RE: Re: common channel length

[Guest guest]

> I had a full Lap BPD/DS (not lap assisted), my lap incisions are

> approx. 1/4 " , 1/2 " , 3/4 " plus one totally hidden inside my

> bellybutton (plus two drain punctures (two tiny dots). My surgical

> report specifically states that my surgeon measured the intestines

> using umbilical tape.

There is a difference between measuring to get the desired

(predetermined) common length, as Dr. Gagner et al do, and measuring the

entire length of the small intestine in order to determine and create

proportional limb lengths (as Dr. Rabkin does). Dr. Rabkin does make a

short incision at the bellybutton which allows him to pull out the

intestine to do this total measurement. I have seen the video of the

procedure. By doing this, he may not be doing a " total lap " procedure,

but the benefits to the patient is that they will have individualized

proportional limb lengths that are more in line with the traditional DS

that has been done since Hess devised it. The predetermined limb lengths

are more " Scopinaro-esque " , and if you read the Scopinaro report on the

DS website, you'll see that even he has modified his approach to be more

proportional and individualized to the patient. Dr. Rabkin, early in his

DS series, used predetermined limb lengths, but quickly switched to

proportional when he became convinced that the benefit to the patient

made it worthwhile.

For a look at a Rabkin LapDS tummy, see this page:

http://www.pacificsurgery.com/Newsletter/Other_Views/other_views.html

M.

---

in Valrico, FL, age 39

Starting weight 299, now 156

Starting BMI 49.7, now 26.0

Lap DGB/DS by Dr. Rabkin 10-19-99

http://www.duodenalswitch.com

Direct replies: mailto:melanie@...

_________________________________________________________

[Guest guest]

> I had a full Lap BPD/DS (not lap assisted), my lap incisions are

> approx. 1/4 " , 1/2 " , 3/4 " plus one totally hidden inside my

> bellybutton (plus two drain punctures (two tiny dots). My surgical

> report specifically states that my surgeon measured the intestines

> using umbilical tape.

There is a difference between measuring to get the desired

(predetermined) common length, as Dr. Gagner et al do, and measuring the

entire length of the small intestine in order to determine and create

proportional limb lengths (as Dr. Rabkin does). Dr. Rabkin does make a

short incision at the bellybutton which allows him to pull out the

intestine to do this total measurement. I have seen the video of the

procedure. By doing this, he may not be doing a " total lap " procedure,

but the benefits to the patient is that they will have individualized

proportional limb lengths that are more in line with the traditional DS

that has been done since Hess devised it. The predetermined limb lengths

are more " Scopinaro-esque " , and if you read the Scopinaro report on the

DS website, you'll see that even he has modified his approach to be more

proportional and individualized to the patient. Dr. Rabkin, early in his

DS series, used predetermined limb lengths, but quickly switched to

proportional when he became convinced that the benefit to the patient

made it worthwhile.

For a look at a Rabkin LapDS tummy, see this page:

http://www.pacificsurgery.com/Newsletter/Other_Views/other_views.html

M.

---

in Valrico, FL, age 39

Starting weight 299, now 156

Starting BMI 49.7, now 26.0

Lap DGB/DS by Dr. Rabkin 10-19-99

http://www.duodenalswitch.com

Direct replies: mailto:melanie@...

_________________________________________________________

[Guest guest]

In a message dated 8/24/01 6:36:44 PM, duodenalswitch writes:

<< Personally, I wouldn't call it " cheating. " Like most decisions in

life, we make tradeoffs between what we want most and what we don't

care as much about. In the case of patients who place high priority

on having the procedure done by full lap, the tradeoff comes in the

form of a one-size-fits-all alimentary limb, and a common channel

that is not tailored to the length of the patient's small intestine.

>>

I agree, Tom. I think the idea of having a totally customized surgery is a

good one. This being said, Dr. Gagner (my surgeon) does the full lap without

major intestinal measurement (except what you mentioned above) and feels

totally satisified with his 'formula'. His standard is 250 cm alimentary and

100 cm common channel, although I know he can make exceptions for people

(based on personal history, starting bmi or whatever criteria is used).

To him, this has worked out very well and I think he's only had one revision

to date (Patti). I'm not saying it's the only way or the 'better way', but I

know that Dr. Gagner feels that it is a formula that he sees that works very

effectively.

all the best,

lap ds with gallbladder removal

January 25, 2001

Dr. GAgner/mt. Sinai/NYC

preop: 307 lbs/bmi 45

now: 224

[Guest guest]

My name is Erbert Keys Jr. and I live in Lompoc,Ca.,200 miles north of Los

Angeles and an ex middle school teacher dismissed for health

reasons,diabetic,respiratory illness with a height of 5 feet 6 inches and

weigh 390 pounds......I have been accepted for duo-denial switch surgery at

the Central Valley Bariatrics medical clinic in Modesto,California under the

director Dr. Ara Keshishian,M.D.. My insruace Pacificare and medicare was

approved for the surgery,but the doctors or clinic fee of 2000,I do not have

and no possible avenue to borrow the money from relaives,lost my home and no

assest.

I am pleading if there is the possibility of your members will donate one or

two dollars each that the 2000 fee will be raised for my surgery.

You may contact me as follows:

Erbert Keys Jr

52 tah vil drive

Lompoc,Ca.

93436

805 736-6097

God Bless

_________________________________________________________