Dr Dakin anyone?
He trained with very experienced bariatric surgeons, and he's at Cornell at which the bariatric surgery program is very well respected. He works with Pomp.
But you have to find out if he has revision to DS experience.
If he's on your insurance, go have a consult and ask him yourself.
He has not been practicing as long as Inabnet and Herron. He finished his residency in 2003, then probably a 3 year fellowship....probably an attending for about 5 years.
You'd be, in my opinion, in very good hands with him and the Cornell team. One of the best in the country.
And see if Dr. Herron at Mt Sinai is on your insurance.
If you are limited to doctors who are on your insurance, and you want somebody with experience revising to DS....you are going to be very limited.
What insurance do you have?
Maybe you should pay just for the consult and second opinion and see Pomp or Inabnet. If they agree with Roslin...you have your answer.
Anyway why don't you wait until Roslin gives you a definite answer, and make sure you understand thoroughly and in detail why his opinion is what it is. Get him to write it down, draw you pictures...whatever you need to understand so that you can explain it clearly to other doctors if necessary. And get copies of all your test results - the GI series, etc etc. Including any films, scans, etc.
The guy is at Cornell, at one of the best programs in the country. He trained with some of the most experienced DS surgeons in the country.
Pomp is not a "vetted" surgeon either, but I would without hesitation recommend him for a DS and a revision.
**** happens to people even with the best surgeons. We never, ever know the whole story just from the patient's side. Ever.
Ask him yourself how many revisions to DS he has done (if he's on your insurance and you want to).
I have heard plenty of stories over the years where people had complications even with Gagner as a surgeon. Does that mean one should stop recommending him? Of course not. **** happens.
on 9/11/11 8:48 am
I was reading your other post about your Sapala Wood Micropouch, and your appointment with Dr Roslin about a revision. If I read correctly, he didn't say that he couldn't / wouldn't do it, but that he wasn't certain it could be done, and he wanted to send you for an EGD, is that right?
If I were you, I would go for the studies so that you know exactly what you're dealing with, and then consult back with Dr Roslin, this time armed with a list of questions. Once you do that fact finding, you will be better prepared for your second opinion.
I also saw where you had an email exchange with Dr K in CA, which is a great idea. I would make sure that you get him the EGD report, as well as the other studies that you have. My understanding is the Micropouch is a patented procedure done mostly in the NYC / LI area, so Dr K might not know exactly what he's dealing with until he sees those reports
My impression is that Dr Rosin has the most RNY to DS experience in the NYC area, so I dont know what Dr Dakin might do or tell you differently. My best advice is to follow through with the studies Roslin ordered, see exactly where you stand with him. Then if you or he are not comfortable, proceed directly to Dr K or Dr Rabkin.
Did someone say PATENTED?!? Just so's ya know:
(1) Patented doesn't mean secret - in fact, it means just the opposite. In exchange for the right to exclude others from making and/or using the invention for a limited period of time, the patentee must fully disclose to the public - DURING THE TERM OF THE PATENT - how to make and use the invention. This is the quid pro quo of the patent system "in order to promote the progress of science and the useful arts" (Article 1, Section 8) - in other words, the patentee has to describe his invention fully, so that while the patent is in force, others can improve upon it, and the inventor doesn't rely on secrecy (which is a societal detriment). So even though Sapala got a patent (see below), it is supposed to be fully disclosed by the teaching of the patent - see below.
(2) But even then, that doesn't matter, because in 1995, the Ganske-Frist amendment to the patent laws made an exception for patented medical procedures (that don't use patented devices) - even though you can get a patent on a medical procedure, you can't enforce it against doctors or hospitals.
35 U.S.C. 287(c):
(1) With respect to a medical practitioner’s performance of a medical activity that constitutes an infringement under section 271 (a) or (b) of this title, the provisions of sections 281, 283, 284, and 285 of this title shall not apply against the medical practitioner or against a related health care entity with respect to such medical activity. (2) For the purposes of this subsection: (A) the term “medical activity” means the performance of a medical or surgical procedure on a body, but shall not include (i) the use of a patented machine, manufacture, or composition of matter in violation of such patent, (ii) the practice of a patented use of a composition of matter in violation of such patent, or (iii) the practice of a process in violation of a biotechnology patent. http://patft.uspto.gov/netacgi/nph-Parser?Sect1=PTO2&Sect2=H ITOFF&p=1&u=%2Fnetahtml%2FPTO%2Fsearch-bool.html&r=1&f=G&l=5 0&co1=AND&d=PTXT&s1=sapala.INNM.&OS=IN/sapala&RS=IN/sapalaUS Patent 6,758,219Sapala-wood.SM. micropouch (SM means service mark)
What is claimed is:
1. A surgical method for treating obese patients, the method comprising: a) incising the patient and entering the abdominal cavity; b) mobilizing the gastrocolic omentum from the watershed to the angle of His; c) identifying and transecting the left phrenoesophageal ligament thereby enabling the exposure and identification of the junction of the longitudinal muscle fibers of the esophagus with the serosa of the cardia; d) opening a window along the lesser curvature of the stomach through the gastrohepatic ligament proximal to the coronary vein; e) transecting the proximal end of the stomach at the junction of the cardia and the fundus; f) constructing a micropouch by making a retrocolic side-to-side Roux-en-Y cardiojejunostomy along the greater curvature of the stomach, thereby preventing inclusion of fundal tissue and lesser curvature acid producing cells in the micropouch; g) incorporating the proximal fundus of the cardia into the stoma of the anastomosis; h) closing the gastrotomy and jejunotomy incisions without inverting the staple line at the apex of the micropouch; i) applying fibrin glue over the closure specified in h); and j) connecting the biliopancreatic limb to the common conduit via side-to-side jejuno-jejunostomy.
2. The method of claim 1 wherein the gastrocolic omentum is mobilized using a multifire endo-GIA stapler.
3. The method of claim 1 wherein the stoma of step (g) is approximately 12 mm in diameter.
4. The method of claim 1 wherein the fibrin glue is Heemaseal.
THIS IS IN MY OPINION AN EGOTISTICAL WASTE OF TIME AND MONEY ON THE PART OF SAPALA AND WOOD. THE PATENT WAS UNENFORCEABLE AGAINST ANY SURGEON OR HOSPITAL AT THE TIME IT WAS FILED (2002). i DON'T KNOW WHY THE PATENT ATTORNEY DID NOT TALK THEM OUT OF FILING AND PAYING FOR IT.
Perhaps a surgeon who used a "multifire endo-GIA stapler" would infringe claim 2, if that specific stapler is patented - but the surgeon could use a different stapler and NOT infringe./end of patent law lesson/
