Too fat for a bypass

[Missouri-Lee's Summit 1,256]

I've made a new friend on this forum. He currently has a BMI of 63. Apparently, there isn't even a term to classify his size. I found somewhere that Super Morbidly Obese is for a BMI of 50 or so. Anyway, this new friend has a great sense of humor so I know he can appreciate his dilemma of being medically nameless. But I digress...

After meeting with his nutritionist and surgeon recently (since he was still trying to decide sleeve vs bypass) his size pretty much decided for him. I found out why below:

"A BMI of 60 or above is categorized as super morbid obesity. A laparoscopic Roux-en-Y gastric bypass in these patients is technically very difficult due to the size of the abdominal wall, the size of the intra-abdominal fat and the size of the liver. Due to these technical aspects of the procedure, the risk of leak and other complications are increased. I think that a laparoscopic sleeve gastrectomy is a much better procedure in higher risk super morbidly obese patients. It is a technically easier operation than a Roux-en-Y gastric bypass and has a much lower complication rate for this patient population. The sleeve gastrectomy can also be the first stage in a two-stage procedure. Once the patient has lost a significant amount of weight, and if he/she is still morbidly obese, it is safer to then convert the laparoscopic sleeve gastrectomy into a gastric bypass or a duodenal switch. The sleeve gastrectomy started as a procedure for high-risk patients but is now used as a primary procedure for lower BMI patients as well."

[New&Improved 1,780]

Watch the show on foxtel "my 600 lb life" one specific doctor in the USA deals specifically with those around 400lb+ i think the heaviest he actually worked on was about 700lbs. he does bypass and sleeve for those patients no other surgeon would touch.

[TX4everLinds 115]

It’s super obese. I was classified as that when I started. I am very short, only 4’11”. I had never heard of it until I saw it in my medical chart. It said (super) in parentheses. My BMI was 61 and is now 42. Surgery 2 months ago. I was surprised that it was called super! Seemed so positive lol

[elcee 3,340]

I can imagine that it would be very difficult to do any surgery laparoscopically. I wonder if open surgery is a safer option

[believexrebecca 14]

I had my sleeve at a BMI of 72, now I'm at a BMI of I believe 62 and converting to distal gastric bypass.

[Frustr8 7,886]

Elcee undoubtedly so, except open surgery has its inherent risks. Wounds heal slower, more risk of infection, incision break down, my own daddy ended up with a ventral hernia post another type of abdominal surgery, strangely my daughter the R.D. did also. RD was able to have hers repaired maybe 10 years later, lost her navel and a lot of broken- down stretched out skin, forbidden to ever gain weight again. Ugly then, not all that gorgeous now, Daddy died with his at 80 unrepaired, ugly, begged him NEVER go shirtless, it upsets your grandsons(and me too) to see IT! Was told in case of any cat accident, roll to floorboards, curl into fetal ball and pray Our GOD allows YOU to live. And although I do have an right paramedian scar from open appendectomy/gall bladder removal nearly 35 years ago (February 1984) , my flabby belly was beautifully laprascopic RNY SEPTEMBER 5th. True recounting, told Dr Needleman at our July 2018 chat I would prefer an Open incision to no surgery. He drew back, said " Do you KNOW how long it takes an Open Incision to heal? Flipped up my T-Shirt, flashed him my belly, and he laughed ruefully " Okay, Point Taken! I'll enter it into My Notes!" And I have the prettiest 7 incisions you ever saw, they're fading into the train wreck of abdominal stretch marks I have, but if YOU look close, HE DID BEAUTIFUL WORK!
Sorry about all of you with the rest ' cause I think I got the BEST! And as long as each one of us feels THAT Way about Theirs. The world🌏 will turn smoothly!

[Frustr8 7,886]

car not 🐱 Daddy always 💓cats, would swerve to miss them and puppies every time.

[CyclicalLoser 155]

I was going to mention Dr. Nowzaradan from "My 600# Life" as well. He does seem to be a pioneer in Super Obese patients. I have noticed that in the largest-of-the-largest patients, he does tend to steer towards VSG, at least first, and then sometimes comes back to do a RNY afterward.

[bonvivant57 14]

Contact Dr Phil Schauer at Cleveland Clinic.

The Dean of bariatric Surgery.

Good Luck.

https://my.clevelandclinic.org/staff/6010-philip-schauer

[JNS0711 14]

I'm 5'5, and my surgery weight was 409, so I fell into the super obese category. I was actually 440 at the start of the program. I had RNY done via laparoscopic surgery and I've had no issues or complications.

[Frustr8 7,886]

Wonderful and I wish you only the best. Do you have a definate goal you're aiming for?