Surgical Consultation Questions

I believe each surgeon should perform the method of weight loss surgery they know they can do safely. Lower BMIs usually are easier to accomplish laparoscopically barring complicating factors. That does not mean that a person whose BMI is over a certain surgeons BMI limits for a technically safe surgery doesn't have other options. Ask what the surgeons BMI limits are and how long it takes as well as how many have you done laparoscopically. Especially what long term training have you had to perform it laparoscopically. What decides conversion from lap to open or whether they would even try laparoscopically. What do you feel you can do safely. If you like what you hear then have it done by that person. If not keep looking. You may get the same answers but at least you know your options. Non scientific reasons for the performance of advanced procedures vs having to do it open, such as previous pregnancies should be questioned closely. I obiously do not agree with this policy. The most important information to emphasize is the best method to safely get the patient through the operation "in my hands" and if thats open or laparoscopically it should be simply stated.

Hi Denise, I too was told I was not a candidate for laprascopic by Barix. The reason for me is two previous C-sections (bikini line incisions). I would prefer to have mine done laprascopic if at all possible. I, too, may go see Dr. C

Do those guys have real long noses that keep growing as they talk? C

Previous abdominal surgery can make the surgery more difficult. Adhesions from previous surgeries can be very difficult to take down laparoscopically if you don't do it everyday. I've said before, I have respect for those that tell you for safety reasons they will only offer open surgery. But, ..I personally believe that everyone with few exception should be offered laparoscopic surgery for weight loss if the surgeon's experience warrants attempting it laparoscopically. If you desire laparoscopic surgery, find the most qualified surgeons in your area, especially if your program tells you they will only do it open because yours may be more difficult. Find surgeons that have gone through a rigorous training program in advanced laparoscopic and bariatric surgery also called a minimally invasive fellowship (one-two years of intensive laparosopic training, just as in vascular, cardiothoracic, plastic surgery fellowships). They have been developed to concentrate on making a laparoscopic approach to weigh loss surgery the safest possible and the after care more effective. Good Luck. Sincerely, Calvin A. Selwyn, Jr., M.D. Assistant Professor of Surgery University of Cincinnati