DS Pioneer Gives Up On DS - For Lapband???

 I was talking to a friend of mine online earlier today .. She's a Dr. B. patient who is many years out, but has been having her follow-up done with Dr. Terry Simpson there in Phoenix, AZ.   For those of you who may not know, Dr. Simpson was one of the first DS surgeons, performing them as far back as in '92.  He also does RNY and band and has co-authored books on WLS, including one about reaching goal after WLS (w. Dr. Katzan, the PS) ..     My friend tells me that on her last visit to Dr. S., he informed her that he is no longer performing the DS and is only going to do LAP-band from now on (his OH profile also mentions that he is "exclusively doing *band*" now).  < CLUNK >   I asked her if he said what the basis for his decision was, and he replied that he was just tired of his DS patients not doing their follow up and getting in trouble b/c of it (by that, I take it he meant blood testing and supplementation).    Wow ..  this is the first time I have heard of a DS surgeon deciding they do not want to perform the procedure anymore (other than to retire).  Has anyone else heard about this, or know of any other DS surgeons that stopped doing it?   I wonder if something else is going on here ..     btw - my friend has lost over 220 lbs., but is still 100 lbs. from goal and frustrated that she can't get the rest of her weight off (I know the feeling!).  Dr. S. refused to do any kind of revision on her, including a banding.   She is also having bad iron absorption problems and has had to have iron transfusions before and is scheduled for another round in the very near future.   From what my friend says, Dr. S.'s local suport group for DSers - of which she is a member - is apparently in a state of uncertainty and anxiety now, since it looks like he may not even be willing to do follow ups for them anymore.    &:-/)     

Both before surgery and since, I've talked to my band surgeon about the DS.  She performs both RNY and bands and I recently found out she used to do the DS as well (I have no doubt she didn't do a lot and/or was not a DS expert).  She very much poo-poo'ed the DS and didn't recommend it at all - not sure what is up with the switch.  Since I wanted to stay away from a malabsorptive procedure I didn't push her on it.

Follow the money. From Dr. Simpson's site: "Because of Dr. Simpson's extensive experience in performing LAP-BAND procedures, and because he is the leading LAP-BAND bariatric surgeon in the Southwest, he was recently selected as a proctor by LAP-BAND maker, Allergan. As Allergan's LAP-BAND proctor, Dr. Simpson is now authorized by Allergan to teach other bariatric surgeons how to perform the LAP-BAND procedure for their patients." From another site: "Allergan had its first Total Care forum, in California on November 14,15, and 16. Dr. Simpson was instrumental in putting together the program. Total Care is the new concept of Allergan, with its commitment to surgical excellence, as well as teaching patients how to take care of the band. Very few surgeons in the country have the results that Dr. Simpson and his staff have -- but those that do were invited to share their ideas with other surgeons. A few simple concepts: successful patients see their surgeon six to ten times in the first year. This is typical for Dr. Simpson's patients. Patients are not on a "set" schedule for band fills, but are allowed to have their band titrated to effect. Most bands are adjusted in the office. Allergan will be rolling out the Total Care package in January, with Dr. Simpson as one of the authors. "

B - I - N - G - O  !!!

Could have something to do with a surgeon with a poor follow-up plan.  I dunno....course then there's another spin too.  Maybe because a surgeon can do several bands in the time of one DS, the surgeon is making more money.  Oh, and then when someone wants their band out, he gets that business too.  If you look at it from a business stance it makes perfect sense for him to want to line his pockets.  Then you have other surgeons who care that their patients get the best surgery out there, and their the ones that will continue to do the DS and screen their DS patients carefully. 

Well said Lori!

My surgeon reports that he was trained in the Duodenal Switch and has performed it successfully and believes it offers some patients excellent outcomes, but feels like the surgeon does in the original post: he has serious doubts about his patients' ability to keep themselves nutritionally safe long-term. While he lists it as a procedure he "can do", he makes no bones about the fact that he'd rather not. My surgeon, incidentally, is in a major hospital in North Philadelphia (where I also worked, years ago--not the greatest part of town) so his patients may or may not always be the best educated people around, IMHO. A great many of them are non-compliant, apparently, even with the limited supplementation they have to follow post LapBand and RNY.

I sympathize with your surgeon and fully understand his lack of faith in humanity having a lick of sense.

It's a damn shame, because it's the rest of us who suffer for the stupidity of a few. How many times a day do you see *that* theme reiterated in this country, a couple billion? Yep, frustrating. I understand his hesitation, I really do.

It's the stupidity of the MASSES I'm afraid, and only a few with any decent sense.  Otherwise we wouldn't be in the pickle we're in as a nation currently, IYKWIM.  *sigh*