Pondering why the RNY is considered the "Gold Standard"?

Revising from an RNY or VBG to a DS is a much trickier surgery than just doing a virgin DS.  There aren't many surgeons who do the DS and there are far less who will revise an RNY or VBG to a DS.  Did you ask Dr. Houston's office if he does?  I'm not sure whether he does or not.  Off the top of my head I only know of 2 surgeons in CA and 1 in NJ that will do it.

Good luck to you!

I did ask their office and get the standard "he does them but its case by case"... which is why I think I may not even go for consult. . . Nashville is 9 hours from me, which is a 2 day round trip to be told he will have to wait until he gets in to see what he can do.   California, NY are out of the question for me, and from my research I agree with you on the surgeons available for this procedure.  I think I have exhausted all my options for a DS.  Thank you sooo much for your encourgement. 

Those who make the gold set the standard.  

It is all about money.   Surgeons can do more RNY's in a day than DS's.  In a fee for service world, the more services (surgeries) performed, the more you make in fees.   It also requires less training to perform an RNY than a DS,  so the barriers to entry into the RNY market are lower.  

Peace,

William

P.S.   For anyone who thinks that "market forces" are the answer to the dismal state of American medicine, they are sadly mistaken.   The horrible state of U.S. medicine is a direct result of uncontrolled market forces.   This is just one sad instance of it.