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anyone have VSG with Dr. Pleatman



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I can only wonder why you are not so busy that you don't have the time to cruise the message boards.

I am sure you are a very nice doctor and have been kind enough on other boards to answer people's questions. However, it would seem that a busy doctor in high demand would have a busy life and not have time to look at message boards.

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I wasn't calling anybody names or singling out a particular surgeon. The article I posted was not preselected. It was from the latest edition of the Obesity Surgery Journal.

I agree that Dr. Cirangle is excellent; he taught me bariatric surgery. Even his leak rate is not zero.

One needs to be careful about making judgments about small series; your statement that under 1% is OK and above 1% is not makes no sense, as it would be the same as saying that 2 leaks in 210 patients is acceptable, but 3 is not. The fact is that there is no statistically significant difference between 2 and 3 leaks in a series this size.

And then, there are other issues to consider. At the recent VSG Summit Conference it was shown that leak rates are higher when narrow bougies are used, as the pressure in the sleeve is higher (though weight loss is better). I use a very narrow bougie (32 Fr), so one would predict that my leak rate would be higher than if I used a large bougie. You also need to consider how many revisional procedures are being done, as well as the risk factors and comorbidities of the patients. You have to make sure you are comparing apples to apples.

Finally, I didn't start this fight. I was responding to the inappropriate comment by Wasabubblebut that I am "kinda cheap for a reason," as well as the downright false statement that my patients are only allowed one night in the hospital. In addition, your administrators are claiming that one needs to have done 250 VSGs before they can be trusted. Please supply data to support this claim. I'm not here to "push myself on anyone in this forum; only to defend myself against false and misleading accusations.

Respectfully,

Mark Pleatman MD

Mark Pleatman MD Weight Loss Surgery Website

Dr. Pleatman:

This is getting old in a hurry.

Nobody said a doctor must have 250 sleeves, it's not quite as you suggest. I think you need to remember that this is a board for sleeve patients to communicate with other sleeve patients. As explained earlier we exchange tips and tricks for everything from procedure types to researching surgeons, to diet and exercise and everything else. We have every right to post our opinions on all these topics. It most certainly is my opinion that it is better to go to an experienced surgeon vs. an inexperienced surgeon. I have the right to express my opinions as well as other WLS patients have a right to express their opinions.

When I wrote the post on how to research a sleeve surgeon I sent that to three experienced sleeve surgeons for their opinions. I removed anything they did not agree with except for one thing, two of three doctors did not feel a UA was necessary as a pre op lab. I added items at their suggestion. Everything was a combination of efforts from these experienced sleeve surgeons and me. I'm sorry you do not agree with it but it still remains to be my opinion.

I agree that revisions need to be considered. Someone with 500-1000 sleeves under their belt is more likely to have done quite a few revisions, all the more reason to go to a very experienced surgeon especially for a revision. At the rate people are losing their bands and switching to sleeves, bypass, and DS - many surgeons are becoming increasingly more experienced with revisions.

Bougie size... I think most surgeons use narrow bougies, the only place I know of that uses large bougies on a routine basis are doctors in Chile, they use a 60F. Most of the more popular surgeons use a 32-38F.

When you come in here and suggest that anyone who has 600 sleeves and no leaks is a God or a liar, you are indeed resorting to name calling. It's just not professional for a surgeon to say that about another surgeon and especially when you cannot support your claims.

As a patient, who would you rather go to? Someone less experienced with a higher complication stat or someone more experienced with a lower complication stat?

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I agree - it is getting OLD very quickly. I'm tired of hearing from you Dr. Pleatman. I don't even know you personally and I already don't like you. Don't you have anything better to do with your time than try and convince us you're the better surgeon? and to call other surgeon's names?

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I followed the link and am so sorry you had complications. It's good to know you're doing better and on the road to recovery. Please post on your progress.

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I think you are still confused. This is not me, it is a post on the other forum. I just started associating Pleatman with posters there who seem to have more complications than normal.

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I think you are still confused. This is not me, it is a post on the other forum. I just started associating Pleatman with posters there who seem to have more complications than normal.

You are correct. I was confused and I'm glad that you're doing well.

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I think you are still confused. This is not me, it is a post on the other forum. I just started associating Pleatman with posters there who seem to have more complications than normal.

WOW - glad you cleared that up - you were about to get yet ANOTHER phone call from me!

Thanks for the information on the phone numbers, too -- we were able to have Nina make us reservations and got to Mexicali about 1:30 a.m. All worked out great!

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Dr. Pleatman:

This is getting old in a hurry.

Nobody said a doctor must have 250 sleeves, it's not quite as you suggest. I think you need to remember that this is a board for sleeve patients to communicate with other sleeve patients. As explained earlier we exchange tips and tricks for everything from procedure types to researching surgeons, to diet and exercise and everything else. We have every right to post our opinions on all these topics. It most certainly is my opinion that it is better to go to an experienced surgeon vs. an inexperienced surgeon. I have the right to express my opinions as well as other WLS patients have a right to express their opinions.

When I wrote the post on how to research a sleeve surgeon I sent that to three experienced sleeve surgeons for their opinions. I removed anything they did not agree with except for one thing, two of three doctors did not feel a UA was necessary as a pre op lab. I added items at their suggestion. Everything was a combination of efforts from these experienced sleeve surgeons and me. I'm sorry you do not agree with it but it still remains to be my opinion.

I agree that revisions need to be considered. Someone with 500-1000 sleeves under their belt is more likely to have done quite a few revisions, all the more reason to go to a very experienced surgeon especially for a revision. At the rate people are losing their bands and switching to sleeves, bypass, and DS - many surgeons are becoming increasingly more experienced with revisions.

Bougie size... I think most surgeons use narrow bougies, the only place I know of that uses large bougies on a routine basis are doctors in Chile, they use a 60F. Most of the more popular surgeons use a 32-38F.

When you come in here and suggest that anyone who has 600 sleeves and no leaks is a God or a liar, you are indeed resorting to name calling. It's just not professional for a surgeon to say that about another surgeon and especially when you cannot support your claims.

As a patient, who would you rather go to? Someone less experienced with a higher complication stat or someone more experienced with a lower complication stat?

:biggrin0:WasA I just love you!!!:biggrin0:

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