Guest guest Posted October 29, 2000 Report Share Posted October 29, 2000 Billroth 11 vs. Open Roux-en-Y Weight loss surgery and controversy go hand in hand. Many surgeons have differing opinions as to which surgery works best. The Billroth 11 loop is the most common way to connect the stomach to the small bowel. This procedure is named for Dr. Theodore Billroth, a German surgeon who invented the procedure almost 100 years ago. In the United States in 1996, there were approximately 13,000 stomach operations that required the stomach be connected to the small bowel. Of these procedures 63% of surgeons used the Billroth 11, 19% chose the Roux-en-y and 18% chose some other method. The Roux-en-y is an open procedure. It requires two connections instead of one as in the Mini-Gastric Bypass. The small bowel must be cut and divided. One part is connected to the pouch, the other end is connected to the small bowel. Also, the gastric pouch is up high near the esophagus. Revision of the Roux-en-y is risky. The configuration of the bowel, stomach and colon makes revision tough and very complex. Other concerns with Roux-en-y are scar tissue and adhesions. The fact that the MGB is much less invasive than the Roux-en-y is the main reason I have selected this procedure. Studies show that weight loss at one year was higher with the MGB than with the Roux-en-y as well. More importantly, the time spent in the operating room was less with the MGB, blood loss was minimal, the hospital stay was significantly shorter, and the pain was considered minimal overall. The Mini-Gastric Bypass appears to meet many of the criteria for an " ideal " weight loss surgery. The Risks of Stomach Cancer It is my understanding that some physicians feel the Billroth 11 connection may cause stomach cancer. The numerous reports done show that gastric cancer in the United States has actually decreased four-fold since 1930. Studies have also shown that post-gastrectomy patients are at little or no increased risk for gastric cancer. In fact, reports show that individuals who consume processed meats and pickled foods on a regular basis have a higher risk of gastric cancer than those people who have had the MGB. I have reviewed all of the criteria to determine if I am at risk for developing this form of cancer. I am very pleased to have none of the risk factors. I am not concerned about developing cancer. Conclusion The years I've spent searching for an answer to my problem with obesity and my obsession with food are hopefully coming to an end soon. I submit this packet to you after having given this procedure much thought. After researching your website and some other materials, I thought it was too good to be true. With that thought in mind, my Mother and I set off for Durham. We wanted to see what this was all about. We came to the clinic full of questions, and left full of answers. I now see what this is all about. It's about hope. Hope that the future will be brighter because I will be a healthier young woman. Hope that I'll shed the emotional shell that I've formed from years of being overweight and feeling inferior. Hope that I'll live a long, healthy life. I know there is no guarantee that this procedure will make me a size 4. A healthy size 14 would be nice though. I know that the success of this procedure depends largely on me and how hard I'm willing to work for it. I also know that medicine isn't an exact science. But I have faith in you and your team and think you will do your best to make this dream become reality. Thank you for your consideration. Amy Ad.. 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 ************************************************ Please join the Mini-Gastric Bypass Community at http://clos.net/forms/mailinglist_form.htm Get the Mini-Gastric Bypass Patient Education Manual http://www.clos.net/get_patient_manual.htm Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 29, 2000 Report Share Posted October 29, 2000 From another Patient... " Greetings Dr Rutledge, " The following is my required patient letter in preparation for the mini-gastric bypass surgery. It is my intent that after reading my letter you will know that I have researched this procedure and feel that it is in my best interest to proceed. Please feel free to call me with any questions you may have. First let me tell you a little about myself I am a 37 year old woman. I have been happily married to my husband for 16 years. We have 4 children the oldest 14 and the youngest is 8. My husband and my children are very athletic and I very much enjoy attending their various sporting events. I am a registered nurse, certified in occupational health. I enjoy my work very much as it is challenging yet allows me to have the flexible hours that I need to keep up with my families busy schedule. I volunteer at my children's school, sing in my church's choir and also volunteer with the youth minister. I have a great life and my goal is to keep myself healthy so I can live long and enjoy it. Understanding the Risks of Obesity As stated earlier, I am a registered nurse and have been practicing nursing for the past 14 years. So I see first hand on a daily basis, the consequences of obesity. I know that some of the complications that arrive from being severely overweight include: high blood pressure, heart disease, respiratory disease, sleep apnea, diabetes, hyperlipidemia, stroke, clotting disorders, endocrine abnormalities, emotional disturbances, various cancers, social stigmas and even death. I also know of the consequences of obesity by seeing my family. My father has adult onset diabetes brought by years of excess weight. I also have two other sisters that are morbidly obese that struggle with low self esteem and they continue the viscous up and downs of diets. .. I also understand that following surgery I may have an intolerance to some foods that I did not have prior to surgery. The " No Alcohol " rule for a year after surgery will not be a problem for me. I currently enjoy a drink socially maybe twice a month if that. Giving this up is no big deal. I am not going to kid myself into thinking this is a piece of cake, I know after surgery I may be tempted to eat thins I shouldn't, but I have a great support system that will help be through any difficult times. Understanding the Billroth II vs. the Roux-en-Y and the risks of stomach Cancer The Billroth II is a standard treatment for ulcer disease, stomach cancer, injury and other diseased of the stomach. The bypass is placed low on the stomach away from the esophagus. The Old Loop Gastric Bypass The stomach pouch was small and high in the abdomen. It is high up on the stomach. This puts the flow of bile acids up close to the esophagus and led to high rates of esophagitis. The high location of the loop also led to problems trying to pull the loop up the high gastric pouch. The new stomach pouch was also based upon the outside of the stomach. This kind o f pouch stretches leading to failure of weight loss. Bile reflux is considered by some to be a causative factor in esophageal and stomach cancer. The Old Loop because of it's placement high on the stomach often lead to bile reflux, where the Mini Gastric Bypass is placed low on the stomach and the stream of bile and other secretions from the liver and the pancreas are far away from the esophagus. It is my understanding that to date the MGB has no patients with esophagitis. Conclusion I am ready for this. I have researched this thoroughly and know this is what I want to do. I have the support of my husband, family and family doctor to assist me. I am not expecting a miracle, but am realistic of the possible complications and the expected results. I look forward to hearing from you to schedule my first clinic meeting and my surgery date. Sincerely, K.. " 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 ************************************************ Please join the Mini-Gastric Bypass Community at http://clos.net/forms/mailinglist_form.htm Get the Mini-Gastric Bypass Patient Education Manual http://www.clos.net/get_patient_manual.htm Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 29, 2000 Report Share Posted October 29, 2000 OK I am going to bed. I just reviewed 35 packets!! To make it easier on me I am asking that people look at the way I want to see what you have done as far as contacting old patients: http://clos.net/contact-patients.htm 7. Contact with at Least 10 Previous Patients To meet this requirement we would like you to send a typed list of at least 10 patient contacts as part of your application package. or Now you can fill out your patient contacts online, Click Here! For each patient that you contact type the patient's first and last name, the method of contact, the patient's email address, the patient's date of operation, the patient's preoperative weight, the patient's weight now, the date of contact and 1-2 paragraphs of written information about the contact demonstrating that the contact was made. Ask questions such as: What did you think about Dr. Rutledge? What did you think about Dr. Rutledge's staff? What did you think about the Hospital? How was your experience with the surgery? How much pain did you have? When did you go back to work? How much weight did you lose? Would you do it again? I also created an online form for people who want to do this all on line: http://clos.net/forms/patient_contacts_form.htm 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 ************************************************ Please join the Mini-Gastric Bypass Community at http://clos.net/forms/mailinglist_form.htm Get the Mini-Gastric Bypass Patient Education Manual http://www.clos.net/get_patient_manual.htm Re: More from Your Packets > > Billroth 11 vs. Open Roux-en-Y > > Weight loss surgery and controversy go hand in hand. Many surgeons have > differing opinions as to which surgery works best. The Billroth 11 loop is > the most common way to connect the stomach to the small bowel. This > procedure is named for Dr. Theodore Billroth, a German surgeon who invented > the procedure almost 100 years ago. > > In the United States in 1996, there were approximately 13,000 stomach > operations that required the stomach be connected to the small bowel. Of > these procedures 63% of surgeons used the Billroth 11, 19% chose the > Roux-en-y and 18% chose some other method. > > The Roux-en-y is an open procedure. It requires two connections instead of > one as in the Mini-Gastric Bypass. The small bowel must be cut and divided. > One part is connected to the pouch, the other end is connected to the small > bowel. Also, the gastric pouch is up high near the esophagus. > > Revision of the Roux-en-y is risky. The configuration of the bowel, stomach > and colon makes revision tough and very complex. Other concerns with > Roux-en-y are scar tissue and adhesions. > > The fact that the MGB is much less invasive than the Roux-en-y is the main > reason I have selected this procedure. Studies show that weight loss at one > year was higher with the MGB than with the Roux-en-y as well. More > importantly, the time > > spent in the operating room was less with the MGB, blood loss was minimal, > the hospital stay was significantly shorter, and the pain was considered > minimal overall. > > > > The Mini-Gastric Bypass appears to meet many of the criteria for an " ideal " > weight loss surgery. > > > > The Risks of Stomach Cancer > > It is my understanding that some physicians feel the Billroth 11 connection > may cause stomach cancer. The numerous reports done show that gastric cancer > in the United States has actually decreased four-fold since 1930. Studies > have also shown that post-gastrectomy patients are at little or no increased > risk for gastric cancer. In fact, reports show that individuals who consume > processed meats and pickled foods on a regular basis have a higher risk of > gastric cancer than those people who have had the MGB. > > I have reviewed all of the criteria to determine if I am at risk for > developing this form of cancer. I am very pleased to have none of the risk > factors. I am not concerned about developing cancer. > > Conclusion > > The years I've spent searching for an answer to my problem with obesity and > my obsession with food are hopefully coming to an end soon. I submit this > packet to you after having given this procedure much thought. After > researching your website and some other materials, I thought it was too good > to be true. With that thought in mind, my Mother and I set off for Durham. > We wanted to see what this was all about. We came to the clinic full of > questions, and left full of answers. I now see what this is all about. It's > about hope. Hope that the future will be brighter because I will be a > healthier young woman. Hope that I'll shed the emotional shell that I've > formed from years of being overweight and feeling inferior. Hope that I'll > live a long, healthy life. > > I know there is no guarantee that this procedure will make me a size 4. A > healthy size 14 would be nice though. I know that the success of this > procedure depends largely on me and how hard I'm willing to work for it. I > also know that medicine isn't an exact science. But I have faith in you and > your team and think you will do your best to make this dream become reality. > Thank you for your consideration. > > > > Amy Ad.. > > > 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 > ************************************************ > Please join the > Mini-Gastric Bypass Community at > http://clos.net/forms/mailinglist_form.htm > > Get the Mini-Gastric Bypass > Patient Education Manual > http://www.clos.net/get_patient_manual.htm > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 30, 2000 Report Share Posted October 30, 2000 Hi Dr. R. I have been a pre-op since 2/19. My packet is complete, but I haven't sent it yet because my insurance coverage won't take effect until January. I have written a short paragraph about my conversation with each contact. I have attended support groups. May I be grandfathered regarding the new contact requirements. Thanks, planning on seeing you again in January. Rozycki. Re: More from Your Packets > > > > > > Billroth 11 vs. Open Roux-en-Y > > > > Weight loss surgery and controversy go hand in hand. Many surgeons have > > differing opinions as to which surgery works best. The Billroth 11 loop is > > the most common way to connect the stomach to the small bowel. This > > procedure is named for Dr. Theodore Billroth, a German surgeon who > invented > > the procedure almost 100 years ago. > > > > In the United States in 1996, there were approximately 13,000 stomach > > operations that required the stomach be connected to the small bowel. Of > > these procedures 63% of surgeons used the Billroth 11, 19% chose the > > Roux-en-y and 18% chose some other method. > > > > The Roux-en-y is an open procedure. It requires two connections instead of > > one as in the Mini-Gastric Bypass. The small bowel must be cut and > divided. > > One part is connected to the pouch, the other end is connected to the > small > > bowel. Also, the gastric pouch is up high near the esophagus. > > > > Revision of the Roux-en-y is risky. The configuration of the bowel, > stomach > > and colon makes revision tough and very complex. Other concerns with > > Roux-en-y are scar tissue and adhesions. > > > > The fact that the MGB is much less invasive than the Roux-en-y is the main > > reason I have selected this procedure. Studies show that weight loss at > one > > year was higher with the MGB than with the Roux-en-y as well. More > > importantly, the time > > > > spent in the operating room was less with the MGB, blood loss was minimal, > > the hospital stay was significantly shorter, and the pain was considered > > minimal overall. > > > > > > > > The Mini-Gastric Bypass appears to meet many of the criteria for an > " ideal " > > weight loss surgery. > > > > > > > > The Risks of Stomach Cancer > > > > It is my understanding that some physicians feel the Billroth 11 > connection > > may cause stomach cancer. The numerous reports done show that gastric > cancer > > in the United States has actually decreased four-fold since 1930. Studies > > have also shown that post-gastrectomy patients are at little or no > increased > > risk for gastric cancer. In fact, reports show that individuals who > consume > > processed meats and pickled foods on a regular basis have a higher risk of > > gastric cancer than those people who have had the MGB. > > > > I have reviewed all of the criteria to determine if I am at risk for > > developing this form of cancer. I am very pleased to have none of the risk > > factors. I am not concerned about developing cancer. > > > > Conclusion > > > > The years I've spent searching for an answer to my problem with obesity > and > > my obsession with food are hopefully coming to an end soon. I submit this > > packet to you after having given this procedure much thought. After > > researching your website and some other materials, I thought it was too > good > > to be true. With that thought in mind, my Mother and I set off for Durham. > > We wanted to see what this was all about. We came to the clinic full of > > questions, and left full of answers. I now see what this is all about. > It's > > about hope. Hope that the future will be brighter because I will be a > > healthier young woman. Hope that I'll shed the emotional shell that I've > > formed from years of being overweight and feeling inferior. Hope that I'll > > live a long, healthy life. > > > > I know there is no guarantee that this procedure will make me a size 4. A > > healthy size 14 would be nice though. I know that the success of this > > procedure depends largely on me and how hard I'm willing to work for it. I > > also know that medicine isn't an exact science. But I have faith in you > and > > your team and think you will do your best to make this dream become > reality. > > Thank you for your consideration. > > > > > > > > Amy Ad.. > > > > > > 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 > > ************************************************ > > Please join the > > Mini-Gastric Bypass Community at > > http://clos.net/forms/mailinglist_form.htm > > > > Get the Mini-Gastric Bypass > > Patient Education Manual > > http://www.clos.net/get_patient_manual.htm > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 31, 2000 Report Share Posted October 31, 2000 > Date: Mon, 30 Oct 2000 20:45:28 -0500 > >Subject: Re: More from Your Packets > >Hi Dr. R. I have been a pre-op since 2/19. My packet is complete, but I >haven't sent it yet because my insurance coverage won't take effect until >January. I have written a short paragraph about my conversation with each >contact. I have attended support groups. May I be grandfathered regarding >the new contact requirements. Thanks, planning on seeing you again in >January. Rozycki. - by all means send in your packet if you have everything ready to go. My insurance also does not go into effect until January 1, 2001. I sent mine in the end of September, received confirmation and have my clinic appointment and surgery date set up. Waunakee, WI MGB 1/10/01 Quote Link to comment Share on other sites More sharing options...
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