NEED ADVICE: How to know if surgeon is experienced enough to do a VSG?

The stats I had on this doctor I'm supposed to be meeting were off.  I found out this correct stats are this:
The doctor has done a VSG 148 times.  Would you say that he's expierenced enough?  Also the doctor has done the dudonal switch a little over 140 times. (which is the first part of the sleeve)  So between the two his done around 290 surgeries.  Complication rate low.  But had to turn 5 cases of the 148 into a laporatomy (open surgery). And 1 case of the DS to an open. 
With the DS and the sleeve he has had no leaks.
Has done about 1000 bypasses and has had 5 leaks within the 1000 bypass.  No deaths with any of surgeries.  Doctor has done a couple hunderd lapbands but now choices to not do lapbands since the complication rate of the lapband in general is high.
Thoughts should I go with this doctor or go to Mexico to one of the DR  As?
Thoese are my only choices since I'm self pay.  This doctor and his colleague are the only ones in the area that are in a price range low enough that I can get a loan.
The two Doctor As in Mexico stats are the best.  However I don't know if I feel up for the travel after surgery.  I have many health problems and it's hard enough as it is to travel with no surgery.

I can't comment on whether it's enough, as to me it's not how many someones done- but how well they do them.. I was self-pay too.. so I ended up doing a lot of research to find someone I could afford within reason, that made the best sleeve possible (for me that meant: tight, great outcomes as far as %EWL, and leak/complication %..) I chose my surgeon on those factors, and got exactly what I expected.. 

As far as travel- it wasn't difficult for me. Yeah, coming back- long flights, long day.. I was tired and sore, but nothing unbearable.. was even ok enough to hang with our friend that picked us up from the airport at 11pm to show off my incisions! I had to walk slow, and DH carried the luggage.. but I could have handled a roll-cart if someone else would lift it for me. I was in pretty poor shape going into this- couldn't handle more than 10mins of walking.. not sure how bad your health issues are, but you can also arrange for wheelchair assistance in the airports.

It's Dr Aceves (your doctor) the one I want.  I just wish he was local.  One thing is I have edma and tendonitiis cause my ankle to swell triple on airport.  Worried about getting blood clots on the plane.  Last time I flew it literally got that large triple size (ankle).  Also I have a very large waist size 30.  Couldnt fit in the seat not even first class.   WAs all bruised up from the seat.  Also the bathroom.  I'm worry since i have IBS anyway how it will be after surgery.  I couldn't even fit in the bathroom properly.  I'm worried about banging up or bruising my incisions just to get into the bathroom. seats  etc.  It my size that is keeping me from flying but yet to get the doctor i want I need to fly.  I can't win. 

I really sympathize with your worries, I had a very large belly, 57" hips.. plane bathrooms are not fun places regardless, much less being big. 

Couple things I would suggest, if you don't mind- and if you are really set on Aceves.. You'll need your PCP on board to do labs anyway, and follow-up. I know the flight time for me was no longer than 5 hrs at a shot.. not sure coming from the east coast, but I'd imagine you'd have a stop-over as well.. You fly into CA and get picked up from there- no customs to deal with.

Here's my thoughts in no particular order:

Buy two economy seats and request an extender. You'll be much more comfy that way anyhow.

Arrange for wheelchair assistance if you think you'd need it on the way back for walking the terminal.


Compression stockings, you'll need assistance to get these on.. but even just a compression wrap put on properly from ankle to knee will help with the swelling & ankle pain (this was/is my on-going issue, tendon damage and bad swelling.) The nurses will happily do this for you before you leave if asked.

If you have had clots before, you can speak to your PCP and see if he will Rx heparin shots (may not be heparin, but similar anti-coagulant to be used post-op..) You can co-ordinate w/ Dr. Aceves office on when to start them... do this with both Drs teams working together, you don't want to cause a problem that isn't there, or not likely to happen.

With flying and clots- you prob know this.. flex you feet, tighten your calves once in a while- like every 15mins or so.. or stand up and just slowly pace the isle once in a while.. people do this all the time on long flights. I personally flexed and stood up next to my seat and kinda stood in place moving my legs a bit. You will likely not be sitting for more than 6hrs though, due to stop-overs.

IBS- I have IBS-d, no issues since surgery (save one flare due to eating a known trigger!).. prob due to less food going in, and I really wonder if some wasn't an inflammation process from grains... anyway, I didn't poop for 3 days.. Not sure how bad yours is, but there are options to help this as well. I only used the airport public facilities.. I held it till we got in the terminal. I brought Imodium just in case for similar reasons, did not want to worry about the bathroom- never needed the Imodium.

You may still bump your incisions, but no damage will happen.. you will be sore, but not in agony.. Your incisions are all in the front, mine were right under the bra line, an inch above my belly button, and a couple along the sides diagonal to that.. I didn't whack them that I recall.. but I was sore. It was tolerable with the meds given to me.


If you do go, please consider having a helper come along. My husband slept just fine on the couch in my room, helped with my small needs, and ate well in the cafeteria on site. If you don't- don't stress, the lady that was in with us was alone and fared just fine by herself. They really do take very good care of you there, much more attentive than any hospital stateside I've had the (dis)pleasure of being in-patient at before.. night and day, wish the US would learn a little from the medical care I got at Almater.

Not trying to talk you into one thing or another.. just wanted to share some things that might help ease some of the feelings that you can't win? You can fly, it may not be the most comfortable right now.. true, it might cost more for you than for someone else- true. It's not comfy for a regular sized person.. but it can be done, and it's a short duration.. one day there, one day back.. in the grand scheme, that can be tolerated for the benefits that it brings.. Good luck with whatever you decide!

HI there, yes I'm very big waisted.  I have a 53 inch waist and my hips are 60 inch even more than yours were. lol
Thank you so much for my good advice!  I just may force myself to do this so I can have a better doctor.  Maybe if I get to Mexico ahead of time and rest and do the same before going back.  I don't know.  Can't make a desicion.  lol :-)  It would be easier to go local but I want to be 100% sure of the doctor not 95% sure.

If the doctor is experienced, it will be obvious when you research the particular surgeon.  Generally, the high profile, highest visibility doctors are the most experienced.  Also, visit their website for stats.  The most experienced ones have performed thousands of WLSs.

Thinking of things from all angles -- I also wanted someone very experienced but not burned out or complacent.  I wanted my surgeon to be a little hungry, driven to excel to perfection.  Pre-op, I wanted a surgeon who could look me straight in the eye.  I wanted a surgeon who is very confident and passionate about the work they do.  To me "experience" is not enough when talking about a life/death decision.

 You are looking only at surgery - Why not also look at the long term suceess rates of the entire program?  How long are they tracking their patients?  What percentage of patients achieve >75% of EBW lost?  Is the center an ASMBS certified center of excellence?

As for the surgical stats, anyone who's done almost 300 sleeves is clearly experienced.  The number that had to be converted to open surgery, is not really even interesting trivia.  Look at the complication rates and compare those to both the ASMBS standards and national averages.  

You want to come through the surgery safe - but you also want to look at long term success.

Yes.  I think they said there average for excess body weight loss is 60%.  I think that  avereage includes patients that don't follow the program and gain all or most of there weight back.    They said that if it's 15% that gain 1/2 to all of there weight back.  But if they follow the program it was only 5%.  So 85% keeps there weight off.  I don't know whether or not these statics are good.  I really don't know what to go by.

Have you checked out Care Credit? I know they finance just about any medical procedure. Not sure what their interest rate is now but I used them a couple of years ago for dental expense. I was also self pay and not only looked for a reasonable price but one of the best rated Dr.'s in the area. I would rather finance for longer at a higher rate and have a Dr. that I was completely sure about in every aspect!
Good luck with your choice.