Pre Op, weighing choices
Dr. Carlos Ferrari did my DS surgery last month at Memorial Hermann. He is an excellent and reputable surgeon and I have had no complications with my surgery. I did a lot of research prior to getting my surgery by reading alot from OH and dsfacts.com. Dr. Ferrari performs the DS surgery. I believe you must have misunderstood him. He most certainly knows the difference in the surgical procedues he performs. He has tons of experience with the DS and has performed over 5,000 bariatrics surgeries. He took really good care of me in the hospital.
I might add my DS was with the sleeve. I know his English can be a little hard to understand, but you will be in safe hands with him. Take a look at his profile on OH and you can read all the wonderful reviews about Dr. Ferrari.
I might add my DS was with the sleeve. I know his English can be a little hard to understand, but you will be in safe hands with him. Take a look at his profile on OH and you can read all the wonderful reviews about Dr. Ferrari.
I am almost reluctant to post here because there is already a lot of good information and misinformation mashed together. I"ll do my best.
First, I do think you may have misunderstood the surgeon. I'm sure he knows the difference between different operations, but maybe you don't, and at least one person who answered you doesn't either.
Bottom line:
The DS, also called BPD-DS, includes a sleeve gastrectomy and the intestinal "switch", which means that the duodenum is divided, the small intestine is divided roughly half way along, the lower half (ileum) is attached to the duodenum and then the upper half is reattached to the ileum to form the common channel. The common channel is where the food and digestive juices meet, and where most digestion occurs. Bypassing so much of the small intestine is what creates both malabsorption and metabolic changes that make the DS the most effective wls available both for weight , and for maintainence of that weight loss, and for resolution of almost all comorbidities.
Gastric bypass is very different. It involves creating a tiny stomach pouch (NOT bypassing above the stomach as someone else said), bypassing just a small amount of the small intestine, and attaching the small intestine directly to the pouch. It works almost entirely via restriction with just a little malabsorption, which tends to fade over time. (I am leaving out lots of technical details and trying to focus on the important points)
Another option the surgeon might have been discussing (I really can't tell) is ERNY, which is the same as gastric bypass but with much more of the small intestine bypassed. Works better than gastric bypass for weight loss, but creates way more potential problems with diarrhea and nutritional deficiences, AND keeps many of the disadvantages of gastric bypass, such as dumping and not being able to take NSAIDs.
Regarding reviews on OH - sorry, but these can't be trusted. OH is funded via advertising. That's great in a way because it allows up to read and post for free, but it also means that people can advertise whatever they want, and that negative reviews can be removed. I'm not saying he isn't a good surgeon - I have no idea. But if I were in your shoes, I would ask him, directly, how many DS he has done (NOT how many bariatric procedures, but specifically DS), and how many have been revisions. As a revision patient, your surgery could be more complicated than a virgin DS. Sometimes bands are easy to remove, sometimes they're very difficult. Sometimes the scar tissue they create makes for a far more difficult operation. So for someone needing a revision, you really need a surgeon with extensive experience in the procedure you plan on having.
That said, I am impressed that his website not only says he does the DS (again, you can't believe everything you read), but he also recognizes that it is the most effective bariatric surgery available.
And if he really is doing the DS on a regular basis, that's great! We need more DS surgeons, and he would be another resource for other patients. So let us know what you find out.
Larra
First, I do think you may have misunderstood the surgeon. I'm sure he knows the difference between different operations, but maybe you don't, and at least one person who answered you doesn't either.
Bottom line:
The DS, also called BPD-DS, includes a sleeve gastrectomy and the intestinal "switch", which means that the duodenum is divided, the small intestine is divided roughly half way along, the lower half (ileum) is attached to the duodenum and then the upper half is reattached to the ileum to form the common channel. The common channel is where the food and digestive juices meet, and where most digestion occurs. Bypassing so much of the small intestine is what creates both malabsorption and metabolic changes that make the DS the most effective wls available both for weight , and for maintainence of that weight loss, and for resolution of almost all comorbidities.
Gastric bypass is very different. It involves creating a tiny stomach pouch (NOT bypassing above the stomach as someone else said), bypassing just a small amount of the small intestine, and attaching the small intestine directly to the pouch. It works almost entirely via restriction with just a little malabsorption, which tends to fade over time. (I am leaving out lots of technical details and trying to focus on the important points)
Another option the surgeon might have been discussing (I really can't tell) is ERNY, which is the same as gastric bypass but with much more of the small intestine bypassed. Works better than gastric bypass for weight loss, but creates way more potential problems with diarrhea and nutritional deficiences, AND keeps many of the disadvantages of gastric bypass, such as dumping and not being able to take NSAIDs.
Regarding reviews on OH - sorry, but these can't be trusted. OH is funded via advertising. That's great in a way because it allows up to read and post for free, but it also means that people can advertise whatever they want, and that negative reviews can be removed. I'm not saying he isn't a good surgeon - I have no idea. But if I were in your shoes, I would ask him, directly, how many DS he has done (NOT how many bariatric procedures, but specifically DS), and how many have been revisions. As a revision patient, your surgery could be more complicated than a virgin DS. Sometimes bands are easy to remove, sometimes they're very difficult. Sometimes the scar tissue they create makes for a far more difficult operation. So for someone needing a revision, you really need a surgeon with extensive experience in the procedure you plan on having.
That said, I am impressed that his website not only says he does the DS (again, you can't believe everything you read), but he also recognizes that it is the most effective bariatric surgery available.
And if he really is doing the DS on a regular basis, that's great! We need more DS surgeons, and he would be another resource for other patients. So let us know what you find out.
Larra
Larra,
I appreciate the common sense approach you took. I'm not sure why people focused on a word or two in my write up when I said I was the one that misunderstood, anyway. thank you.
This is not going to be a revision for me, I am selecting the DS-BPD as my original surgery. Based on my research, I believe the VSG is an offshoot of the DS-BPD. When the surgery was first devised it always included sleeving the stomach WITH the intestinal "switch". Over time, and based on collected data, "they" (US Military, Army and Air force who performed this surgery at no cost to active duty family members, read: no financial incentive to select this surgery over types) separated these surgeries out and found out that sleeving the stomach could be done as a stand alone surgery that still provided great results. I chose the DS-BPD based on long term meta data looking at quality of life, from 3 mos out to 5 years, number of complications both routine and serious, mortality rates, etc. I'm really looking forward to getting this done too!
I appreciate the common sense approach you took. I'm not sure why people focused on a word or two in my write up when I said I was the one that misunderstood, anyway. thank you.
This is not going to be a revision for me, I am selecting the DS-BPD as my original surgery. Based on my research, I believe the VSG is an offshoot of the DS-BPD. When the surgery was first devised it always included sleeving the stomach WITH the intestinal "switch". Over time, and based on collected data, "they" (US Military, Army and Air force who performed this surgery at no cost to active duty family members, read: no financial incentive to select this surgery over types) separated these surgeries out and found out that sleeving the stomach could be done as a stand alone surgery that still provided great results. I chose the DS-BPD based on long term meta data looking at quality of life, from 3 mos out to 5 years, number of complications both routine and serious, mortality rates, etc. I'm really looking forward to getting this done too!
HI,
I think you probably misunderstood him (his english isnt that great, lol). BUt Dr. Ferrari is AWESOME! He is my surgeon and I will be having the DS on Thursday 10/18/12. I am a nurse at Memorial Hermann and he is the surgeon of choice for all the employees that I know that have had WLS. He has performed THOUSANDS of WLS and he is the MD of choice for the DS surgery here at Memorial City. Like I said, Im a RN at MHMC and I have not heard one negative thing about him, from other nurses and medical professional that have had surgery with him or from nurses that work on the surgical floor and in ER that take care of his patients. He does not have a high rate of return for bowel obstuctions, bleeding, or other surgical related issues. I did alot of research before settling on him and Im VERY confident with my decision. I will post ASAP after surgery on Thursday and let you know how it went.
I think you probably misunderstood him (his english isnt that great, lol). BUt Dr. Ferrari is AWESOME! He is my surgeon and I will be having the DS on Thursday 10/18/12. I am a nurse at Memorial Hermann and he is the surgeon of choice for all the employees that I know that have had WLS. He has performed THOUSANDS of WLS and he is the MD of choice for the DS surgery here at Memorial City. Like I said, Im a RN at MHMC and I have not heard one negative thing about him, from other nurses and medical professional that have had surgery with him or from nurses that work on the surgical floor and in ER that take care of his patients. He does not have a high rate of return for bowel obstuctions, bleeding, or other surgical related issues. I did alot of research before settling on him and Im VERY confident with my decision. I will post ASAP after surgery on Thursday and let you know how it went.
Karmel42 
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