Dr Marchesini

Hi everyone,

I have received an initial reply email from Dr. Marchesini regarding my interest
in having a DS revision (I had gastric bypass in 2009). I have gained back
almost half of what I lost and cannot seem to lose anymore.
I am confused by the info he has provided me with so far.

He recommends a biliopancreatic diversion without the switch. I have read a lot
about people saying this is an old method and not very successful. As stated in
his email "To convert to a biliopancreatic diversion with duodenal switch the
stomach will need a reconstruction involving several suture lines that will
offer higher risk of leakage and fistula...The difference between
biliopancreatic diversion with and without duodenal switch is the way to cut the
stomach. In the first one the gastrectomy is distal and in the duodenal switch
the gastrectomy is vertical (sleeve). The final results are the same"

Is there anyone that can help me understand his recommendation further? I have
been doing quite a bit of research but hoped to hear from someone that the Dr.
has done a complete DS revision on them. I have read that he does do this
revision so that is why I am confused.

Thanks for reading : )

That really disappoints me.  It is NOT the same, but many docs turn to this because it is "easier".  You can get this anywhere.  If Dr. M doesn't want to do a real DS revision, then I recommend reaching out to Dr. Ungson next.  

Is this a dr in Mexico? I read that he doesn't do gastric bypass revision to ds...

Dr. Ungson is in MX, but I'd be surprised if he doesnt' do revisions.  Either way, insist on a true DS revision.

Ok thanks...I am hoping some of Dr Marchesini's patients can also clear up some of this for me.

Thanks again

What happens when you go back to him and say no, I want a functioning pylorus and a sleeve w/DS?  Would he just say no? Just because he recommends doesn't mean he won't give you what you pay for.  Worth a try.

--gina

Yep worth a shot

Thanks GIna

The other doc to check out for price is Dr Stewart in Texas. Keshishian in Calaifornia is one of the best but I don't know about his prices.

--g

www.dsfacts.com 

The reason the BPD was modified to the modern day DS is that the BPD causs significant problems with nutritional deficiencies and diarrhea. The modern day DS (unfortunately also called BPD-DS, which causes some confusion) was created to preserve the excellent weight loss of the BPD while avoiding the nutritional and diarrhea problems. It has been largely successful at this.

I think Dr. M is right that doing a BPD would pose less surgical risk in your situation than revision to a true DS. However, you would face greater risk down the line for nutritional problems and diarrhea. And of course, once the lower part of the stoma*****luding the pyloric valve, is removed, there is no replacing it ever.

Dr. Marchesini has also done a type of revision to an existing RNY that he claims is "just as good" as a real DS and supposedly relieves the pouch issues of the RNY. Since he preserves the pouch without any change to it at all in this operation, that doesn't make sense to me.

There are other surgeons doing a true RNY to DS revision. Check out Dr. Roslin in NYC, Dr. Stewart in TX, and Drs. Rabkin and Keshishian in CA. To my knowledge, Dr Ungson in Mexico does lap band to DS revisions but not RNY to DS revisions, and I know of no surgeon in Mexico doing RNY to DS revisions. This is a very complex, challenging operation and you need to find just the right surgeon.

Larra

Thank you so much for your message. This helps in regards to my next message to Dr. M. Iive in Canada and do not have $30,000 to get a revision. I am trying to work harder on my weight loss but its not like before RNY in that I could lose weight every day by just cutitng back and not snacking, etc., It just seems so much harder...harder than it should be, I believe. I could manage the cost of Dr. M but I have to be more informed on this revision process I think.

Still hoping past patients of Dr. Marchesini chime in (hint hint  nudge nudge LOL)

Thanks again Larra