Question:
Which surgeon should I go with???

Need help deciding between two surgeons. I want to have a "LAP" RNY. Surgeon #1- Experienced, well known board certified bariatric surgeon. Has done close to 1,500 RNY's OPEN. Just started doing lap procedures about 18 months ago. Has done 80 lap. Says procedure takes about 3 hours. Has full program including weekly support groups, nutritionist, nurses. Surgeon #2- Is an advanced lap surgeon, but not board certified with hundreds of abdominal lap surgery (hernias, etc) but has just started doing WLS surgery about a year ago and has done 100 lap RNY procedures. Surgery time is about 1 1/2 hours. Does not have a full bariatric program and only offers support groups once a month. Patient comments for both surgeons have been very positive. Any advice would be greatly appreciated.    — Natalie F. (posted on May 11, 2002)

May 11, 2002
Natalie, what do you mean by "board certified"? Are you talking about the ASBS? If so, the ASBS isn't really a "board", it's a society. Membership is voluntary, and many board-certified surgeons who perform WLS are not members of the ASBS. If you mean that the second surgeon is not board certified at all (i.e., not a diplomate of the American Board of Surgery or a fellow of the American College of Surgeons), then I would be very wary of choosing him or her as my surgeon. Have you already asked all of the questions about mortality rates, leak rates, etc? Ask the surgeon who used to do the open RNYs what his leak rates are on the *lap* RNY, specifically. Then ask the same question of the lap surgeon. Also, what are their conversion rates (lap converted to open mid-procedure due to unexpected problems)? Do they both sew the intenstinal connections (anastomoses), or do they only staple? If they only staple, the risk of leaks is probably higher. It's just my opinion (and I'm still pre-op too), but all things being equal, I would go with the person who has more experience with the lap procedure and a shorter operation time. Just be aware that you'll have to be more proactive about seeking out your own support post-op. Good luck to you!
   — Tally

May 11, 2002
Additional information. Surgeon #1 is a diplomat of the American Board of Surgery as well as a fellow of the American College of Surgeons. Surgeon #2 does not have these credentials.
   — Natalie F.

May 11, 2002
There is one real advantage with going with surgeon #1. Say he starts in LAP, and then has some problem and has to go with open... you said he is VERY experienced in that. So he sounds the best to me. As far as the other surgeon not being board certified, personally that would'nt bother me. The reason is that back in 1993 I had a board certified surgeon (not WLS) and got butchered badly. So having a board certified surgeon "still doesn't protect you fully" from a surgeon's unskilled knife. It may help, but it certainly is no guarantee as I found out. Sounds like both your surgeons are going to be great! We all should be so lucky! In any case, I like the fact that the first guy is very skilled in the open, should the LAP have to be converted. But only you can make that decision. Best wishes to you.
   — Danmark

May 11, 2002
As far as one guy's LAP taking 3 hours and the other one 1.5 hours. Personally I would prefer the 3 hours! Yes I know a shorter time under anesthesia is better. However, have you ever been around people who are fast workers? I have. And most of the time their work is poor. I know when it comes to being under the knife, I'd want my surgeon to take his time and do it right. I would be very concerned about a LAP too. (I like the OPEN where they can see better and not have to trust a camera). So with a LAP, I would'nt want him/her going so fast that he may nick something. FASTER IS NOT ALWAY BETTER. ;)
   — Danmark