Re: Surgeon switching back to Scorpinaro

[Guest guest]

In a message dated 10/19/2001 8:13:51 PM Central Daylight Time,

romanstenseventeen@... writes:

> higher risk of ulcers,

I don't get this one!!! The literature shows the opposite. I believe that

these doctors that are going back to the standard BPD are just finding it

quite difficult to do the procedure lap and are not willing to do open

procedures as a routine and therefore are giving up on the BPD/DS. The

BPD/DS really pushes the limits on lap procedures. I heard both Ren and

are now going to the standard BPD. In my opinion they are not

willing to admit that their lap skills are not good enough to do the BPD/DS

procedure lap. It is ashamed that they are blaming the mechanics of the

BPD/DS and not how the procedure is done and the doctor's skill.

Who is your surgeon???

Dawn--South Suburban Chicago area

Dr. Hess, Bowling Green, OH

BPD/DS

4/27/00

www.duodenalswitch.com

267 to 165 5' 4 "

size 22 to size 10

have made size goal

no more high blood pressure, sore feet, or dieting

[Guest guest]

This will still be lap. And my surgeon is ! She gave me

very good arguments...

> In a message dated 10/19/2001 8:13:51 PM Central Daylight Time,

> romanstenseventeen@y... writes:

>

>

> > higher risk of ulcers,

>

> I don't get this one!!! The literature shows the opposite. I

believe that

> these doctors that are going back to the standard BPD are just

finding it

> quite difficult to do the procedure lap and are not willing to do

open

> procedures as a routine and therefore are giving up on the BPD/DS.

The

> BPD/DS really pushes the limits on lap procedures. I heard both

Ren and

> are now going to the standard BPD. In my opinion they

are not

> willing to admit that their lap skills are not good enough to do

the BPD/DS

> procedure lap. It is ashamed that they are blaming the mechanics

of the

> BPD/DS and not how the procedure is done and the doctor's skill.

>

> Who is your surgeon???

>

> Dawn--South Suburban Chicago area

> Dr. Hess, Bowling Green, OH

> BPD/DS

> 4/27/00

> www.duodenalswitch.com

> 267 to 165 5' 4 "

> size 22 to size 10

> have made size goal

> no more high blood pressure, sore feet, or dieting

>

>

>

>

>

>

>

[Guest guest]

Dawn,

I think you've got it just right, as several wise people an this list

have been telling us for awhile,

Kathy in Arlington,WA

> In a message dated 10/19/2001 8:13:51 PM Central Daylight Time,

> romanstenseventeen@y... writes:

>

>

> > higher risk of ulcers,

>

> I don't get this one!!! The literature shows the opposite. I

believe that

> these doctors that are going back to the standard BPD are just

finding it

> quite difficult to do the procedure lap and are not willing to do

open

> procedures as a routine and therefore are giving up on the BPD/DS.

The

> BPD/DS really pushes the limits on lap procedures. I heard both

Ren and

> are now going to the standard BPD. In my opinion they

are not

> willing to admit that their lap skills are not good enough to do

the BPD/DS

> procedure lap. It is ashamed that they are blaming the mechanics

of the

> BPD/DS and not how the procedure is done and the doctor's skill.

>

> Who is your surgeon???

>

> Dawn--South Suburban Chicago area

> Dr. Hess, Bowling Green, OH

> BPD/DS

> 4/27/00

> www.duodenalswitch.com

> 267 to 165 5' 4 "

> size 22 to size 10

> have made size goal

> no more high blood pressure, sore feet, or dieting

>

>

>

>

>

>

>

[Guest guest]

That's a shame Lee Anne. My understanding was that the DS was an

improvement over the BPD. Maybe the best person to talk to about it is

Sharon Snyder. She had the BPD ten years ago and seems pretty happy.

She could tell you what to expect specifically with the BPD. I don't

have her email, but you can find the link to her email here:

http://groups.yahoo.com/group/duodenalswitch/message/101141

Hope everything goes well!

Kathleen F

Open Duodenal Switch

Drs. Rabkin/Jossart

01/02/01 - 374#

10/16/01 - 245#

http://www.webniche.com/wls/

> My surgeon is changing which part of the stomach she removes. I'm

> afraid to post this because of the reaction I got with my other

> egroup.

>

> The original Scorpinaro surgery removed the lower 2/3 of the stomach

> rather than along the greater curvature. The key thing that you'll

> all freak out about is the pyloric valve. ..snip..

> No normal BPD/DS option, unless she has already seen you, she'll give

> you the option. I'm reminding myself that she has the MD behind her

> initials and I DO NOT.

>

...snip..

>

> Lee Anne

>

> surgery is MONDAY

[Guest guest]

At 1:11 AM +0000 10/20/01, Lee Anne Krause wrote:

>My surgeon is changing which part of the stomach she removes. I'm

>afraid to post this because of the reaction I got with my other

>egroup.

>

>The original Scorpinaro surgery removed the lower 2/3 of the stomach

>rather than along the greater curvature. The key thing that you'll

>all freak out about is the pyloric valve. She says that the 'DS

>people' put the pyloric valve on a pedestal. Those were her words.

Not only the pyloric valve, but also the production of intrinsic

factor in the antrum (lower stomach) near the pylorus. Intrinsic

factor is necessary for the production (or is it absorption--I

forget) of Vitamin B12.

>

>

>Some of the reasons I remember her saying: Thin walls in the valve,

>higher risk of ulcers, higher risks of leaks, higher risk of

>pancreatitis.

Higher demands on a surgeon's skills . . .

>

>I wanted the DS, because I wanted the larger capacity, no dumping and

>normal functionality of the stomach. I'll have the first two. She

>says that with ANY WLS you never have the " normal " functionality of

>the stomach.

Bull$#!^. I am almost 6 months post-op. For the past 4 months or

so, I have eaten everything and anything, and I have not had to chew

my meat 25 times before swallowing. Sure, I don't eat as much as

before the DS, but I have not denied myself anything that I want to

eat. I have developed a lactose intolerance, but that has to do with

the intestine and not the stomach.

>

>This is what you'll hate to hear.

>No normal BPD/DS option, unless she has already seen you, she'll give

>you the option. I'm reminding myself that she has the MD behind her

>initials and I DO NOT.

But, you are the customer, and she is the service provider. This is

a lifetime decision for you. has been characterized on

this list as a " my way or the highway " type of dictatorial doc. If I

were the patient, I'd find another doc. But, I understand and

support your need to get it over with.

>

>I'm emotionally drained with all the hub bub that my other egroup

>gave, but I had to put this out here.

It sounds as if you are going to go along with 's dictate.

I truly and sincerely wish you the very best of success. The

Scopinaro procedure is still better than the RnY, and patients who

have had it are doing well, so do what you have to do, and feel

welcome here. Thanks for bearing your soul with us, and we hope to

hear from you as soon after surgery as you can get to a computer.

--Steve

--

[Guest guest]

My surgeon said that sometimes the improvements me make are not

actually improvements... and it is necessary to revert.

Thanks for the message reference. I emailed her.

> > My surgeon is changing which part of the stomach she removes.

I'm

> > afraid to post this because of the reaction I got with my other

> > egroup.

> >

> > The original Scorpinaro surgery removed the lower 2/3 of the

stomach

> > rather than along the greater curvature. The key thing that

you'll

> > all freak out about is the pyloric valve. ..snip..

> > No normal BPD/DS option, unless she has already seen you, she'll

give

> > you the option. I'm reminding myself that she has the MD behind

her

> > initials and I DO NOT.

> >

> ..snip..

> >

> > Lee Anne

> >

> > surgery is MONDAY

[Guest guest]

Forget that I posted anything... I am feeling bashed... and like I'm

being told that I am ignorant. If you known the crap that I have

gone through to get this approved... you would be thrilled that I am

having this at all.

> My surgeon is changing which part of the stomach she removes. I'm

> afraid to post this because of the reaction I got with my other

> egroup.

>

> The original Scorpinaro surgery removed the lower 2/3 of the

stomach

> rather than along the greater curvature. The key thing that you'll

> all freak out about is the pyloric valve. She says that the 'DS

> people' put the pyloric valve on a pedestal. Those were her

words.

>

> Some of the reasons I remember her saying: Thin walls in the valve,

> higher risk of ulcers, higher risks of leaks, higher risk of

> pancreatitis.

>

> I wanted the DS, because I wanted the larger capacity, no dumping

and

> normal functionality of the stomach. I'll have the first two. She

> says that with ANY WLS you never have the " normal " functionality of

> the stomach.

>

> This is what you'll hate to hear.

> No normal BPD/DS option, unless she has already seen you, she'll

give

> you the option. I'm reminding myself that she has the MD behind

her

> initials and I DO NOT.

>

> I'm emotionally drained with all the hub bub that my other egroup

> gave, but I had to put this out here. So this weekend I'm

> going to have my brownies, fruit juice, and other things that I'll

> have to revisit at a later time.

>

> Lee Anne

>

> surgery is MONDAY

[Guest guest]

I'm sorry that you're feeling bashed Lee Anne. I hope it wasn't

anything I said. I assure you that I don't feel that you're ignorant.

And I have been following your messages on the AMOS board and do know

how much you have gone through to get this surgery. I wish you only the

best. A successful surgery, and a swift and uneventful recovery.

I think I was just a little surprised by Dr. 's sudden

decision to no longer perform the DS. And maybe felt a little defensive

by her comment that " 'DS people' put the pyloric valve on a pedestal. "

However, this is not a reflection on you or your decision to have the

BPD. I'm sure you will do well and look forward to hearing your

experiences with this surgery.

Peace,

Kathleen F

> Forget that I posted anything... I am feeling bashed... and like I'm

> being told that I am ignorant. If you known the crap that I have

> gone through to get this approved... you would be thrilled that I am

> having this at all.

[Guest guest]

Lee Anne-

I'm not bashing you.. it is ultimately your choice. I think that

everyone here is just concerned that you know the facts as published.

I can't say your choice is wrong, because I'm not you.. plus, Sharon

seems perfectly happy w/her Scopinaro BPD. As long as YOU feel

confident with your doctor's decision, you go for it, honey. I DO

recall how hard you worked to get approval, and I AM happy for you.

Don't leave.. I'm gonna still need to know how you're doing postop!!

Love you, girl.

Hugs,

Liane

> > My surgeon is changing which part of the stomach she removes. I'm

> > afraid to post this because of the reaction I got with my other

> > egroup.

> >

> > The original Scorpinaro surgery removed the lower 2/3 of the

> stomach

> > rather than along the greater curvature. The key thing that

you'll

> > all freak out about is the pyloric valve. She says that the 'DS

> > people' put the pyloric valve on a pedestal. Those were her

> words.

> >

> > Some of the reasons I remember her saying: Thin walls in the

valve,

> > higher risk of ulcers, higher risks of leaks, higher risk of

> > pancreatitis.

> >

> > I wanted the DS, because I wanted the larger capacity, no dumping

> and

> > normal functionality of the stomach. I'll have the first two.

She

> > says that with ANY WLS you never have the " normal " functionality

of

> > the stomach.

> >

> > This is what you'll hate to hear.

> > No normal BPD/DS option, unless she has already seen you, she'll

> give

> > you the option. I'm reminding myself that she has the MD behind

> her

> > initials and I DO NOT.

> >

> > I'm emotionally drained with all the hub bub that my other egroup

> > gave, but I had to put this out here. So this weekend I'm

> > going to have my brownies, fruit juice, and other things that I'll

> > have to revisit at a later time.

> >

> > Lee Anne

> >

> > surgery is MONDAY

[Guest guest]

>I did ask about the connection and how I do NOT want

> to have to chew the hell out of my food... and I do not want a

> stoma. She basically said that everything is bigger in this

surgery>>>>>>

>

Lee Ann, you do understand that with BPD you WILL have a stoma,

right? Yes the pouch is larger than with RNY, but it is still a

pouch, with artificial connection to the intestine.

Chris

[Guest guest]

She is very wrong. From the time she got out on her own (she was a

Lap Fellow and Mt Sinai) she resisted doing the DS and pushed the

RNY. And then she fell madly in love with the lap band. Her arguments

are not supported by research. Nor would her old mentor, Dr Gagner

agree with her. I think she just has trouble doing this very complex

surgery by lap. I have followed her career closely since she got to

Portland.

Her bizarre statements regarding this and other things have been

circulated in the Pacific Northwest medical community. ly, I'd

run far far away from her before I'd let her put a hand on me or

anyone I love. Abd yes, I know others have had good experiences with

her. Even so, I would never refer anyone to her. I think she is

trying to convince people that her personal agenda and preferences

are shared by others. I do not believe this for one minute.

And as a non medical professional, you probably are not in a position

to call her bluff with the literature and quotes from other DS

surgeons. Someone should. Someone really should.

, Seattle

> > In a message dated 10/19/2001 8:13:51 PM Central Daylight Time,

> > romanstenseventeen@y... writes:

> >

[Guest guest]

And sometimes a surgeon realizes they lack the skills to do the more

difficult surgeries lap. And they stop doing them. But how often do

you think they admit that this is the reason???

, Seattle

> My surgeon said that sometimes the improvements me make are not

> actually improvements... and it is necessary to revert.

>

> Thanks for the message reference. I emailed her.

>

[Guest guest]

I'm shocked she didn't insist you have the lapband. I understand she

has been selling that one really hard these days.

, Seattle

. I wonder if she is offering the BPD just so people will

> turn it down and go with the RNY.

>

[Guest guest]

In a message dated 10/20/01 9:41:52 AM, duodenalswitch writes:

<< Also in a BPD procedure the common channel was made smaller because the

patient can eat more. Is she going to do this? Is she going to go by what

the research says a BPD should be, or is she making up her own??? Also will

you end up with NO restriction. Standard BPD patients say they usually end

up eating MORE than they did preop. This can be o.k. because they still lose

weight, but this also means increased bms. If the doc did not bring all this

up in the discussion, I am not sure she is being forthright. That is what

would concern me. I wonder if she is offering the BPD just so people will

turn it down and go with the RNY.

>>

this is a really good question, Dawn and one I was thinking of. The

traditional BPD has a common channel of 50 cm. It incurs greater nutritional

risks because of this (and some may say a greater risk of diahhrea, etc.

although there are those with the DS at 50 cm common channel lengths who

DON'T experience this).

Of course, if I were just told that this would happen my first thought would

be simply to ABSORB this information and deal with the shock/adjustment!

I just wanted to note that there is a contingency here in NYC that perform

the DS via lap and do not feel that it is a substandard or riskier way of

performing the surgery necessarily (I'm sure this depends on patient history,

presence of co-morbids, etc.). Dr. Gagner pioneered his form of the 'lap ds'

(and the methodology is not totally identical to Dr. hess in that he does not

measure the intestines to determine the common channel length, etc.) and him

and his associates still offer the procedure laparoscopically, although they

now advise the procedure be done in two parts via lap for those with upper

bmis (I think 55-60 and above).

all the best,

lap ds with gallbladder removal

January 25, 2001

Dr. Gagner/Mt. Sinai/NYC

almost 9 months post-op and still feelin' fabu

preop: 307 lbs/bmi 45

now: 213 ????

[Guest guest]

HAS been clearly linked to an increased risk of pancreatic cancer>>>>>

does anyone know WHY there is increased risk of pancreatic cancer with the

removal of the lower stomach?

Judie

[Guest guest]

Hi -

You said: " " the lap DS is the most risky of surgeries . . . " If that is

so, there are other versions of the DS which are far more common than the

pure lap version.

It would seem to me that a procedure that is so risky that it is often

performed in two stages is, in fact, more risky.

Could it be that the open DS and the lap assisted DS are less risky? Is the

RNY less risky than either of these? I don't think so, myself, but it would

be interesting to hear other people's comments.

When a surgery as superior as the DS is available, I am left with the

question of why any surgeon would perform it completely lap when safer and

equally effective versions are more commonly performed.

Best -

Nick in Sage

[Guest guest]

You might find Dr Rabkin's s presentation to the ASBS this year

interesting. I have not looked to see if the abstract is on his

webpage. However, given the learning curve info that others studying

the lap have delineated, it seens that after 70 laps are done, the

risks of the lap become equal to that of the open.

Intresting, eh?

, Seattle

-- In duodenalswitch@y..., " Nick " <sage@i...> wrote:

> Hi -

>

> You said: " " the lap DS is the most risky of surgeries . . . " If

that is

> so, there are other versions of the DS which are far more common

than the

> pure lap version.

[Guest guest]

Hello again Nick. Sorry for the delay in getting back to you on this.

As I said in my prior message, I have done a good bit of research

(though not as much as many of you out there, I'm sure)on WLS,

including having read a couple of books on the topic. The most recent

of these, written by Woodward entitled " A Complete Guide to

Obesity Surgery, " and which I think I was initially referred to by a

message on this board, has this to say about the DS(p.43)under

Disadvantages of the DS for obesity: " the DS is technically more

demanding and invasive than other bariatric procedures, requires

longer operating time in most surgeon's hands, increasing risk to

patient and aversion by most anesthesiologists as well as maintains a

higher risk of both surgical and general complications than other

bariatric procedures. " I clumped it all into one big runon sentence

(if my 6th grade English teacher saw that I'd be in big trouble-

haha), but I will also mention that the book lists numerous

advantages of the surgery as well. Either way, I'd guess, in my NON-

medical professional opinion, that the risk factor is not overly

significant in terms of one being THAT much more so than an another,

as you said.

If anyone's interested in that book, I think you can order it online,

if you didn't see the original post mentioning it, at:

www.obesitysurgerybook.com. From what I've read so far, it's quite

informative.

Anyway, this is what I was referring to in my original message. So

please, if you have issue with that, take it up with , not me.

In other words, don't shoot the messenger.

Again, may I reiterate, that that has NOT changed my opinion nor

desire to have the DS! Assuming (and hoping!) that the nice people at

my insurance company agree, I'll be joining you and all the others on

the 'other side' in 2 weeks from today.

And by the way, my surgeon, Dr. Ren, does not have balls, not

literally, that is. Hope that's not what you meant! hahaha.

Thanks for your words of support on my journey to the new, slim me!

~ D. in NYC

p.s. GO YANKEES!

> > > Hi -

> > >

> > > You said: " " the lap DS is the most risky of surgeries . . . "

If

> > that is

> > > so, there are other versions of the DS which are far more common

> > than the

> > > pure lap version.

> > >

> > > It would seem to me that a procedure that is so risky that it is

> > often

> > > performed in two stages is, in fact, more risky.

> > >

> > > Could it be that the open DS and the lap assisted DS are less

> > risky? Is the

> > > RNY less risky than either of these? I don't think so, myself,

but

> > it would

> > > be interesting to hear other people's comments.

> > >

> > > When a surgery as superior as the DS is available, I am left

with

> > the

> > > question of why any surgeon would perform it completely lap when

> > safer and

> > > equally effective versions are more commonly performed.

> > >

> > > Best -

> > >

> > > Nick in Sage

> >

> >

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

----

> >

[Guest guest]

,

I have Oxford Liberty (the crappy plan) Dr's Gagner, Herron, Pomp, Inabet, Ren

are all out of network for me the only in-network doctor for me were 8 RNY

doctors and Dr. Macura who did my surgery. I knew that Mt. Sinai and NYU bunch

were out of network but I didn't mind paying because up until then I had heard

positive reviews for all of them. I originally called Oxford and asked about Ren

and the rep told me that seeing Ren would be no problem because she was covered

on an out of network basis so I would end up paying 30% of her fees. Which I was

ok with. Then after the treatment on the phone I said no way I then went and

started calling the Mt. Sinai bunch(this was in march) the quickest date for my

initial consultation was June 29 (mind you I had surgery June 25th) and then I

was called that week to tell me that I had been bumped and the next available

would be in july.

I dont know what they did at Dr. Macura's office but I I had my initial

consultation end of may and of june I had surgery so as you can see the process

was QUICK for me. I remember that the 2 week of June the office manager was

trying to set me up with a surgery date for the following week but that was way

to soon for me and I defered till the week after. I ended up getting someone

Sue's surgery date because she had a conflict on that date. So yeah I can not

complain I had my surgery done open I originally wanted lap but the more

patients of Dr. Macura I spoke with the more I realized that the recovery time

for Dr. Macura's open patients and the other surgeons performing the surgery lap

was almost the same! That sinched it for me.

Its important that the surgeon be well versed in the surgery regardless of

whether its done lap or open....I sit and rub my scar all the time when someone

catches a glimpse of it they think its ugly when I rub it feels good. It reminds

me that I took control of a situation that was out of control I realize taht

this ugly scar just gave me my life back and that this ugly scar is a part of me

as intimately as my heart or lungs....I love this scar!!!!!!!!!!!!!!

Lisbeth (who should be ticketed for writing long posts)

mushnyc@... wrote:

Hey Lisbeth,

A few days, eh? Wow! It's amazing how there is such a discrepency

between individuals and their insurance experiences. If only they

could all be as easy as yours (Elle, if you're reading this, I'm

wishing you good thoughts in your battle and know that you will come

out victorious! Hang in there and do NOT give up!)!

I have Oxford Freedom(through Cobra at the moment, actually), so

let's hope that I have the same luck as you. I know of another DS'er,

however, who didn't get approval until 3 days before surgery...eeks!

I am confused about something though I read in a subsequent post of

yours. You said that when you called Dr. Ren's office, when

contemplating surgery, that she said she wasn't in your network, yes?

I'm confused because she IS in Oxford's network. Is it possible that

changed since when you had your surgery?

Anyway, thanks for the reply. And congrats on getting below the 200

LB mark! !

~ D. in NYC

pre-op Dr. Ren 11/6/01

>

>

> ,

>

> I have Oxford (liberty) to be exact I had my approval in days! and

a few days later they send me the confirmation via snail mail. I was

surprised at fast Oxford was

>

> Lisbeth

>

> Anyway, enough said. We all do need to stick together and support

> each other, pre and post-opers alike. As someone who's due to have

> surgery in 2 weeks (though I'm still waiting to hear if I got the

> okay from Oxford yet), I for one need all of it I can get! And I

know

> I'm not alone in that sentiment.

>

> Best to you,

> D. in NYC

> pre-op 11/6/01 Dr. Ren

---------------------------------