RE: Re: VGB vs. RNY

[Guest guest]

some patients with the RNY

actually weigh more 10-15 years after surgery then they did before

surgery). >>>>>>>

really, Chris? Why dont the RNY docs tell their patients that? Or are they

indivudually taking patients in their own practice and hoping it wont happen

that way?

Not sure Im clear on my question lol

Judie

[Guest guest]

that was excellent, Chris! I am sooooooo glad right now that I have the DS

and not the RNY! I bet everybody else can echo my sentiments!

Just take a look around in the ossg hungry group.....all RNyers for the most

part and they are scared to death of regain and some do find themselves

already on that trail!

Judie

[Guest guest]

you are so right (and funny too!). I do know

from Dr Rabkin's meetings they are very diligent in

follow-up care because they want their reports to be

accurate.

And they claim a 97% excess weight loss, much higher

than the average of 80%. Not bad!

dee

--- chull1@... wrote:

The big problem for RNY surgeons is that they don't

like follow-up.

It is more lucrative to funnel new suckers (I mean

patients) in then to worry about how old patients are

doing. Therefore, the studies of RNY often have poor

follow-up rate. On the other hand the DS surgeon

understands the requirement of keeping up with all his

patients, and thus has better response rates when they

do long term follow-ups.

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[Guest guest]

> The best results I was able to find on the RNY were from Wittgrove

> and (ironically) Rabkin. Both of these reports were preliminary (2-4

> years). Since Rabkin has basically abandoned the RNY in favor of the

> DS, it really is incumbent upon Wittgrove to show that he can get

> good long term results.

there's a reason that Dr. Rabkin's " RGB " results were as good as

they were. It's not readily apparent without a careful reading, but if

you look at his published article, it's there. He reports on BPD, RGB,

and DS, and explains that the RGB series actually received a modified

BPD.

I learned this myself because I specifically asked Dr. Rabkin how he

achieved such good results with his " RNY " . It was then that he explained

to me that after his initial 32 BPDs, he just wasn't comfortable with

the removal of the stomach/pylorus, which left no " fallback " for

reversal in case of problem. He subsequently went to a modified

Scopinaro (that he termed " distal RGB " ) which was essentially the same

as a BPD except that it left the bypassed stomach inside. (I don't

recall offhand if these patients were stapled or transected, but it may

say in his report).

Ultimately, Rabkin found that in order to see good long-term results, he

had to progress to a smaller stomach pouch than he was comfortable with,

so he abandoned his RGB in 1994ish, in favor of the Duodenal Switch. In

addition, the RGB folks, despite good overall results, saw too many

ulcerations and other ongoing " pouch " -related side effects for Rabkin's

comfort.

If you compare Rabkin's " RGB " numbers to Scopinaro's BPD stats, they are

very similar, and we know that the DS gets similar stats too, so that is

why Rabkin's numbers are so similar from his three compared procedures.

Hope this illuminates a bit.

M.

---

in Valrico, FL, age 39

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

Starting weight 299, now 155

Starting BMI 49.7, now 25.8

Starting size 26/28, now 10/12

http://www.duodenalswitch.com/Patients/_M_/melanie_m_.html

Direct replies: mailto:melanie@...

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