Different Surgeons/Different Results???

Hi Everyone!

I'm in the process of choosing a surgeon for the RNY. There are many in my state and I just can't decide where to go..... Closer to home would be the obvious choice however, I've read some reviews about the surgeon in my city and some people aren't having great results and many are regaining. 

**Do some surgeons make the pouches smaller than others and do some bypass more intestine than others?** This is something that I've never heard of until I started reading more in the reveiws. Yes, I want to be healthly and I know there are many risks with malubsorption but I also want to get every penny worth of what this surgery is going to cost me since my insurance isn't going to cover it. 

Does anyone out there know anything about this????

THANKS!!!!
Laurie

Hi Laurie, There is more than one bariatric surgeon in Wilmington, but the only one I would recommend would be Dr Harris.  His practice is a bariatric center of excellence, and he has a long history of laparascopic surgical experience.  I checked out the other surgeon in this area and Dr Harris wins hands down. Your surgeon, whoever it is, will make the decision, based on your weight and other factors, on how large a pouch to provide to you and exactly how much of the small intestine to bypass. I always caution self-pays to consider the possibility of complications and the added expense they can pose.  I had a bad reaction to an antibiotic and that had me in the hospital for a week and prior to that I had a small leak and wound up in the hospital for another week due to that.  That would have wiped me out if I hadn't had insurance!  Read my profile for more details. All the best to you!

With the RNY surgery there is distal, proximal and medial... these terms referr to how much of the intestines is bypassed. Distal is around 150 cm (the largest), Proximal is on the low end (I think around the 80-120ish range??) and medial is in the middle... dont quote me on my numbers but you can research.

The pouch will stretch naturally over time... I believe all surgeons basically form around the same size, some smaller... but over time they stretch so you can eat more. Surgeons also use different areas of the stomach to make the pouch which can make a difference in some peoples opinion! IMO the smallest is not the best... its a struggle enough to eat early out I cant imagine my pouch being smaller than it was. My biggest goal with this surgery was to feel normal.. which I do now!!! With bypassing the intestines its not always necessary to go for the higher amount. The end result is ALWAYS the same... those with less bypassed do lose slower than those with more... but we all can meet goal and stay there. I know you want to get everything you can out of this surgery so do your research and make the RIGHT decision - dont automatically jump on the smallest pouch and most bypassed.

My surgeon bypasses on the low end (80cm)... I am SO happy I had a less amount bypassed. I have had NO issues with food intolerance, no gas issues, no diarreah issues, extremely minimial hairloss, great labs and I have never dumped. I see most people who had proximal have the same experience. Those who have distal procedures suffer from more of the side effects because they had more intestines bypassed... this is my opinion of course but the more you look around the more you will see it. The distal procedures have to eat much more protein and many many more calories than I do. I will basically eat around 1200 calories for LIFE - many distal RNYers were eating 1500-2000 after 6 months out! Of course it varies by surgeon and plan... but I saw it over and over again. I eat around 60g protein a day and somebody who is as far out as I am is eating 100++.. basically they have to be more vigilant about their nutrition because of the additional malabsorption. The biggest thing to consider are the long term effects of the malabsorption... since they really dont know and there havent been long term studies you have to decide what is the best for you. Definately ask these questions to a surgeon. My surgeon feels bypassing less is the way to go since your body doesnt 'suffer' as much. Surgeons will sometimes tailor the surgery depending on the size of the patient... but only by a little.. many have a range they will bypass - lets say 120-130... if somebody is larger they may do the 130 and smaller they may do the 120... some surgeons do everybody the same so theres something else to look at (overwhelming eh?!). I did see people ZIP to goal in 6 months who had surgery when I did and around the same weight to lose... I just hit goal last week (I am 1.4 years out)... Ive learned over time its not a race and I knew I would reach my goal... in the end I am happy with the route I chose.  Hopefully this helps you out some.. of course do your own research and speak to surgeons to find out information... a lot of what I said is my opinion based on what Ive seen on OH :-)

WOW!!! Thank for all the great information!!! I'm so glad that we have this forum!

From my experience I know that some surgeons require a preop liquid diet for two weeks and some dont.  This is the only difference i know of, also the post op eating plan can differet too. Other then that, alot has to go with your anatomy, how they do it, open vs laproscopic.  As for the outcome, if you do things right you will loose weight.