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MGB vs Duodenal Switch

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I live in California and North Carolina is too far for me to go.

I am limited to what is offered in my area.

I've narrowed my options to a Duodenal Switch that I could get in San

Francisco versus a major expense to try to go to North Carolina.

I need answers to the following questions:

How is the MGB superior to the Duodenal Switch?

Why should I consider a MGB with the added effort and expense coming

from California over a Duodenal Switch available in San Francisco.

Thanks for any assistance...Lucy

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In a message dated 7/16/2000 4:37:14 PM Eastern Daylight Time,

lindat@... writes:

<<

> Why should I consider a MGB with the added effort and expense coming

> from California over a Duodenal Switch available in San Francisco.

> >>

I saved money going to NC. Having WLS surgery in CA was 9,000. more. So all

my airfare, hotel etc. was nothing compared to that.

There are a lot of wonderful people MGBers that would be happy to pick you up

and show you around. You can come on a Monday evening, Go to clinic on

Tuesday, Have surgery Wednesday and go home Friday morning. some people have

even went home right from the hospital. I wouldn't recommend it. Not

because you won't feel like it, but to be safe. The effort was worth it!!!!!

just my 2 cents

Trisha

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Hi,

>

> How is the MGB superior to the Duodenal Switch?

>

> Why should I consider a MGB with the added effort and expense coming

> from California over a Duodenal Switch available in San Francisco.

>

Great questions:

Ideal Weight Loss Surgery and the Mini-Gastric Bypass

Features of an " Ideal " Weight Loss Surgery

Mini-Gastric Bypass

Duodenal Switch

1. Safe

* Low mortality (0.15%) and complication (5.8%) rates

Higher Mortality Rates

2. Major Weight Loss

* 82% excess weight loss at one year

Similar Weight loss

3. Easily performed

* As seen in the short operating times and short length of stay

Very Complex and demanding surgery (3-10 hours)

4. Short operative times

* Average = 38 minutes in recent cases (Shortest ever reported.)

Long operating times

5. Outpatient or short hospital stay

* Hospital stay is now outpatient or 1 night for > 95% of patients.

(Shortest ever reported)

Long hospital stay

6. Minimal Blood Loss

* ~75 ml.

Greater Blood Loss

7. No Need for ICU Stay

* Rare

Common need for ICU

8. Minimal Pain

* After the first day managed with out-patient oral medication

More Pain

9. Very High Patient Satisfaction

* 98% of patient grade patient satisfaction as excellent

Moderate patient satisfaction

10. A Good " Exit Strategy "

* Revised 4 times, minimal adhesions, operating times ~1 hour

No Exit. Your stomach is gone and there is no way back.

Easily Reversed or Revised Laparoscopically

Not easily reversed or revised

11. Induction of change in eating behavior and preferences

* Bypass leads to aversion to sweets and fats

Big often unpleasant changes in eating.

12. Minimal Retching and Vomiting

* Minimal Nausea and Vomiting

Similar Nausea and vomiting

13. Few adhesions or hernias

* No hernias (0/667) and minimal adhesions

Lots of adhesions and hernias.

14. Minimal impact on Heart and Lung Function

* Short, low stress surgical procedure

Much more stress on the heart and lungs

15. Low Failure Rate

* 4 revisions

higher failure rate

16. Low Cost

* Estimated total ~$12,000.00

much more expensive

17. Short Recovery Time

* Shortest of any reported surgery for weight loss

much longer recovery time weeks not days

18. Rapid Return to Work

* Very rapid return to full activity

longer time needed to return to normal activities

19. Low Risk of Pulmonary Embolus

* No DVT, PE or MI (0/667)

Higher risk of Pulmonary Embolus and Death

20. Durable weight loss

* Longer studies needed

Good long term weight loss but lots of malabsorption problems

21. Low Risk of Ulcer

* 3% risk of marginal ulcer, manageable with medications. No

esophagitis (0/667)

similar ulcer risk

22. No Malabsorption or Malabsorption easily managed

* Minimal Malabsorption

Severe malabsorption

23. No Plastic Foreign Body Material

* No foreign body used

No foreign body

24. Easily Verifiable Results

* Over 90% of patients have volunteered to be available to others to

assess their results

Hard to confirm reported data. Unhappy campers flamed off Duodenal

Switch Web sites.

25. Procedure Performed by a High Volume Bariatric Surgeon

* > 400 cases / year

Varies

26. Performed as part of an extensive program of education and

follow-up

* Very extensive pre and post op program

varies

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.

MGB vs Duodenal Switch

> I live in California and North Carolina is too far for me to go.

> I am limited to what is offered in my area.

> I've narrowed my options to a Duodenal Switch that I could get in San

> Francisco versus a major expense to try to go to North Carolina.

> I need answers to the following questions:

>

> How is the MGB superior to the Duodenal Switch?

>

> Why should I consider a MGB with the added effort and expense coming

> from California over a Duodenal Switch available in San Francisco.

>

> Thanks for any assistance...Lucy

>

>

> ------------------------------------------------------------------------

> Life's too short to send boring email. Let SuperSig come to the rescue.

> http://click.egroups.com/1/6809/3/_/453517/_/963755245/

> ------------------------------------------------------------------------

>

> 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

>

>

>

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Guest guest

> How is the MGB superior to the Duodenal Switch?

>

> Why should I consider a MGB with the added effort and expense coming

> from California over a Duodenal Switch available in San Francisco.

>

> Thanks for any assistance...Lucy

There have been people who came from Iceland and Oregon to get this

procedure. With plane travel, distance isn't really much of an issue,

but if you are afraid of travelling by plane, it would surely be a very

long car ride, at least 3-4 days. It's about a 7 hour plane trip, which

is less time than it took me to get to Durham from Alabama, because I

had to drive an hour to get to the airport, then enroute, I had to

change planes and hang out in airports.

But that's up to you as to whether you want to do that or not. Having

it close to home wasn't an option for me because there's no one within 4

hours of me doing any procedure, much less any procedure I'd consider.

The added expense is about $600.00 for airfare and hotel. Whether it's

worth it to you or not is your call.

I chose the MGB over a *lap* d/s. I wouldn't even have considered *any*

open procedure because the risk, pain, recovery and possible

complications are too great and *completely unnecessary* when all the

procedures are available laparoscopically (including the d/s).

My biggest concern was safety and the MGB is the safest procedure there

is and it is easily reversible. It has the least complications and side

effects.

My second concern was weight loss and the MGB weight loss figures are as

good or better than any of the other procedures.

My third concern was pain and scarring -- I did not want a huge

rope-like scar across my abdomen that could also herniate, leak, or form

keloids, to add to the hysterectomy scar I already have running hip to

hip.

My fourth concern was the doctor and his office. I was approved for a

different procedure and changed my mind a week before surgery because I

was treated like a number by that office, where they were running people

through like cattle. On the support list for that particular group,

dozens of people were openly complaining about complications like

leaking incisions, bowel obstruction, and so on, as well as not being

treated well by the staff and the doctor.

Ultimately, I picked the MGB over the d/s because it offered:

(1) Surgery that lasts 35 min., not 4-7 hours under anesthesia and the

knife; if you have ever had a major surgery before, then you know the

effects of anesthesia itself are debilitating afterwards and the longer

you are under, the worse it is; plus one of the greatest risks of any

surgery is complications from anesthesia. Shorter is better, without

any question.

(2) Rapid recovery (about 24 hours, versus 6-8 weeks for an open d/s and

1-2 weeks for a lap d/s)

(3) Easily reversible in a 1-hour procedure.

(4) Virtually no side effects, versus the likelihood of frequent and

uncontrollable bad, oderous gas (farts), hair loss, vitamin and mineral

deficiencies from malabsorption, greater chance of bowel obstruction and

leaks.

(5) No huge scar, no painful/leaking/herniated incision (versus any open

procedure).

(6) A personable doctor and staff and a publicly available group of pre

and post ops who publicly discuss the ins, outs, pros, and cons of the

procedure. After I interviewed 97 of Dr. Rutledge's patients myself, I

had found less than a handful who had any sort of complications at all

and of those, only two were serious (leaks). All of them loved Dr.

Rutledge, even the ones with complications.

The d/s relies on major malabsorption by the intestines, so on the plus

side, you get a larger stomach and can eat more after the surgery, but

on the downside, you will have the farts forever, and have a greater

risk of hair loss and other side effects such as vitamin deficiencies,

for life.

The D/S has faster initial weight loss, which is one of its big

attractions, but the long term weight loss is the same. On the down

side, rapid weight loss also equals more saggy skin to deal with.

However, I've interviewed lap d/s patients who have had none of these

problems at all.

If you're having your procedure lap, you don't get the big scar and the

long recovery time, though you are still in surgery a lot longer and the

recovery time is still longer than the MGB, about 1-2 weeks, instead of

one day.

Do your own pro vs. con chart. Maybe you have more " pros " for the d/s

than for the MGB, for reasons I didn't consider.

Bottom line, you have to pick what's right for you, for your own

reasons. We all did, no matter what we chose.

Kind regards,

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I wanted the MGB from the first but it was so far from me, I thought.

Iwas going to have the surgery closer to home although I prefered the

mgb. Then I got to thinking, everything considered the mgb is not

only the best surgery, it is also the cheapest, if you sit down and

count up everything involved. EVERYTHING! That is what is sending me

to NC as soon as I get the ____insurance company to approve me.

Dinah in Ala

Still packing!!

> In a message dated 7/16/2000 4:37:14 PM Eastern Daylight Time,

> lindat@m... writes:

>

> <<

> > Why should I consider a MGB with the added effort and expense

coming

> > from California over a Duodenal Switch available in San

Francisco.

> > >>

>

> I saved money going to NC. Having WLS surgery in CA was 9,000.

more. So all

> my airfare, hotel etc. was nothing compared to that.

> There are a lot of wonderful people MGBers that would be happy to

pick you up

> and show you around. You can come on a Monday evening, Go to clinic

on

> Tuesday, Have surgery Wednesday and go home Friday morning. some

people have

> even went home right from the hospital. I wouldn't recommend it.

Not

> because you won't feel like it, but to be safe. The effort was

worth it!!!!!

> just my 2 cents

> Trisha

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Guest guest

Dear Lucy,

I would think that the money saved with the MGB would more than pay for a

airline ticket. I got a round trip ticket from AL for $131. I did well in

geography and know tha CA is a lot farther away but...I was going to pay out

of pocket close to $30K for a lapRNY here in Huntsville and my MGB was a

total of about $13K. I literally could have bought over ONE HUNDRED round

trip air tickets with the money that was saved. Add to that, less time off

of work, etc and you have great financial incentive to opt for the MGB as

well as what most of us feel is a vastly superior surgery. If your

insurance is paying 100% these incentives may not mean as much, as I aluded

to I am a self-pay. Keep reading the posts and clos.net to find how the MGB

is superior to the Duodenal Switch. Lastly, I'm sure that the surgeon in

California is wonderful and gifted and cool, but Dr. R. is way wonderful and

way gifted and way cool!! Good luck in whatever you decide and I'm sure we

are all behind you!

Dr. Bill in AL

> I live in California and North Carolina is too far for me to go.

> I am limited to what is offered in my area.

> I've narrowed my options to a Duodenal Switch that I could get in San

> Francisco versus a major expense to try to go to North Carolina.

> I need answers to the following questions:

>

> How is the MGB superior to the Duodenal Switch?

>

> Why should I consider a MGB with the added effort and expense coming

> from California over a Duodenal Switch available in San Francisco.

>

> Thanks for any assistance...Lucy

>

>

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Guest guest

I don't understand the difference between the MGB versus the DS. Because of

geography the best I could do was the DS in San Francisco. Why should I

consider the MGB over the DS.

Still confused...........Lucy

Re: MGB vs Duodenal Switch

> I wanted the MGB from the first but it was so far from me, I thought.

> Iwas going to have the surgery closer to home although I prefered the

> mgb. Then I got to thinking, everything considered the mgb is not

> only the best surgery, it is also the cheapest, if you sit down and

> count up everything involved. EVERYTHING! That is what is sending me

> to NC as soon as I get the ____insurance company to approve me.

> Dinah in Ala

> Still packing!!

>

>

>

> > In a message dated 7/16/2000 4:37:14 PM Eastern Daylight Time,

> > lindat@m... writes:

> >

> > <<

> > > Why should I consider a MGB with the added effort and expense

> coming

> > > from California over a Duodenal Switch available in San

> Francisco.

> > > >>

> >

> > I saved money going to NC. Having WLS surgery in CA was 9,000.

> more. So all

> > my airfare, hotel etc. was nothing compared to that.

> > There are a lot of wonderful people MGBers that would be happy to

> pick you up

> > and show you around. You can come on a Monday evening, Go to clinic

> on

> > Tuesday, Have surgery Wednesday and go home Friday morning. some

> people have

> > even went home right from the hospital. I wouldn't recommend it.

> Not

> > because you won't feel like it, but to be safe. The effort was

> worth it!!!!!

> > just my 2 cents

> > Trisha

>

>

> ------------------------------------------------------------------------

> To email plain text is conventional, to add graphics is divine.

> We'll show you how at www.supersig.com.

> http://click.egroups.com/1/6808/3/_/453517/_/963785646/

> ------------------------------------------------------------------------

>

> 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

>

> To Unsubscribe Send and Email to:

MiniGastricBypass-unsubscribe (AT) egroups (DOT) com

>

>

>

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