Top Doctor's Opinion on Lap Band
Dr Keshishian is a well respected bariatric surgeon who is well practiced in all types of WLS. In his own words : Adjustable Gastric Banding The adjustable gastric banding was approved and became widely used in the United States starting in 2002-2004. The early resulting data was acceptable in regards to the excess weight loss and the complications rate associated with it. As more and more scientific data was published, it became clear adjustable gastric banding was not as benign or effective as initially thought. The associated weight loss was significantly less for the majority of patients. This information was even present in the literature provided to the patient by the manufacturer. Additional patients started developing Delay complications associated with the band, whi*****ludes esophageal dysmotility, a worsening of reflux, and continuous nausea and vomiting, in addition to inadequate weight loss. In my opinion, the adjustable gastric banding procedures are inferior to the alternatives available. The specifics of different surgical outcomes are outlined on the poster available on our website. Adjustable gastric banding should be considered as a last resort, if at all, as a surgical procedure for treatment of morbid obesity and its associated comorbidities. Other complications that continue to plague adjustable gastric banding include slipped band, erosion, esophageal dilatation, and the required need for frequent adjustments. The LAP-BAND AP® System http://www.dssurgery...ng.php?subnav=2 http://www.dssurgery...oster-large.jpg
The fact that his website is "dssurgery.com" is very telling. It appears he really wants to do ONLY DS, since NO surgery appears to come off as recommended EXCEPT the DS, which he makes sound incredibly benign -
Duodenal Switch is a hybrid surgical procedure that has two aspects that reduce weight.
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The smaller stomach size limits the amount of food that can be taken in to about 120-150cc (1/2-3/4 Cup).
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The small bowel is reattached in such a fashion as to keep the biliopancreatic juices away from the food until the last portion of the small bowel, limiting the absorption of the food that is eaten. The stomach is decreased in size by doing a Sleeve Gastrectomy, which uses proportional amounts of the stomach areas that make important enzymes and chemicals. The hallmark of the Duodenal Switch operation is the preservation of the pyloric valve. The pyloric valve is at the last portion of the stomach and acts as a gateway to the small bowel. The food needs to be of the right chemical and mechanical consistency before the pyloric valve allows it to progress into the small bowel. The appendix and the gallbladder are also removed.
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Duodenal switch provides the best remedy for failed gastric bypass.
- When necessary, the revision or reversal of the Duodenal Switch operation is technically the safest and easiest of all revisional surgical procedures.
on 4/9/13 11:38 pm - Califreakinfornia , CA
. I've met Dr Keshishian in person three times, spoke with him on the phone twice, as well as had a few emails and PM'S with him. I have nothing but the utmost respect for the man. He is not my surgeon, but he is a top notch ETHICAL surgeon.
Agree wholeheartedly. He's not my surgeon, either, but he took the time to talk to me on the phone... on his own time... and his own dime for an hour, answering my questions about revision.
He knows what he's talking about, that's for sure. I'd trust him completely. He is the polar opposite of what my horrible surgeon, kemmerling, was like.
Avoid kemmerling, Green Bay, WI
on 4/10/13 8:03 pm - Wiesbaden, Germany
He IS my surgeon, for the revision. I wish I had gone to him in the first place.