > > It is not close to the esophagus it is far away. " > > **************************************************************************** > ***** > " Hi again Mr. Lindstrom, > RE: your comments on my note. > > First I have only given you a very small part of the argument that makes me > favor the MGB. > > There are at least 4 other major factors that I would be happy to detail for > you more of the apologia for the MGB that I have in my mind. > > Briefly let me just say " failure " : i.e. what to do after any other surgery > if > the operation fails, to much to little or something else. In an MGB > revision is a 60 minute laparoscopic procedure. That is not true with any > other surgery as you well know. > > Also think about a 20-30 minute surgical cure of diabetes. On Wed. of this > week I did 9 cases from 8:30 to 4:30. All had an overnight stay in the > hospital... > > What if I were to be right? > > and there is more... > > Re: my colleagues, I do not think that they have had a chance to hear what I > am saying.They " know " the Mason Loop was bad and it is hard to get over that > " knowledge " . > > I think it will take time. > > There have been two surgeons here to visit and learn and watch the surgery. > > One has done 10-15 so far. > > Another has expressed an interest in coming down to spend > the day. > > I think as you imply if a few people get to think about it I may get more of > chance to explain my procedure. > > I think people are very right to be skeptical but look at the evidence that > I have. > > I have almost 700 patients that I follow meticulously and are available for > anyone else with any real interest to investigate themselves. > > Never in the history of Bariatric surgery has an operation appeared with > such strong supporting data. > > Peace. " > > RR > > Rutledge, M.D., F.A.C.S. > The Center for Laparoscopic Obesity Surgery > 4301 Ben lin Blvd. > Durham, N.C. 27704 > Telephone #: > Fax #: > Email: DrR@... > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 15, 2000 Report Share Posted July 15, 2000 In a message dated 7/15/2000 7:38:36 PM Eastern Daylight Time, Dr_Rutledge@... writes: > > Hi Laurie in Ohio, > > Thanks for your nice post. > > I will summarize: > > No one now criticizes the MGB about weight loss, leak rates, pulmonary > embolus rates, hospital stay, operative times, costs mortality rate... > > Let me tell you that in the beginning I was criticized for concerns about > all of these things and we have now clearly demonstrated that in every case > the MGB results are as good or better than any other operation. > > So what can an uninformed physician complain about? > > Well how about Bile reflux? > > First let me correct you we have, as far as I am aware, no patient that is > over 3 months after surgery with any bile reflux esophagitis. > > In the old loop gastric bypass up to 40% of patients had bile reflux > esophagitis soon after surgery. > > Mr. Lindstrom and I have been having a nice friendly dialog privately and > here is some of what I wrote to him: > > **************************************************************************** > ***** > " Hi again Mr. Lindstrom, > > I just finished my print outs for tomorrow's surgery. 9 cases, yikes. > > Let me again try to apologize for the strong comments that have been > directed at you from some of the people on my lists. > > I earnestly hope that you can find it in your heart to be forgiving. > > I think you are very right to do what you have done. > > You asked your trusted friends and colleagues their opinions about an area > that is their expertise and they said that the MGB is bad. You > did what can only seem to be right in your eyes. > > I honestly respect you for that. > > Now as to me. > > I could do a VBG or RNY or even a BPD if I wanted to. > > Why would I dare to do something different? > > What if I honestly felt it was better? > > Let's look at the concerns about the MGB. > > Short term, well since my people have done so well, the raft of short term > complaints and concerns have been silenced. > > Long term, bariatric surgeons feel that the loop leads to bile reflux and > esophagitis (inflammation and irritation of the esophagus) and this then > leads to cancer! > > Sounds bad. > > They feel that they know this will happen because of the 20 year old > experience of the Mason " Loop Gastric Bypass " as you heard at the meeting up > to 40% of patients developed esophagitis. > > Hmmm... > > But None of my patients have esophagitis. None. > > But 40% of the old loop patients did. > > None of mine do. > > In fact many of my patients had severe esophagitis preop and it, the MGB, > has cured their esophagitis. > > But how can that be? > > The obvious answer 1) I am fibbing (I am not, find one of my patients with > esophagitis) or 2) the MGB is not the old loop. > > Now lets go at this same question from another tack. > > Billroth II, loop gastrojejunostomies are done at a rate of ~12,000 cases > per year by general surgeons in America for ulcers, cancer and trauma. > > Is their a similar crusade by nonbariatirc General surgeons against this > very high rate of Billroth II gastrojejunostomies? > > Are the bariatirc surgeons creating a petition to stop loop > gastrojejunostomies? > > No of course not, but why not? > > If your colleagues were concerned about cancer why not get wound up and > criticize all of these other surgeons? > > > Basically there is a difference between the " old loop " gastric bypass and > the Billroth II done by most general surgeons for ulcers etc. > > > My MGB is designed to be like the usual Billroth II loop and to avoid the > problems of the " Old Loop " gastric bypass. > > It is easy to do. > > The difference is that in the old loop bypass the loop was close to the > esophagus and in the usual Billroth II loop gastrojejunontomy done by the > average general surgeon the loop is placed far from the esophagus. > > In the MGB the loop is far away from the esophagus. > > It is not close to the esophagus it is far away. " > > > **************************************************************************** > ***** > " Hi again Mr. Lindstrom, > RE: your comments on my note. > > First I have only given you a very small part of the argument that makes me > favor the MGB. > > There are at least 4 other major factors that I would be happy to detail for > you more of the apologia for the MGB that I have in my mind. > > Briefly let me just say " failure " : i.e. what to do after any other surgery > if > the operation fails, to much to little or something else. In an MGB > revision is a 60 minute laparoscopic procedure. That is not true with any > other surgery as you well know. > > Also think about a 20-30 minute surgical cure of diabetes. On Wed. of this > week I did 9 cases from 8:30 to 4:30. All had an overnight stay in the > hospital... > > What if I were to be right? > > and there is more... > > Re: my colleagues, I do not think that they have had a chance to hear what I > am saying.They " know " the Mason Loop was bad and it is hard to get over that > " knowledge " . > > I think it will take time. > > There have been two surgeons here to visit and learn and watch the surgery. > > One has done 10-15 so far. > > Another has expressed an interest in coming down to spend > the day. > > I think as you imply if a few people get to think about it I may get more of > chance to explain my procedure. > > I think people are very right to be skeptical but look at the evidence that > I have. > > I have almost 700 patients that I follow meticulously and are available for > anyone else with any real interest to investigate themselves. > > Never in the history of Bariatric surgery has an operation appeared with > such strong supporting data. > > Peace. " > > RR > > Rutledge, M.D., F.A.C.S. > The Center for Laparoscopic Obesity Surgery > 4301 Ben lin Blvd. > Durham, N.C. 27704 > Telephone #: > Fax #: > Email: DrR@... > Gotta love that Dr. R!!!! Holly Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 15, 2000 Report Share Posted July 15, 2000 Rutledge, M.D., F.A.C.S. wrote: > I will summarize: > > No one now criticizes the MGB about weight loss, leak rates, pulmonary > embolus rates, hospital stay, operative times, costs mortality rate... > > Let me tell you that in the beginning I was criticized for concerns > about all of these things and we have now clearly demonstrated that in every > case the MGB results are as good or better than any other operation. That right there really puts the current so-called " controversy " (tempest in a teapot if you ask me, but nobody did so I'll stop that for now. ) into crystal-clear perspective. I think it should be read again: * * * * * * * * * * * * * * * * * > No one now criticizes the MGB about weight loss, leak rates, pulmonary > embolus rates, hospital stay, operative times, costs mortality rate... * * * * * * * * * * * * * * * * * > So what can an uninformed physician complain about? > > Well how about Bile reflux? > > First let me correct you we have, as far as I am aware, no patient that is > over 3 months after surgery with any bile reflux esophagitis. > > In the old loop gastric bypass up to 40% of patients had bile reflux > esophagitis soon after surgery. > > Mr. Lindstrom and I have been having a nice friendly dialog privately > and here is some of what I wrote to him: > > **************************************************************************** > " Hi again Mr. Lindstrom, > > Let me again try to apologize for the strong comments that have been > directed at you from some of the people on my lists. Well, let me reiterate my comments, lest you apologize for them, because I was *not* pleased at the totally unprofessional and unsupported attack Lindstrom made publicly, in private emails, and in conversations with others, on the MGB, you, personally, and on the basic intellectual capacities of your potential, past, and present patients. When called upon to support his " opinions, " with some facts, he could not, did not and has not. I am quite satisfied to note that a woman, a prospective MGB patient, one of " we-the-misguided " had to come to his rescue, albeit inadvertantly, by at least providing a morsel, a crumb, from which the source of the rumors could be deduced and addressed. (Take a bow, Laurie-in-Ohio!!) > I earnestly hope that you can find it in your heart to be forgiving. I was *just* about to keep my chicken fettucine dinner down and you had to add that??! > I think you are very right to do what you have done. > > You asked your trusted friends and colleagues their opinions about an > area that is their expertise and they said that the MGB is bad. Up to that point, no problem. But that's not where he stopped (see above). > You did what can only seem to be right in your eyes. > I honestly respect you for that. Yep, there goes the fettucine. > > Now as to me. > > I could do a VBG or RNY or even a BPD if I wanted to. > > Why would I dare to do something different? > > What if I honestly felt it was better? > > Let's look at the concerns about the MGB. > > Short term, well since my people have done so well, the raft of short > term complaints and concerns have been silenced. > > Long term, bariatric surgeons feel that the loop leads to bile reflux > and esophagitis (inflammation and irritation of the esophagus) and this > then leads to cancer! > > Sounds bad. > > They feel that they know this will happen because of the 20 year old > experience of the Mason " Loop Gastric Bypass " as you heard at the > meeting up > to 40% of patients developed esophagitis. > > Hmmm... > > But None of my patients have esophagitis. None. > > But 40% of the old loop patients did. > > None of mine do. > > In fact many of my patients had severe esophagitis preop and it, the > MGB, has cured their esophagitis. > > But how can that be? > > The obvious answer 1) I am fibbing (I am not, find one of my patients > with esophagitis) or 2) the MGB is not the old loop. > > Now lets go at this same question from another tack. > > Billroth II, loop gastrojejunostomies are done at a rate of ~12,000 > cases per year by general surgeons in America for ulcers, cancer and trauma. > > Is their a similar crusade by nonbariatirc General surgeons against > this very high rate of Billroth II gastrojejunostomies? > > Are the bariatirc surgeons creating a petition to stop loop > gastrojejunostomies? > > No of course not, but why not? > > If your colleagues were concerned about cancer why not get wound up > and criticize all of these other surgeons? > > Basically there is a difference between the " old loop " gastric bypass > and the Billroth II done by most general surgeons for ulcers etc. > > My MGB is designed to be like the usual Billroth II loop and to avoid > the problems of the " Old Loop " gastric bypass. > > It is easy to do. > > The difference is that in the old loop bypass the loop was close to > the esophagus and in the usual Billroth II loop gastrojejunontomy done by > the average general surgeon the loop is placed far from the esophagus. > > In the MGB the loop is far away from the esophagus. > > It is not close to the esophagus it is far away. " Thank you for the great explanation! > > Rutledge, M.D., F.A.C.S. > The Center for Laparoscopic Obesity Surgery > 4301 Ben lin Blvd. > Durham, N.C. 27704 > Telephone #: > Fax #: > Email: DrR@... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 15, 2000 Report Share Posted July 15, 2000 , I know I missed my calling now!!!! Found men much more interesting on a personal level!!!!! LOL You are my Heroine!!!!!!!!! Joannie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 15, 2000 Report Share Posted July 15, 2000 DebLaMan@... wrote: > > In a message dated 7/15/00 6:30:06 PM Pacific Daylight Time, > lindat@... writes: > > << > Well, let me reiterate my comments, lest you apologize for them, > because > I was *not* pleased at the totally unprofessional and unsupported > attack > Lindstrom made publicly, in private emails, and in conversations with > others, on the MGB, you, personally, and on the basic intellectual > capacities of your potential, past, and present patients. > > When called upon to support his " opinions, " with some facts, he could > not, did not and has not. > >> > > Oh my God! Can we just give this a rest--PLEASE!! I am about to have > a > severe case of reflux myself and I haven't even had surgery yet!! > LOL > > Regards, > Debbie in IL > Daughter MGB 8/9 Cigna (3rd appeal)--BMI 45 > Counting on Cigna for Debbie (BMI 40) ins letter sent 7/14 Read the paragraph *after* that. You cut off the best part!!! Wah! LOL! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 16, 2000 Report Share Posted July 16, 2000 happygirl0925@... wrote: > > In a message dated 7/15/2000 7:38:36 PM Eastern Daylight Time, > Dr_Rutledge@... writes: > > > > > Hi Laurie in Ohio, > > > > Thanks for your nice post. > > > > I will summarize: > > > > No one now criticizes the MGB about weight loss, leak rates, pulmonary > > embolus rates, hospital stay, operative times, costs mortality rate... > > > > Let me tell you that in the beginning I was criticized for concerns about > > all of these things and we have now clearly demonstrated that in every case > > the MGB results are as good or better than any other operation. > > > > So what can an uninformed physician complain about? > > > > Well how about Bile reflux? > > > > First let me correct you we have, as far as I am aware, no patient that is > > over 3 months after surgery with any bile reflux esophagitis. > > > > In the old loop gastric bypass up to 40% of patients had bile reflux > > esophagitis soon after surgery. > > > > Mr. Lindstrom and I have been having a nice friendly dialog privately and > > here is some of what I wrote to him: > > > > > **************************************************************************** > > ***** > > " Hi again Mr. Lindstrom, > > > > I just finished my print outs for tomorrow's surgery. 9 cases, yikes. > > > > Let me again try to apologize for the strong comments that have been > > directed at you from some of the people on my lists. > > > > I earnestly hope that you can find it in your heart to be forgiving. > > > > I think you are very right to do what you have done. > > > > You asked your trusted friends and colleagues their opinions about an area > > that is their expertise and they said that the MGB is bad. You > > did what can only seem to be right in your eyes. > > > > I honestly respect you for that. > > > > Now as to me. > > > > I could do a VBG or RNY or even a BPD if I wanted to. > > > > Why would I dare to do something different? > > > > What if I honestly felt it was better? > > > > Let's look at the concerns about the MGB. > > > > Short term, well since my people have done so well, the raft of short term > > complaints and concerns have been silenced. > > > > Long term, bariatric surgeons feel that the loop leads to bile reflux and > > esophagitis (inflammation and irritation of the esophagus) and this then > > leads to cancer! > > > > Sounds bad. > > > > They feel that they know this will happen because of the 20 year old > > experience of the Mason " Loop Gastric Bypass " as you heard at the meeting > up > > to 40% of patients developed esophagitis. > > > > Hmmm... > > > > But None of my patients have esophagitis. None. > > > > But 40% of the old loop patients did. > > > > None of mine do. > > > > In fact many of my patients had severe esophagitis preop and it, the MGB, > > has cured their esophagitis. > > > > But how can that be? > > > > The obvious answer 1) I am fibbing (I am not, find one of my patients with > > esophagitis) or 2) the MGB is not the old loop. > > > > Now lets go at this same question from another tack. > > > > Billroth II, loop gastrojejunostomies are done at a rate of ~12,000 cases > > per year by general surgeons in America for ulcers, cancer and trauma. > > > > Is their a similar crusade by nonbariatirc General surgeons against this > > very high rate of Billroth II gastrojejunostomies? > > > > Are the bariatirc surgeons creating a petition to stop loop > > gastrojejunostomies? > > > > No of course not, but why not? > > > > If your colleagues were concerned about cancer why not get wound up and > > criticize all of these other surgeons? > > > > > > Basically there is a difference between the " old loop " gastric bypass and > > the Billroth II done by most general surgeons for ulcers etc. > > > > > > My MGB is designed to be like the usual Billroth II loop and to avoid the > > problems of the " Old Loop " gastric bypass. > > > > It is easy to do. > > > > The difference is that in the old loop bypass the loop was close to the > > esophagus and in the usual Billroth II loop gastrojejunontomy done by the > > average general surgeon the loop is placed far from the esophagus. > > > > In the MGB the loop is far away from the esophagus. > > > > It is not close to the esophagus it is far away. " > > > > > > > **************************************************************************** > > ***** > > " Hi again Mr. Lindstrom, > > RE: your comments on my note. > > > > First I have only given you a very small part of the argument that makes me > > favor the MGB. > > > > There are at least 4 other major factors that I would be happy to detail > for > > you more of the apologia for the MGB that I have in my mind. > > > > Briefly let me just say " failure " : i.e. what to do after any other surgery > > if > > the operation fails, to much to little or something else. In an MGB > > revision is a 60 minute laparoscopic procedure. That is not true with any > > other surgery as you well know. > > > > Also think about a 20-30 minute surgical cure of diabetes. On Wed. of this > > week I did 9 cases from 8:30 to 4:30. All had an overnight stay in the > > hospital... > > > > What if I were to be right? > > > > and there is more... > > > > Re: my colleagues, I do not think that they have had a chance to hear what > I > > am saying.They " know " the Mason Loop was bad and it is hard to get over > that > > " knowledge " . > > > > I think it will take time. > > > > There have been two surgeons here to visit and learn and watch the surgery. > > > > One has done 10-15 so far. > > > > Another has expressed an interest in coming down to spend > > the day. > > > > I think as you imply if a few people get to think about it I may get more > of > > chance to explain my procedure. > > > > I think people are very right to be skeptical but look at the evidence that > > I have. > > > > I have almost 700 patients that I follow meticulously and are available for > > anyone else with any real interest to investigate themselves. > > > > Never in the history of Bariatric surgery has an operation appeared with > > such strong supporting data. > > > > Peace. " > > > > RR > > > > Rutledge, M.D., F.A.C.S. > > The Center for Laparoscopic Obesity Surgery > > 4301 Ben lin Blvd. > > Durham, N.C. 27704 > > Telephone #: > > Fax #: > > Email: DrR@... > > > Gotta love that Dr. R!!!! > Holly > > ------------------------------------------------------------------------ > Get a NextCard Visa, in 30 seconds! > 1. Fill in the brief application > 2. Receive approval decision within 30 seconds > 3. Get rates as low as 2.9% Intro or 9.9% Fixed APR > http://click.egroups.com/1/6630/3/_/453517/_/963723854/ > ------------------------------------------------------------------------ > > This message is from the Mini-Gastric Bypass Mailing List at Onelist.com > Please visit our web site at http://clos.net > Get the Patient Manual at http://clos.net/get_patient_manual.htm Doctor Rutledge, I just read your post to Mr. Lindstrom. All I can say is " RIP EM UP BUBBA! " reddena@... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 16, 2000 Report Share Posted July 16, 2000 happygirl0925@... wrote: > > In a message dated 7/15/2000 7:38:36 PM Eastern Daylight Time, > Dr_Rutledge@... writes: > > > > > Hi Laurie in Ohio, > > > > Thanks for your nice post. > > > > I will summarize: > > > > No one now criticizes the MGB about weight loss, leak rates, pulmonary > > embolus rates, hospital stay, operative times, costs mortality rate... > > > > Let me tell you that in the beginning I was criticized for concerns about > > all of these things and we have now clearly demonstrated that in every case > > the MGB results are as good or better than any other operation. > > > > So what can an uninformed physician complain about? > > > > Well how about Bile reflux? > > > > First let me correct you we have, as far as I am aware, no patient that is > > over 3 months after surgery with any bile reflux esophagitis. > > > > In the old loop gastric bypass up to 40% of patients had bile reflux > > esophagitis soon after surgery. > > > > Mr. Lindstrom and I have been having a nice friendly dialog privately and > > here is some of what I wrote to him: > > > > > **************************************************************************** > > ***** > > " Hi again Mr. Lindstrom, > > > > I just finished my print outs for tomorrow's surgery. 9 cases, yikes. > > > > Let me again try to apologize for the strong comments that have been > > directed at you from some of the people on my lists. > > > > I earnestly hope that you can find it in your heart to be forgiving. > > > > I think you are very right to do what you have done. > > > > You asked your trusted friends and colleagues their opinions about an area > > that is their expertise and they said that the MGB is bad. You > > did what can only seem to be right in your eyes. > > > > I honestly respect you for that. > > > > Now as to me. > > > > I could do a VBG or RNY or even a BPD if I wanted to. > > > > Why would I dare to do something different? > > > > What if I honestly felt it was better? > > > > Let's look at the concerns about the MGB. > > > > Short term, well since my people have done so well, the raft of short term > > complaints and concerns have been silenced. > > > > Long term, bariatric surgeons feel that the loop leads to bile reflux and > > esophagitis (inflammation and irritation of the esophagus) and this then > > leads to cancer! > > > > Sounds bad. > > > > They feel that they know this will happen because of the 20 year old > > experience of the Mason " Loop Gastric Bypass " as you heard at the meeting > up > > to 40% of patients developed esophagitis. > > > > Hmmm... > > > > But None of my patients have esophagitis. None. > > > > But 40% of the old loop patients did. > > > > None of mine do. > > > > In fact many of my patients had severe esophagitis preop and it, the MGB, > > has cured their esophagitis. > > > > But how can that be? > > > > The obvious answer 1) I am fibbing (I am not, find one of my patients with > > esophagitis) or 2) the MGB is not the old loop. > > > > Now lets go at this same question from another tack. > > > > Billroth II, loop gastrojejunostomies are done at a rate of ~12,000 cases > > per year by general surgeons in America for ulcers, cancer and trauma. > > > > Is their a similar crusade by nonbariatirc General surgeons against this > > very high rate of Billroth II gastrojejunostomies? > > > > Are the bariatirc surgeons creating a petition to stop loop > > gastrojejunostomies? > > > > No of course not, but why not? > > > > If your colleagues were concerned about cancer why not get wound up and > > criticize all of these other surgeons? > > > > > > Basically there is a difference between the " old loop " gastric bypass and > > the Billroth II done by most general surgeons for ulcers etc. > > > > > > My MGB is designed to be like the usual Billroth II loop and to avoid the > > problems of the " Old Loop " gastric bypass. > > > > It is easy to do. > > > > The difference is that in the old loop bypass the loop was close to the > > esophagus and in the usual Billroth II loop gastrojejunontomy done by the > > average general surgeon the loop is placed far from the esophagus. > > > > In the MGB the loop is far away from the esophagus. > > > > It is not close to the esophagus it is far away. " > > > > > > > **************************************************************************** > > ***** > > " Hi again Mr. Lindstrom, > > RE: your comments on my note. > > > > First I have only given you a very small part of the argument that makes me > > favor the MGB. > > > > There are at least 4 other major factors that I would be happy to detail > for > > you more of the apologia for the MGB that I have in my mind. > > > > Briefly let me just say " failure " : i.e. what to do after any other surgery > > if > > the operation fails, to much to little or something else. In an MGB > > revision is a 60 minute laparoscopic procedure. That is not true with any > > other surgery as you well know. > > > > Also think about a 20-30 minute surgical cure of diabetes. On Wed. of this > > week I did 9 cases from 8:30 to 4:30. All had an overnight stay in the > > hospital... > > > > What if I were to be right? > > > > and there is more... > > > > Re: my colleagues, I do not think that they have had a chance to hear what > I > > am saying.They " know " the Mason Loop was bad and it is hard to get over > that > > " knowledge " . > > > > I think it will take time. > > > > There have been two surgeons here to visit and learn and watch the surgery. > > > > One has done 10-15 so far. > > > > Another has expressed an interest in coming down to spend > > the day. > > > > I think as you imply if a few people get to think about it I may get more > of > > chance to explain my procedure. > > > > I think people are very right to be skeptical but look at the evidence that > > I have. > > > > I have almost 700 patients that I follow meticulously and are available for > > anyone else with any real interest to investigate themselves. > > > > Never in the history of Bariatric surgery has an operation appeared with > > such strong supporting data. > > > > Peace. " > > > > RR > > > > Rutledge, M.D., F.A.C.S. > > The Center for Laparoscopic Obesity Surgery > > 4301 Ben lin Blvd. > > Durham, N.C. 27704 > > Telephone #: > > Fax #: > > Email: DrR@... > > > Gotta love that Dr. R!!!! > Holly > > ------------------------------------------------------------------------ > Get a NextCard Visa, in 30 seconds! > 1. Fill in the brief application > 2. Receive approval decision within 30 seconds > 3. Get rates as low as 2.9% Intro or 9.9% Fixed APR > http://click.egroups.com/1/6630/3/_/453517/_/963723854/ > ------------------------------------------------------------------------ > > This message is from the Mini-Gastric Bypass Mailing List at Onelist.com > Please visit our web site at http://clos.net > Get the Patient Manual at http://clos.net/get_patient_manual.htm Doctor Rutledge, I just read your post to Mr. Lindstrom. All I can say is " RIP EM UP BUBBA! " reddena@... Quote Link to comment Share on other sites More sharing options...
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