Question:
Should I be concerned about my surgeon only doing one other WLS?
My Surgeon just started a new program for weight loss surgery and i will be her second surgery ever for weight loss, she has done alot of Liver transplants and other Lapriscopic surgeries for years now and has even done surgery on me in the past, should i be worried? — roxxyblue72 (posted on February 11, 2003)
February 10, 2003
Depends...is her first WLS patient still alive? See, this is just another
way for her to make money on the weight loss surgery wave. For my body, I
wanted a committed bariatric surgeon. How many conferences, articles,
research, has she participated in that relate to post-op management of
bariatric surgery patients? Does she think that it is so simple that
anyone can do it? I would query her more. I wouldn't necessarily not have
her do the surgery, I would just make sure that she was highly qualified.
Even my brilliant doctor, Marek Lutrzykowski, MD, had a first and second
patient at one time...
— merri B.
February 10, 2003
All of the people I have talked to told me that they would only use a
surgeon that has done at least 100-200 of these as a minimum. This is your
life at steak here! :) I would also ask any surgeon as to what their death
or complication rate is for them doing the surgery. I would want to know
everything!!!
Linda
— Linda E.
February 10, 2003
I was in the first 15 gastric bypasses that my surgeon did. He opened this
practice in September. I decided to go with him because he is a
laproscopic master, the director of laproscopic surgery at the hospital and
teaches lap techniques all around the world--most that are much more
complicated than lap rny. He is highly recognized and published in the lap
field and has pioneered lap techniques. All the docs who know him and
work with him (including my PCP) give him the highest praise. His
assisting surgeons are two highly regarded surgeons, one of whom did a
bariatric surgical residency at one of the most respected hospitals in the
country and they will start being primary in their surgeries as soon as
they assist a certain number. I met the whole team and based on their
reputation went with them. However, if the reputation wasn't there,
neither would I be. If I was uncomfortable with anything at all, I
wouldn't have been there. I don't know if I would have been first because
the fact that they had two patients that had complications actually helped
me with my decision. Complications can and do happen and I knew this team
had handled the two cases about as well as any medical team can handle them
(both pts are doing great now). So I needed that information also. The
team not only opened this as a new specialty but also head the bariatric
clinic at the hospital so if this program failed, their reputations would
be on the line. I knew they had a lot to lose if something went wrong.
I consulted with another group and spoke by phone and email to several more
and then made my decision. In my area (California) I have a lot of surgeons
to choose from and I wanted to make the right decision. I am extremely
comfortable with it and know that I received the best care and had the best
surgeon. However, it is a very very scary process and if you are not
comfortable with your surgeon's ability, don't use that surgeon. If your
surgeon is new to gastric bypass, please please please research what she
has done, her reputation in the medical community, who is assisting her
surgeries and how long they take (my surgeon took a lot of extra time with
the first several). You also might want to wait for her to do a few more.
If she is going to be dedicated to the practice, she should be doing them
on a regular basis (one or two a week). PLEASE do your research on any
surgeon but be especially diligent when they are new to this. Also my
conversation with my surgeon at my consultation sealed the deal. He said
if I was uncomfortable with the relative inexperience to go to another
surgeon (and he said it very nicely and with a lot of concern) because the
patient must be comfortable with the surgeon and that is absolutely true.
If you are not absolutely comfortable for ANY reason, find another surgeon.
— susanje
February 10, 2003
Hi Roxanne - first, I read your profile and a big congrats on your weight
loss so far! You can be very proud of yourself -- keep chompin' those
bananas! I don't have an answer to your question, but just a couple
thoughts: While doing your surgery, does your surgeon plan to have another
surgeon present who is more experienced in doing WLS via laparopscope to
assist and advise her? This is common practice, especially in larger
medical centers.
Also, are you willing to accept the fact that you will have a greater
chance of ending up with an open incision if she runs into a problem due to
her inexperience? I'm not saying you're more likely to have a
life-threatening complication necessarily. She's probably an excellent
surgeon and can handle any complication that arises. But can she handle
glitches that are exclusive to WLS? In your favor of course is the fact
that she IS skilled in laparoscopy technique in other procedures. I worked
for a group of OB-GYNs for 10 years and went into surgery with them to
observe some pelvic laparoscopies, and I still don't see how they can do
what they do thru that little scope!
Also a big plus is that the way you described the program your doctor is
with, you're not going to be abandoned after surgery to figure out on your
own what you're suppose to be doing nutritionally.
One last thing -- as you probably know there is a reason they want a weight
loss prior to surgery other than the sadistic "to prove you're
committed" b.s. -- it makes your liver and stomach shrink up and
therefore easier to manipulate via scope. Luckily, my surgeon didn't
require a weight loss but instead requires a "protien drink only"
fast for 2 weeks prior to surgery. I never would have been able to stick
to it (or attempt the weight loss as you're doing) except I kept telling
myself that if I didn't I'd end up with an open incision, which I REALLY
didn't want!
Hang in there - the wait is horrible, but you'll do great once you're on
the other side. Julie lap RNY 12/11/02 290/245
— Jules B.
February 10, 2003
I think that if you trust your doctor it will be ok. Ask if she has a back
up plan if something does not go the right way. The surgeon I am seeing has
only done 12 LAP procedures and about 3 OPEN procedures. He is the 'king of
Lap' in this area so I think he will be capable. Also his partner will be
assisting him and he has done 1000's of OPEN procedures. I know that I may
have a Lap procedure turn to Open right in the surgery, but I am willing to
take that risk. I also know that if I wait to see someone else who is more
experienced I could be waiting another year or so. Good Luck!!
— Jan S.
February 10, 2003
I would ask how many gastric bypasses has the doctor assisted with prior to
doing it themselves. And will the be a more experienced doctor on call to
assist if there are problems.
— Linda A.
February 10, 2003
It's a percentage thing. On average, the percentage of complications are
higher if a surgeon has done less than 100 or 200 weight loss surgeries
(sorry I can't remember the exact number from the study). It's up to you
if you feel comfortable taking the add'l risk. During the surgery, there
are some things that are judgement calls, so personally, I would be
concerned. However, if it was my ONLY choice, I would probably have gone
ahead anyway.
— mom2jtx3
February 11, 2003
I found out about my WLS docs thru a member of this site (Cindy Ruben) and
I will always be grateful to her for that. Like your doctor, they had not
had a lot of experience either, but were lap experts, and had attended John
Hopkins - which is saying a lot. I have liked having them as surgeons
because I feel I have been able to get individualized attention...that I
was more than just another belly to be splayed open. Of course now their
practice is HUGE (er...pardon the phrasology) but I think they still do
their best to really know each and every patient. So, I guess what I am
saing is that, in my mind, lack of experience isn't a big problem...lack of
time and caring is. As you should always do when it comes to WLS...,go
with your gut!
— rebeccamayhew
February 11, 2003
We have the same surgeon as previous poster, Susan Elliott. Of course, we
were very concerned about what appeared to be inexperience with the
Roux-en-Y procedure. It was becoming educated about his laparoscopic
bariatric experience and the exemplary recommendations we received from
everyone from the PCP, GI doc, cardiologist, and previous patients.
Positive references and education about this person will put your mind at
ease, if the feedback is good. If not, why risk it?
Best of luck.
— jnc
February 11, 2003
Rebecca Mayhew and I had the same surgeons. At the time I went to them,
they had performed less than 20 RNY's but had been praticing internal
surgeons for years and specialized in lap procedures. Since I wanted lap,
I checked this aspect out first-both of the docs had attended the very best
medical schools in our area. I also met the first patient they had
operated on with the RNY at at 7 months post-op, she was doing very well.
The docs also answered all my questions, were extremely knowledgeable (I
asked alot!) and gave me lots of personal attention, both pre-op, while in
the hospital and to this day (1 year post-op). I love them! I'd say if
you have confidence in your surgeon, go for it.
— Cindy R.
February 15, 2003
Roxanne, will she have anyone assisting her? I think that's pretty
standard practice for a surgeon doing a new surgery. If she's a good
laprascopic surgeon and has an experienced bariatric surgeon overseeing the
operation, I wouldn't be too worried. My surgeon has been doing RNY's for
over two years, and is just starting surgeries for the adjustable band, and
he's going to have experts in the field from Europe observing his first 6
to 12 surgeries (sorry, can't remember if it was 6 or 12!)
— sandsonik
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