approved for revision, now what???
No, Schlessinger is a Bait-and DON'T-Switch revision surgeon. He doesn't do revisions to the DS, because he doesn't feel HE can do them safely -- and then disses the surgery. He SAYS he does the DS as a revision, and then talks people out of it and convinces them that the ERNY is better.
If you are talking about Kerry, who had a DS revision from Dr. Rabkin (a REAL DS revision surgeon), he didn't have a leak, he had a relatively minor stricture/flap of tissue from his previous Ruined-and-WHY? surgery that was fixed in a second surgery.
Yeah, Schlessinger is doing a lot of surgeries. And? Let's see how well folks do with that:
Surg Endosc. 2007 Nov;21(11):1924-6. Epub 2007 Sep 3.
Links
Brolin RE, Cody RP.
Department of Surgery, University of Pittsburgh Medical School, Pittsburgh, PA, USA. [email protected]
OBJECTIVE: To present a technique of revisional RY gastric bypass in patients with unsatisfactory weight loss after primary gastric bariatric operations. METHODS: The Roux limb was lengthened by creating a 75-100 cm common channel below the enteroenterostomy with concomitant revision of the gastrojejunostomy. RESULTS: Fifty-four patients had this distal modification of RYGB including 47 patients who had primary gastric bypass and 7 patients who failed pure restrictive operations. Mean excess weight loss was 47.9% in patients followed for > or = 1 year. CONCLUSIONS: This distal modification of RYGB resulted in satisfactory weight loss for nearly half of the 54 patients in this series.
----------------
Less than half achieved "satisfactory weight loss" after revision to ERNY. And that includes the 13% of the patients who were conversions of restrictive only procedures to ERNY revisions (which means they had a higher chance of doing well, because it was the first go-round with malabsorption for them).
By the way, "satisfactory weight loss" in the bariatric lingo means 50% EWL. 50%.
For DSers, after 10 years, the data from the Hess study is 94% (Obesity Surgery, 15, 408-416, 2005) MAINTAINED >50% EWL. In the 15 year Marceau study, it was 82% (Obesity Surgery, 17, 1421-130, 2007). Keep in mind that because of insurance reasons, a high proportion of these folks started out SMO.
Research all your options.
If you are talking about Kerry, who had a DS revision from Dr. Rabkin (a REAL DS revision surgeon), he didn't have a leak, he had a relatively minor stricture/flap of tissue from his previous Ruined-and-WHY? surgery that was fixed in a second surgery.
Yeah, Schlessinger is doing a lot of surgeries. And? Let's see how well folks do with that:
Surg Endosc. 2007 Nov;21(11):1924-6. Epub 2007 Sep 3.
LinksAdding malabsorption for weight loss failure after gastric bypass.
Brolin RE, Cody RP.
Department of Surgery, University of Pittsburgh Medical School, Pittsburgh, PA, USA. [email protected]
OBJECTIVE: To present a technique of revisional RY gastric bypass in patients with unsatisfactory weight loss after primary gastric bariatric operations. METHODS: The Roux limb was lengthened by creating a 75-100 cm common channel below the enteroenterostomy with concomitant revision of the gastrojejunostomy. RESULTS: Fifty-four patients had this distal modification of RYGB including 47 patients who had primary gastric bypass and 7 patients who failed pure restrictive operations. Mean excess weight loss was 47.9% in patients followed for > or = 1 year. CONCLUSIONS: This distal modification of RYGB resulted in satisfactory weight loss for nearly half of the 54 patients in this series.
----------------
Less than half achieved "satisfactory weight loss" after revision to ERNY. And that includes the 13% of the patients who were conversions of restrictive only procedures to ERNY revisions (which means they had a higher chance of doing well, because it was the first go-round with malabsorption for them).
By the way, "satisfactory weight loss" in the bariatric lingo means 50% EWL. 50%.
For DSers, after 10 years, the data from the Hess study is 94% (Obesity Surgery, 15, 408-416, 2005) MAINTAINED >50% EWL. In the 15 year Marceau study, it was 82% (Obesity Surgery, 17, 1421-130, 2007). Keep in mind that because of insurance reasons, a high proportion of these folks started out SMO.
Research all your options.
mew6495
on 12/22/08 10:08 pm - MI
on 12/22/08 10:08 pm - MI
Hi Iisabelll,
Definitely talk to your doctor about the proper diet you should follow. But as an original RNYer I can tell you you should keep most of your food intake to protein and the lesser portion to complex carbs. Stay away from the refined sugars and flours etc and make sure you chew your food throughly.
Not sure how Schlesinger's name came up in this string of posts as you did not appear to be asking for advice on him but I can tell you from my personal experience that I felt he was up front and honest with me and I am very happy with my revision to date for many reasons.
Dr Schlesinger gave me several options as far as revisions and stated clearly up front that he did not perform DS revisions on original RNYers due to the elevated risk associated with it. He did not in any way, what-so-ever try to change my mind and talk me into something else. At no time did I feel pressured or baited. I also consulted with several "DS" revision surgeons (some of them came highly recommended from individuals on this site) and they relayed the same info as far as the risk factor goes and 2 of them also mentioned that if it was the DS I decided on that they could not guarantee they would perform the total DS on me until they opened me up to see what my internal system was like. They did promise they could do the bottom portion switch but with a already existent pouch system they would make the evaluation and determination at the time of surgery. I for one appreciated ALL the surgeons I spoke with honesty and advice. The risk was the factor that helped me decide on what was right for me.
Good luck to you. I hope all turns out well. Keep us posted on how you proceed.
Definitely talk to your doctor about the proper diet you should follow. But as an original RNYer I can tell you you should keep most of your food intake to protein and the lesser portion to complex carbs. Stay away from the refined sugars and flours etc and make sure you chew your food throughly.
Not sure how Schlesinger's name came up in this string of posts as you did not appear to be asking for advice on him but I can tell you from my personal experience that I felt he was up front and honest with me and I am very happy with my revision to date for many reasons.
Dr Schlesinger gave me several options as far as revisions and stated clearly up front that he did not perform DS revisions on original RNYers due to the elevated risk associated with it. He did not in any way, what-so-ever try to change my mind and talk me into something else. At no time did I feel pressured or baited. I also consulted with several "DS" revision surgeons (some of them came highly recommended from individuals on this site) and they relayed the same info as far as the risk factor goes and 2 of them also mentioned that if it was the DS I decided on that they could not guarantee they would perform the total DS on me until they opened me up to see what my internal system was like. They did promise they could do the bottom portion switch but with a already existent pouch system they would make the evaluation and determination at the time of surgery. I for one appreciated ALL the surgeons I spoke with honesty and advice. The risk was the factor that helped me decide on what was right for me.
Good luck to you. I hope all turns out well. Keep us posted on how you proceed.
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