I don't get it!

We have a tool that has been around for a while...it's the top part of *this* tool...yet no one talks about the DS!  It's like the DS is the shame of the bariatric profession!  Here's the link:

http://gma.yahoo.com/woman-loses-130-pounds-months-radical-s tomach-surgery-182125253.html

I think it has more to do with popularity/availability. The VSG is the "cool new up-and-comer" in the bariatric world, and LOTS of surgeons are hopping on board that gravy train, so it's available almost everywhere now.

That's true...and it's a restriction-only procedure, and much less complicated than the DS. 

Gravy-train, cash register ringing... All apropos.   I  was admitted at the hospital at 9:00am. I was in my room, awake, dressed in my jammies  and walking by 1:00pm.  I was out the door the following morning at 7:00am.  I wasn't a revision or anything, but my total time on the operating table was 45 minutes.  On surgery days, they run 2 operating suites at a time and Dr. Kim goes back and forth between them.  RNY takes 2x as along but they can't charge 2x the VSG price -- at least now. 

Yup, and super ditto for the DS - takes even longer and requires more skill/experience, yet most insurance companies won't pay more (or much more) than for RNY.

And I read your other post in this thread, too, and I totally agree about the hair color comment! I still pop over to the VSG board occasionally, but most posts nowadays just make me roll my eyes, so I don't participate much anymore.

Hey Congrats Jilly Bean!  Did not know you were expecting!!

 My wife was recently in LA for business and she said there were quite a few Billboards advertising the VSG out there...  I agree with the "gravytrain" statement...  It's "en vouge" and doc's will make a good buck doing them.  It's a good procedure for some people, just as the DS is.  To me, it's all about patient selection and patient knowlegde.

Significant malabsorption is scary to many people I think and difficult for television to explain in a 5 minute segment.  Not to mention though, it's been my experience that most dsers are very knowledgeable when it comes to vitamins and staying on track. Not so much in my experience with RNYers though (not all, but many). They just don't know what they should know and what they should be doing to stay healthy. We DSers tend to be a stoic bunch who work hard to keep doctors doing the DS by staying compliant. If DS was like RNY (72% of all wls that are performed are RNY), how long do you think it would be before surgeons stopped doing the DS because patients are not compliant with their vits and presenting with lots of malnutrion and other deficiencies?

 

From what I gather, most surgeons expect VSG to virtually replace RNY and the band over the next 5 years. It wasn't covered by most insurance until the last 2 years, and much of the long-term efficacy data really is for Stage 1 DS patient that chose not to get switched rather than standalone VSG.  My understanding is that Dr. Criangle is getting ready to publish a study that should be pretty intructive.

The failings of the band an RNY are pretty widely understood, at this point.  The day I went in for my pre-op appointment, there were 20 of us -- 17 being operated on in one day (12 VSG/5 band) and 3 RNY's being done several days earlier.  My surgeon is a former DS surgeon, and they are very big on the sleeve in his practice.   The 3 RNY's and 2 of the bands were medicare patients for whom VSG is not an option.

Additionally, Gastrectomy, along with being part of DS, is a fairly familiar procedure to surgeons. They're done all the time for a wide variety of medical reasons including including stomach cancer. The skill level it takes to do journeyman level DS is higher than that for a VSG.  The VSG board abounds, however, with patients coming from surgeons new to the procedure with wacky plans or no defined eating plans/support, etc. IT will be interesting to see how fast the newer surgeons get up to speed.
 
The VSG boards also seem to  have a plethora of people, recently, who gave more thought to their most recent hair color change than removing 85% of a major organ.  While steering folks like that to DS might result in a darwinian thinning of the herd, it probably wouldn't be good for malpractice insurance rates amongs tthe DS surgeons. 

" The VSG boards also seem to  have a plethora of people, recently, who gave more thought to their most recent hair color change than removing 85% of a major organ.  While steering folks like that to DS might result in a darwinian thinning of the herd, it probably wouldn't be good for malpractice insurance rates amongs tthe DS surgeons. "

Agreed!  Couldn't have said it any better!  People shouldn't go into ANY WLS without knowing *exactly* what they're getting themselves into.  While this responsibility falls somewhat onto the surgeon, ultimately it falls onto the individual.  So many have said it before - having the DS without knowing what one is getting oneself into can lead to a potentially deadly situation.