For Dr. C: a Conundrum

[NancyRN 1]

:help: I'm the nurse who developed the list of questions to ask your surgeon and reminded you to post the article on complications. I'm determined to have bariatric surgery and, after extensive research, had decided on a Lapband. I had my initial consultation yesterday at the University of California, San Francisco bariatric surgery center (the only one my insurance will cover in Northern California). Really liked the surgeons but am troubled by the number of Lapbands they've done. They've done hundreds of lap bypasses but very few Lapbands -- about 50 among the 3 of them since they started doing Lapbands a year and a half ago. I remember you posted some time ago that a given surgeon should have done a minimum of 50 Lapbands. So here's my conundrum:confused: :

Is it wise to have a Lapband, even though they've done so few?

Or do I have a bypass even though I'd prefer not to?

Any advice will be appreciated!

NancyRN

[babsintx3 0]

Hi Nancy,

I know you posted this to Dr. C, but I thought I would drop in as a 3+ year post op and talk about how important aftercare is with the lapband. I had a great surgeon, but once he got too big for his britches having done over 1000 lapbands, his aftercare sucks and he has turned into a money making machine billing 700+ for fills in his office with flouro and just funnels people in and out of his office with no personalized service. Since you are in the medical profession, you know how important aftercare is and practices like the one you are describing seem to be pro bypass and only do the lapband as an afterthought.

If it were me, I would find a surgeon that only does lapbands, but if that is not possible and this is the only in-network provider, just remember that you may not get the support you need both emotional and post op fills which are critical to your success with the band since it requires so much more compliance. You may want to organize post op care or get more clarity on their post op care before making a decision. The problem with having surgery with one surgeon is that many other surgeons dont want to touch other surgeons patients and this is a problem that you may encounter if you dont agree with their post op methodology.

Babs in TX

334/180 ish

-150 ish

6/23/03 Banded

8/04/05 full abdominoplasty/medial thighplasty

[NancyRN 1]

Babs,

:eek: Thanks for the wise info. I'll definitely follow it up.

NancyRN

[white rabbit 0]

I agree with Babs - the aftercare is absolutely critical to success. I'm based in the UK and went with a specialised weight loss company. The consultant put the following argument to me: surgeon's simply do a technical job of putting the band in place - so you really want one that has done the job many, many times to reduce the possibility of surgical complications.

Supporting the patient afterwards however, is the job of others who are equally expert in their roles. So, the consultant (not the surgeon) conducts my band fills, I have a personal dietician, a dedicated weight loss mentor and access to an 8 week behavioural programme following surgery. Each member of 'my team' is there to offer different types of support -- something the average surgeon is neither qualified or particularly interested in doing.

[babsintx3 0]

Hi Nancy,

I went back and looked at my post and I guess what I was trying to say in answer to your question was that it isnt a question of how few they have done since a bypass is a more complicated lap surgery than lapband generally speaking, but the question would be why they do so few??? I think any surgeon who is a laparoscopic specialist proctored by Inamed or another surgeon could do the procedure so its really gonna boil down to how they treat you post operatively and whether you will get the support you need to be successful with the band.

Regarding your second question, if you are not opposed to bypass or this center is your only choice, only you can decide if a bypass is an acceptable procedure for you.

I wish you lots of luck and success!!!

Babs in TX

[Trace Curry 1]

Nancy,

I don't know anything about your surgeons per se so this has nothing to do with them personally...

There are surgeons out there who are not "believers" in the band who do it every now and then anyway rather than losing patients who refuse to have a bypass. You want to make sure that is not the situation wherever you choose to go. As far as how to figure that out, that's up to you!

Dr. C

Cincinnati, Ohio

www.TheBandDoctor.com 877.442.BAND

DISCLAIMER: I am not your surgeon, any comments made by me are not meant to be taken as medical advice, just general guidelines. Contact your surgeon about your specific problem!

[GE Mom 0]

My surgeon told me he's only done 30 lap bands because his program just started doing them in the past year. However, he's an accomplished general surgeon, and he's done hundreds of RNY and similar operations for stomach cancer. He is moving toward doing more and more lap bands because his patients are losing almost as much total on the band as they do on RNY, and he likes the less invasive procedure.

He's also meticulous about after care. I think because the program is new they're being very, very careful. I've checked him out with a number of people who know him, and his reputation is that he's extremely careful and won't take risks. My primary care doc says he's the one she'd choose for any surgery for herself or her family.

So anyway, I'm two days post banding and so far, so good.

[Dody 0]

Congrats on your surgery. I told you in an earlier thread not to worry that everything would be fine, and it sounds like it is. God Bless and keep up the good work. It should be clear sailing from now on. Sounds like everything went great with your surgery.

[GE Mom 0]

Dody, thanks go to you for calm and complete information. It really helps.