Most sleeve Drs out of country?

[betrthnever 107]

It seems like many people on this site have been banded by a Dr. in Mexico. Is this procedure not widely done yet in the US?

[Oregondaisy 2,021]

It's only because most ins. companies will not pay for the sleeve. That's why so many of us are going to Mexico. It's cheaper there for someone paying out of pocket.

I would have been thrilled to have an ins. company pay for my surgery, but since I didn't, I feel that I went to the best doctor for the best price, who happens to practice in Mexico.

[shanda7182 5]

Ditto to what Daisy said. In a few years, you will probably see it level out- as bypass and the band have. Once more insurance companies, start to approve the sleeve, more people will start to hear about it, I remember going to a WLS seminar and the sleeve was not even discussed. I happen to hear about it because one of my coworkers had band complications and had a revision to a VSG, when she returned back to work, she looked really good. That is how I found out about the gastric sleeve.:thumbup:

[Oregondaisy 2,021]

in her original post, she was asking about people being banded by doctors in mexico.

I was banded by a doctor right here in my town. He just barely started doing sleeves. i wanted a doc experienced in band to sleeve revisions, and Dr. Aceves fit that bill.

[Phoenixrising 0]

It seems like many people on this site have been banded by a Dr. in Mexico. Is this procedure not widely done yet in the US?

I am a bit confused about your post. Are you asking about the lap band or are you talking about the VBG (as compared to VSG) procedure. The lapband is frequently done in the US and has been for several years. The VBG is done far less frequently either in MX or the US. The VSG is starting to be done more often in the US now that some insurance companies have started covering it. That having been said many of the US surgeons have little or no experience doing the VSG as compared to many Mexican surgeons who are far more experienced with the procedure and have been doing them longer.

Cost is a primary reason most folks go to MX for any of the procedures. Many folks have no insurance or like in my case have insurance that either covers only RNY and Lapband or have WLS exclusions across the board.

Having my sleeve done in MX cost me less than 9K vs 21 -25K here in my local area however there are no surgeons in my local area that are as experienced with the sleeve or have done near the numbers of the sleeve that my surgeon in MX had.

[betrthnever 107]

Oops, sorry I meant sleeved in out of country. That's what I get for typing when tired!

[betrthnever 107]

Phoenixrising, if complications arise would you be able to go to Scottsdale Bariatric? Is there a partner of his in the US that offers support?

[Rosebud2 26]

I went to Mexico for a number of reasons.

One was that my insurance said they wouldn't pay for it and I wasn't willing to jump through their hoops to try to reverse the decision.

Secondly, even if they had said they would pay, the surgeons in my town had little to no sleeve experience. Sleeve experience was high on my list.

Third, I was in a hurry. I was able to arrange the Mexico surgery rather quickly.

[MacMadame 81]

That having been said many of the US surgeons have little or no experience doing the VSG as compared to many Mexican surgeons who are far more experienced with the procedure and have been doing them longer.

I don't really agree with this. There are a handful of surgeons all over the world who are very experienced with the VSG. A few are in MX and a few more are in the US, a few are in Europe and there are a few scattered around the rest of the world. The rest of the surgeons in both the US and MX and everywhere else are not very experienced with the sleeve.

It was different with the band. Because the band had to be approved by the FDA, surgeons in other parts of the world, especially MX, had quite a head start on US surgeons. The MX surgeons pioneered some of the techniques used today by US surgeon. But that didn't happen with the sleeve.

The pioneers of the sleeve are Balastar in Spain, Gagner on the East Coast of the US and LapSF (Jossart & Cirangle) on the West Coast. There are a couple of other guys whose names appear on the all early papers about the sleeve, as well, but these are the guys who put a lot of effort into refining sleeve technique and promoting the surgery.

Edited September 10, 2009 by MacMadame

[Phoenixrising 0]

Originally Posted by Phoenixrising

That having been said many of the US surgeons have little or no experience doing the VSG as compared to many Mexican surgeons who are far more experienced with the procedure and have been doing them longer.

I don't really agree with this. There are a handful of surgeons all over the world who are very experienced with the VSG. A few are in MX and a few more are in the US, a few are in Europe and there are a few scattered around the rest of the world. The rest of the surgeons in both the US and MX and everywhere else are not very experienced with the sleeve

Mac I am not sure what the point of your post is other than to "disprove" what I am saying. Help me understand how my saying MANY US surgeons having little or no experience with the sleeve is different from you saying A HANDFUL are very experienced.

In my local area there are NO experienced sleeve surgeons that I would have trusted to do my surgery. I find it ironic that in another post you went to great effort and made repeated posts about how experienced Dr Aceves is yet in this post you argue with me about Mexican surgeons not being experienced.

FYI Susan, and Alex this is another example of the problem I have with this and selected other posters that want to argue and find fault with a post by someone who has challanged their posts in the past. It appears Mac is arguing with me for arguments sake since we were both saying essentially the same thing.

[MacMadame 81]

It appears Mac is arguing with me for arguments sake since we were both saying essentially the same thing.

And I would say the same thing about your post. Instead of saying "please clarify", you make it personal and like there is something wrong with ME. There is absolutely NO NEED to make it personal like this.

But I will clarify anyway:

You said that the MX surgeons are much more experienced than the US surgeons. I said that they are about the same. Both countries have a handful of experienced, but the vast majority in both countries are inexperienced.

It's important that people don't assume that, if they go to MX, they will automatically get better and more experienced than US. They have to do their research and make sure their surgeon is one of the handful that is experienced and not the vast majority that are inexperienced.

[Bob_350lbs 105]

Good advice Mac. Especially since most ins co don't cover the sleeve, people are forced to go to MX. So, Where can people find unbiased statistical reports, etc. for MX and US surgeons? I don't trust people that are working for the doctor they are recommending, and I don't trust what I read on their websites. Buyer beware is how I feel. You can give me all the testimonials in the world, but I always wanted the cold, hard, facts. It is a serious decision not to be made lightly. We are not buying soap here, but having most of our stomachs removed. If it were me, I would want unbiased data. But, where can you find that? Thanks for listening, and I didn't want to stir up the pot, but this is how I feel about it.

[MacMadame 81]

Honestly, I'm not sure where you can find unbiased data. And that's for any doctor, not just one outside the US.

This is one reason why I think it's important that your surgeon belong to some sort of organization that enforces some kind of minimum standards. Then they have incentive not to inflate their stats or lie about their complication rates as they will be called to task, if they do.

The other thing you can do is see if their info passes the sniff test. There are surgeons out there claiming ridiculous stats. But you can't find their patients. It's unlikely their patients are not on the internet in larger proportions than anyone else's so if you see a doc who claims 1000 sleeves and you see their patients everywhere and another doc claims 1000 sleeves and you can hardly find their patients, well.... it's a hint, anyway. :sad0:

Another way to "sniff" is to consider how many surgeries it is possible for them to do in a year. Most surgeons do 3-5 surgeries a day a few times a week. The busiest surgeons do about 500-750 a year. So, if you have a doc who claims to do RnY, bands and sleeves and he's been doing sleeves for less than a year, he hasn't done 1000 of them either.

But I don't know of anyway to know *for sure*. If there is such a way, I'd love to hear about it!

[Bob_350lbs 105]

Well Mac, we were fortunate that Dr. C is close to home and that he is a highly-qualified bariatric surgeon. He has done sleeves for years. The day I was there, he did 5 surgeries that day. And, most of us had the sleeve. A couple of them flew in from Hawaii and spent the week in SF.

I don't think I would have done it if it weren't for that. It just isn't me to travel to a 3rd world country for surgery. I was afraid of all the drug wars going on down there, afraid that if I had complications and needed ICU and specialists, could they provide that? And, I didn't have family to travel with me to Mexico. Probably, with Dr. Aceves, it would have went fine...but...I'm nervous Nellie.

I want PS so bad when I reach my goal, but I don't know about having it done in Mexico, but the prices sure are tempting.

[MacMadame 81]

Yes, I do feel lucky. Not only that Dr. C was here locally to me, but that I really like him and we have a good patient-doctor relationship.

But I would have gone to MX, if I didn't like one of the 3 local guys here who have done a lot of sleeves. I had my list narrowed down to Dr. Rumblaut and Dr. Aceves. But I was waffling. Rumblaut hadn't done a lot of sleeves at that time and I know Aceves is kind of worshiped here on VST, but there are a couple of things in his protocol that I don't agree with. They weren't deal-breakers, but they contributed to my indecision.

So I was waffling back and forth about it. You can imagine how glad I was when I went to the seminar and decided Dr. C was the one I wanted to cut me! I was afraid I'd hate him and have to keep looking... :sad0:

I agree that PS in MX is very tempting as well. The things is, I think bariatric surgery is pretty straightforward most of the time and even the medocre docs don't have horrible stats. (But don't get me started on the butchers.) So doing it out of state or out of country seems reasoanble.

But PS requires so much more downtime and so much more follow-up. Plus, revisions and multiple procedures are very common. So it's actually something that doesn't work nearly as well long-distance. Yet, the price differential between the US and MX makes it 100x more tempting than it was for my sleeve surgery!