Most sleeve Drs out of country?

[Rosebud2 26]

Plastic surgeons are some of the hardest doctors to choose. Anybody who is a doctor can claim to be a plastic surgeon. So then you narrow it down to cerifications. And then you have to find good recommendations because there are still many out there who do not have good skills. It is a scarey proposition - especially those areas that show.

[Phoenixrising 0]

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.

If what I wanted was simply clarification I would have asked for that. I did not misunderstand what you said, I believed and still believe that you were being argumentative. I was no advocating that anyone go anywhere to get their surgery. I am all about folks researching and getting UNBIASED, FACTUAL information so they can make an EDUCATED decision.

[Phoenixrising 0]

If what I wanted was simply clarification I would have asked for that. I did not misunderstand what you said, I believed and still believe that you were being argumentative. I was no advocating that anyone go anywhere to get their surgery. I am all about folks researching and getting UNBIASED, FACTUAL information so they can make an EDUCATED decision.

I also enlisted help from the admins for what I perceived as your argumetative and inflamatory response.

[Phoenixrising 0]

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?

Actually complications are not very common in sleeve patients but if I did have a major issue I would probably go to my PCP and have him make a referral unless it was some sort of an immediate medical issue in which case I would go to the ER.

[Rosebud2 26]

OMG, give it up already.

[Tiffykins 673]

OMG, give it up already.

My sentiments exactly. It's like high school all over again. "I'm gonna go tell on you" is so juvenile, and who cares if there is a difference of opinion.

Perception is so individualized, and can be skewed. Build a bridge and get over it.

[Rosebud2 26]

It seems to be about getting the last word in. Having to be right. It is juvenile.

[*susan* 1,709]

And, we now return you to our regularly scheduled topic, courtesy of the original poster!

[Bob_350lbs 105]

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... :thumbup:

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!

Marie, check out this PS @ www.afterobesity.com. He specializes in PS after massive weight loss and he does it all too; face, eyes, arms, thighs, abd, boobs. His prices are on his web site too.

The Mary from "Mary's story" was at the first seminar I went to. She looked great! The whole front row of women all had become runners.

There are lots of before/after pics too.

TTFN

[Jagator88 1]

Actually complications are not very common in sleeve patients but if I did have a major issue I would probably go to my PCP and have him make a referral unless it was some sort of an immediate medical issue in which case I would go to the ER.

I would be happy to discuss the "what ifs" of complications as I believe I experienced every one possible (leak, destroyed esophagus, diaphragm, lung collapse, blood transfusion). Complications are uncommon until they happen to you :biggrin2:

This is not intended to scare anyone out of having the surgery or using a doctor in Mexico as I "think" I would do it the same again including using the same doctor as I believe my pcp overlooked several medical issues that affected the outcome of my VSG surgery.

[Phoenixrising 0]

I would be happy to discuss the "what ifs" of complications as I believe I experienced every one possible (leak, destroyed esophagus, diaphragm, lung collapse, blood transfusion). Complications are uncommon until they happen to you :biggrin2:

This is not intended to scare anyone out of having the surgery or using a doctor in Mexico as I "think" I would do it the same again including using the same doctor as I believe my pcp overlooked several medical issues that affected the outcome of my VSG surgery.

I agree that while complications are not the "norm" they can be devastating when it is you they are happening to. I am sorry you had to go through all that. Sounds like things went from bad to worse for you when your PCP overlooked some things.

Hopefully things have started to turn around for you.

[ChroniclesofaFATGIRL 0]

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.

Mac, With all Due Respect....

I Must Ask...What about Dr.Aceves *Protocol* Do you NOT Agree With?:sad0:

I Have to Ask, Because My Surgery is NOT for 3Months, and I Want to Make Sure. I'm Making the Right Decision.

[MacMadame 81]

Marie, check out this PS @ www.afterobesity.com. He specializes in PS after massive weight loss and he does it all too; face, eyes, arms, thighs, abd, boobs. His prices are on his web site too.

Hey, DK35 on OH used him and loves him. He gives a 10% discount if you lost more than 100 pounds, too.

It's still a lot of money and down time though.

I Must Ask...What about Dr.Aceves *Protocol* Do you NOT Agree With?

I don't agree with putting people on 10 days of clears. There is no real medical reason to do this that I have found and I think it makes the first two weeks post-op much more miserable than they have to be. The ASMBS also says that there is no real reason to do clears post-op, just a liquid diet.

Now, to be clear, it is VERY important to do 2-3 weeks of liquids post op while the incision is healing. But they don't have to be *clear* liquids.< /p>

I am also on the fence about oversewing the staple line. Some doctors believe that it puts some stress on the incision and can actually increase the risk of leaks. OTOH, Dr. Aceves' leak rate is very good. So I went back and forth on that one.

He's also started to use a larger boughie size and I wanted the smallest I could get and still be safe. I know the difference between 36 oversewn and 32 not oversewn is tiny and probably not stastically significant, but at the time I was researching, 32 f seemed to be the norm so that's what I wanted.

Like I said, none of these were deal-breakers. Deal-breakers would be things like doing the surgery on an out-patient basis, having done less than 100 sleeves, using a 40 f or larger boughie, putting you on softs almost immediately out of the hospital and having minimal to non-existent after care. And, yes, I've seen all those things...

Edited September 14, 2009 by MacMadame

[Oregon Rose 2]

As a scientist I have read the published papers of those bariatric surgeons who pioneered VSG. About 5 years ago there were only about 15 surgeons who did VSG. Let me pass on some of the history of this operation.

Around 2000, some surgeons who were performing the Duodenal Switch Operation began to do VSG as a first-stage for poor-risk patients. They intended to do the rest of the Duodenal Switch Operation about one year later. The thinking was that a two-stage operation would lower mortality and complication rates for the Duodenal Switch procedure.

Of the patients operated on in 2000, when the year was up, many of the patients had lost sufficient weight so that the second state was unnecessary. Thus, the first VSGs were performed in 2000.

By 2002, a handful of physicians worldwide began to do VSG as a stand-alone

procedure. Between 2002 and 2007 surgeons performing this operation gradually revised the VSG procedure to what it is today, publishing their findings as they learned how to improve the operation.

In 2007, The First International Consensus Summit for Sleeve Gastrectomy as held in New York City. The first day consisted of live surgery by experts performing VSG for the 250 attendees wishing to learn the procedure. Afterwards, presentations were given by the experts. The presenters (experts) at this conference were:

Gagner of New York, NY

Dakin of Cornell, NY

Parikh of New York Pomp of New York

Jossart of San Francisco

Crookes of Los Angeles

Elariny of Virginia

Schauer of the Cleveland Clinic Florida

Rosenthal of the Cleveland Clinic Florida

Assalia of Israel

Langer of Austria

Himpens of Belgium

Kotidis of Greece

Melissas of Greece

Basso of Italy

Baltasar of Spain

Lacy of Spain

Mognol of France

Krawczykowski of France

Weiner of Germany

Won Woo Kim of Korea

Boza of Chile

De Paula of Brazil

So, here is your list of those considered "experts" in this field by their peers as of 2007. So, I think the discussion of who has a lot of experience and who does not has already been established by the medical community itself. The list is above.

The procedings of the conference were published in Obesity Surgery 18:487-496 2008. See for yourself.

Best wishes,

[Bob_350lbs 105]

Dr. John Feng told me that he taught the VSG to "those guys" at LapSF. I wonder why he isn't on the list as an *expert*? Maybe he couldn't make it.