Dr. Now

Interestering.... Why is he doing so many VSGs and seems to have dropped bypass??? So many pts appear to be among the RNY group stats??? Is he moving toward shorter surgical time?? Just saying...we haven't seen pts with great weight in the first year like we did in 2024-2015 ...what up doc???

Interestingly enough, many people have questioned that as well and he explained to us at the OH2016 event and in some recent My 600lb Life episodes, that if he does a VSG it is because the RNY is too risky for the patient. The OR time for a VSG is much shorter than a RNY, so the patient is under general anesthesia for less time and there is less chance of a sentinel event.

So, he is doing this for the benefit of the patient, not for any other reason. You will also see that he will do a VSG on some patients and once they have lost enough weight to be considered a lower risk, he will convert to RNY.

This observation is not about Dr Now per se, but it's pertinent to the OP question ...

Unfortunately, we are seeing more and more VSGs being converted to RNY because of life altering gerd. Some of these people looked to be bad candidates pre surgery and it begs the question why? Some surgeons seem to almost run surgery mills and VSG is so much quicker than RNY and I'm sure I read that insurance reimbursement is about the same. Then they get to get a second bite at the insurance cherry with the revision.

None of us like to think we are moneymakers, but it appears to be so in too many cases. Like practices that insist you drink their overpriced and overhyped shakes and take their expensive vitamins.

Seeing the uptick in revisions makes me so glad my surgeon was adamant that VSG would have been a bad fit for me due to GERD.

My surgeon also insisted I have gastric bypass instead of a sleeve and I'm so glad he did as my GERD has resolved.

Had I suffered from GERD prior to my original surgery, my practice would never have approved me for VSG, and had I insisted, my surgeon would have told me to find another doctor. Sadly, I developed my GERD as a result of my VSG, so I really had no choice but to convert to RNY. I have heard of too many surgeons who give the patient what they want rather than what is medically appropriate. It makes me a good mix of sad and mad.

VSG to RNY as opposed to DS? I'm really surprised - but I agree that a distal RNY works many years post op like a DS ( my ex husband had one) with the added benefit of no GERD .