Dr Ren

[Guest guest]

I quit reading or posting to this forum for many reasons. A member

of another group mentioned the forest fire on this list about Dr Ren

and her choice to quit performing the DS. I knew about this choice

for some time now. She personally told me to expect a storm about

this and she wanted to tell me in advance.

You know, she has the right to perform whatever operations she wants

to. And I am not about to get into the BPD vs BPD/DS but to all

those that are interested in what Dr Ren has said, read on:

" I just wanted to let you know something that may be upsetting to

some people. (no, it's not that terrible!)

I attended an internation bariatric surgery conference in Crete,

Greece and learned alot. I also spent much time speaking with Dr.

Scopinaro and Dr. Baltasar, a BPD and a BPD/DS surgeon, in addition

to others. I am going to stop performing the DS and modify it to

just the BPD. I just don't think that the DS provides much advantage

over the BPD, and the DS carries greater chance of having a surgical

complication. I have been lucky so far, but have had complications

that have, knock on wood, resolved. I just wanted to let you know

about this just in case you start hearing it from other patients.

And this does not mean that individuals who had a DS had an inferior

operation, it just meant that you had a great operation that was

really really hard to do and had a chance to go really bad, but it

didn't and you did great. I'm just looking at the risk/benefit ratio,

and it appears that the BPD gives the same weight loss, no dumping,

perhaps a quicker transit time, some people may have a slightly

higher chance of having diarrhea, but with a lower risk of leak or

pancreatitis. "

When I asked her what the main difference between the BPD and the RNY

were this is what she told me:

" The BPD has a bigger pouch (200-250 cc) vs the distal RNY (15-20cc).

This is advantageous because it allows for more protein intake (less

protein malnutrition) and decreases time for emptying of the stomach

(decreased diarrhea/lower transit time). Also, the common channel of

the BPD is 50 cm vs the 100 cm common channel of the distal RNY.

However, the only paper that has compared the 2 had very few patients

in each arm and it was comparing open surgeries. The BPD had

slightly greater weight loss but a slightly higher operative risk.

But it was not statistically significant. And I just can't argue

with Dr. Scopinaro who has done over 2500 BPD's and has almost a 20

year follow-up. "

Now I have to tell you that I really wanted to have the BPD (when I

was in the researching phase) till I came across the information

about the BPD/DS. Everyone convinced me that the pyloric valve was

essential to having a more natural approach. Well, no one has

convinced me at this date that the pyloric valve works in most cases,

actually what I hear leads me to believe the opposite. That the

trauma to the area causes the pyloric valve to malfunction. In the

immediate months after surgery, I had such problems. Sometimes, it

was like my stomach quite shut down. Something I could tolerate

well, sometimes made me throw up. I felt like a rock sat in my

stomach. Either time helped the healing process as I have not had it

happen in a few months, or it simply has remained open, I do not know

but I am going to have a gastric emptying study done so that it can

help Dr Ren with her research on whether the pyloric valve actually

does work after surgery and if so just how well it does work.

Research that is much needed to satisfy insurance companies and to

get the BPD/DS off the experimental list.

The BPD does offer a wonderful alternative to the RNY. You have the

shorter common channel, with a larger stomach pouch. You can eat

more, lose more weight and that is very impressive.

Sharon, a lady that has been on the DS list for quite some time now,

had the BPD over 10 years ago, her mother had it and an aunt. I am

including a link to her page within the DS website but a few days ago

she emailed her story to this list and was quite extensive in her

remarks.

The one objection that most people have to this surgery is the

dumping. But as Sharon will tell you, she does not dump and the

stomach is configured to prevent it from happening. I think the

insurance companies have an easier time paying for this surgery

because it is tried and true. It is not considered experimental.

http://www.duodenalswitch.20m.com/Patients/Sharon/sharon.html

If you have considered to use Dr Ren, give her a chance to explain it

all to you. If you are not convinced then make another appt to see

another surgeon. No one is forcing anyone to consider having this

surgery over the BPD/DS. If you really want to have the BPD/DS then

go for it.

To my knowledge Dr Ren has not actually denied any of her current

patients this surgery. I think she will not consider this surgery

with any of her new patients.

Thank you for listening,

Viau

Dr Ren, BPD/DS

3/29/01

-91 pounds

awaiting hernia surgery