There are two facilites that offer Bariatric Surgery in my town (Tulsa, OK), and only one of them offers the sleeve. I went to the info session for that one last night, and came away with questions.

This was at one of the three major hospitals here (St. Johns), and they have just started a Bariatric Services and Weight Loss Center there. The program (staff, doctors, facilities, etc) are all brand new. In fact, this appeared to be the first info session they had put on (they were asking things that seemed to point to that, i.e. things that could better the session in the future).

Also, the surgeon (they only have one at this time) is just out of residency, and appears to have specialized in RNY surgery (he said this is what he had done the most of).

I really want to get the sleeve, and this is the only place that has it. The other place is not even officially affilliated with a hospital (though they use one of the other major hospitals in town).

Do you think its safe to go with a new program and a young surgeon? It has me a little nervous, but I want the sleeve so I cant decide whether to stick with it.

PS, the other place offers the band and RNY, but no sleeve.

Thanks in advance!

I was reading some research that concludes that after 300 surgeries the risk of complications directly related to the surgery (leaks, perforations, too small or too large, etc) and errors reduces to almost none. According to the research, after 500 surgeries, there is no diference between those with 500 and those with 2000+ surgeries in therms of complications and errors.

This is what I like about the certified bariatric surgeons in Mexico, they are doing 2-4 surgeries per day.

Thanks for all the great responses. The nurse for the inexperienced Dr called yesterday to go over some information with me prior to my consult on Thurs, and I spoke to her about the concerns I had. She said that the Dr. had gone through a surgical residency, as well as a bariatric residency, and was well qualified. She was very nice about it. She also said that since my insurance doesnt require a 6 month dr supervised diet that I should be able to get surgery within 6 weeks. I really like that.

I still plan to go to the information session for the more experienced place on Monday evening. The one thing I seem to have against this place is that they are strict about the 6 month doc supervised diet, and I dont have this. I have dieted on my own forever, but it was never dr supervised. Also, my insurance doesnt require the dr supervised diet, so I dont think it should be in the way of me getting surgery. I really dont want to wait 6 months, as that will give me more time to change my mind.

Finally, on the Mexico option, thats just not for me personally. I really want to get someone that is close to where I live, but thats just a personal decision.

I feel your anxiety and it's legitimate. Every surgeon has to do their first sleeve. I've recently started doing them as well. Some of us tend to wait until the 5 year studies came out to assure that the sleeve was as good as we thought it was...and it seems to be.

We as surgeons know that the best bariatric surgeons are the ones who have done plenty of advanced laparoscopy. Most of us trained doing the Lap RNY gastric bypass which is one of the more advanced technical operations we do laparoscopically. Also, Nissen fundoplications (i.e. stomach wrapped around the esophagus for reflux) or large hiatal hernia repairs are both technically more difficult to do than a sleeve. But the sleeve is not an appendix or a gallbladder so technique for advanced laparoscopy is key.

Being close to your home, I just want to know which insurance company doesn't require you to have the 6 months of medically supervised weight loss! That's awesome and I wish they would all go to that. It has never shown to be of benefit or be an indicator of your success after a bariatric operation. The psych eval is similar but we all tend to do them because the NIH recommends it. I've gone away from the psych eval on self-pay patients unless they have indicated the need for an evaluation.

Go with your gut. Meet with the surgeon or go to the seminar. I do highly recommend a board certified general surgeon.

I feel your anxiety and it's legitimate. Every surgeon has to do their first sleeve. I've recently started doing them as well. Some of us tend to wait until the 5 year studies came out to assure that the sleeve was as good as we thought it was...and it seems to be.

We as surgeons know that the best bariatric surgeons are the ones who have done plenty of advanced laparoscopy. Most of us trained doing the Lap RNY gastric bypass which is one of the more advanced technical operations we do laparoscopically. Also, Nissen fundoplications (i.e. stomach wrapped around the esophagus for reflux) or large hiatal hernia repairs are both technically more difficult to do than a sleeve. But the sleeve is not an appendix or a gallbladder so technique for advanced laparoscopy is key.

Being close to your home, I just want to know which insurance company doesn't require you to have the 6 months of medically supervised weight loss! That's awesome and I wish they would all go to that. It has never shown to be of benefit or be an indicator of your success after a bariatric operation. The psych eval is similar but we all tend to do them because the NIH recommends it. I've gone away from the psych eval on self-pay patients unless they have indicated the need for an evaluation.

Go with your gut. Meet with the surgeon or go to the seminar. I do highly recommend a board certified general surgeon.

Thanks for the insight, Doc.

The less experienced Dr is board certified in surgery, but I didnt see a certification in bariatrics in my online search. I plan to ask him about that in my one-on-one with him Thursday. I want to find a way to be tactful about inquiring into his experience level.

As far as my insurance, its BCBS (Empire Blue) that I have through my employer (a major contractor for the gov't). My insurance does require psych eval, nutritionist eval, physical eval, doc approval etc., but changed their policy to exlude a required 6 month Dr supervised diet as of this year (EDIT: Here is the exact language in the policy, and notice they removed the length of non surgical attempts, as well as PCP documentation: The individual must have actively participated in non-surgical methods of weight reduction; these efforts must be fully appraised by the physician requesting authorization for surgery ). I was really happy about that. Oh, and my work also offers Aetna, which is MUCH cheaper, but their coverage and "bucket" scheme was not attractive to me. Of course, management was trying to get everyone on Aetna (cheaper for employer) and they brought in the guy that was working the hard sell from Aetna to get people to switch (Glen Garry anyone?), but myself and many others stayed with BCBS which we've had for years. Yes, the premiums are high, but the insurance is top notch when it comes to work needing to be performed at the hospital level.

EDIT: Added verbatim language. Also, the policy requires a BMI of 40 or a BMI of 35 with ONE co-morbidity. I feel thats pretty lenient as well.

My insurance, Western Health Advantage does not require a 6 month weight... They accept what the Doc recommends. The Medical Center I go to told me that they are the best insurance to work with and they never have any problems from them. I have a high deductible plan, but the service was great. The Med center I go to offers WHA to its employes.

I have always heard that you want a surgeon who has done at least a THOUSAND of the procedure you are going for. I know that seems like a lot, but an experienced surgeon will have no problem getting this number under his belt and you really, really want to be with someone who knows what he's doing, backwards and forwards.

Like previous posters said, it seems there's a lot of finesse involved in the sleeve and you want to stay safe and have good results! I'd be sure you feel completely comfortable with the experience of your surgeon; you deserve it!

I was about to respond to this and tell you that you should make the drive to meet Dr. Goodnight and then noticed his post! I am scheduled for 3/28 with him. I am driving 2 hours to get there, but I have heard EXCELLENT things about him and felt VERY comfortable after my consultation. I work with physicians for a living and another surgeon that does not perform VSG actually recommend him to me. While it may be a newer program, I know that someone is always going to be in that first 100, 200, 500.....whatever the comfort level is. I look not only at their experience in VSG, but as a surgeon as a whole. If they are already very experienced in complex laparoscopic surgeries, I feel a lot more comfortable.

Hi, I have the same choice- go to a doctor who does all kinds of baratric surgery and is more experienced- and in a hospital- or a highly experienced surgeon with the lap-band and has only done 5 sleeves so far- but also has aanother doctor who has done over 100 RYN's/sleeves in there with him. I choose the latter- BECAUSE- he really cares about his patients and has a great after care program and follow-up plus after surgery He sees you - not just a nurse like the more experienced doc. - That was a hard decision based on the amount of actual sleeve experience- but I feel more comfortable with everything about it. And like the Doc above said- my doc said the same thing- he wanted to wait before he started doing them because he didn't feel there was enough information out on them yet- and wanted to make sure he was doing something not only safe but effective for his patients.