Considering DS
Hello DS Community,
I am new to this site and have enjoyed reading your encouraging posts. I am wondering more about the downsides to DS surgery and its permanance and side effects.
Has anyone regretted the surgery or had extensive complications?
Also, can someone recommend a DS surgeon in the Los Angeles area? (If we are allowed to post that info).
Thanks, I appreciate your input.
Keshishian is one of the best. Rabkin is great too. Be very cir****pect about the docs who advertise here. Many who claim to do the DS do not. The idea is to get you into their office to sell the surgery they do! Be a critical thinker and always follow the money.
A good thing for you to do is hang out on the revision forum. Learn what others did first that didn't work.
There is no better WLS available today than the DS. Best results losing the weight and keeping it off. And postop DS life is pretty normal. You can still eat.
There are very few people *****gret the DS. Just like any surgery there are some people who have complications. No surgery is risk free. And it's not risk free to go on being heavy either.
One caution. If you want a DS make sure you are getting a true 2 anastomosis DS. There are some experimental look alikes that are regretfully, being sold as a DS. Make sure you are getting what you pay for.
The only DS surgeon in SoCal is Dr. Ara Keshishian in Glendale. Dr. John Rabkin is in San Francisco. Both are excellent and very experienced with the DS, and do the true, standard of care DS with 2 anastamoses.
The DS has the best statistics of any bariatric surgery for percetage excess weight loss, for maintaining that weight loss, and for permanent resolution of almost all comorbidities. I'm over 11 years post-op with no regrets, ever.
Larra
I've been on this DS forum for over 11 years, and on others as well, and have never heard of this doctor, or of any surgeon at Eisenhower doing the DS, with or without robotics. I would be very cautious about this information. If you are considering this surgeon, I would make very, very sure he is experienced with the DS, and also that he is doing the real, standard of care DS and not the new, experimental procedure than some surgeons are calling "the DS" but which isn't the same, goes by multiple other names (loop DS, SADI, SIPS). The long term results for the standard of care DS with 2 anastamoses are well documented and excellent - best statistics of any bariatric surgery for percentage excess weight loss, maintenance of that weight loss, and for permanent resolution of almost all comorbidities. The long term results of the new procedure are not known. Also, insurance generally doesn't cover experimental procedures, so surgeons are either using the DS code incorrectly, or cobbling together other codes.
If you should learn that this surgeon is truly doing the standard of care DS, has trained with someone experienced with the DS, etc, let us all know - it's always good to see more surgeons doing the DS. But again, I would be cautious and ask lots of specific questions.
Larra
Thank you for providing his website.
Sure enough, he is not offering the standard of care DS. He is doing what he calls a "modified" DS, which is the loop DS than I discussed in my prior post. While he touts the excellent long term results of "the DS", those results are not for the operation he's doing, they are for the standard of care DS with a RNY configuration, not a loop, and with 2 anastamoses, not the one you get with the loop.
Now, he may be a fine surgeon, and in 5-10 years we may learn that this experimental variation also has good results, but it's NOT a true DS. If what he's doing is what you want, fine, go for it, though I would also caution you to ask how he's coding this for insurance approval, since there is no code for it. Some insurers are catching on to the fact that surgeons are using the DS code for something the code doesn't cover and are now specifically excluding this operation in their policies. There have also been cases where the insurer figures out, after the fact, that the surgeon did an operation different from what was approved and are sending the patient large bills.
Larra
I checked with his office and this is not loop with just one anastomoses. It's called modified because it spares the gallbladder and the pylorus of the stomach. It also has two anastomoses.
When you say standard of care, what do you mean? I've been a Registered Nurse for 20 years and standard of care doesn't mean a specific surgery. In tort law, the standard of care is the only degree of prudence and caution required of an individual who is under a duty of care. The requirements of the standard are closely dependent on cir****tances. When you say standard of care, what do you mean?
The office is giving you somewhat confusing information. Whether or not the gall bladder is removed has nothing to do with having a DS, vs having gastric bypass, or some other operation. Some surgeons remove the gall bladder routinely because so many people develop gall stones from rapid weight loss. Other surgeons don't. This has nothing to do with the rest of the DS. And as far as the pylorus goes, every DS includes a sleeve gastrectomy, which always spares the pylorus.
The issue is loop configuration vs RNY configuration. Loop has one anastamosis, RNY (NOT to be confused with gastric bypass, which many people call RNY) configuration has 2 anastamoses. According to what I read on this surgeon's own website, he's doing a loop DS. So either the website is wrong or his office staff is wrong.
Standard of care - more than one meaning. With regards to different operations, some are considered standard of care and others are experimental. The DS with 2 anastamoses is a standard of care operation, accepted by the ASMBS, Medicare, and other medical organizations. The loop DS is considered experimental, and thus not a standard of care operation. This is different from what you are talking about with quality of care either meeting accepted standards or falling below the standard of care.
Larra
