Questions to ask Dr about VSG

Ok I am trying to make sure that I have the right Dr so that my surgery goes as smoothly as possible.  I am currently scheduled with Dr Alverez but went to a meeting with Dr Borland in New Iberia, LA yesterday evening.   So I need to choose between Dr A and Dr B LOL

Dr A

   In MX so if a problem occurs cant just go back easy

    More Experience

    I am leaning this way

 

Dr B

   Local so follow up is easy if needed

   Has done about 40 VSG

   Mother/ Husband prefer this but my choice

 

I know Dr B has had one leak/death.  the lady ate chicken 5 days out from surgery and did not call the Dr unill over 12 hours later and throwing up the whole time.  That kind of scares me to be honest.  He says if she would have called early she would not have had the complications that set in.  (she died 3 weeks later)   He was upfront about it and did not hide this fact.....

 
But I need to know what all I should ask to get a full comparison:  I have a few questions that I have come up with but if there is anything else please tell me.

1.  Rate of Leaks?

2. Infections?

3. How stomach is closed up?

 

I DON'T KNOW IF YOUR PRIVATE PAY OR INSURANCE, BUT HAVE YOU LOOKED INTO DR. HARGRODER IN GONZALES, LA  HE COMES TO LAFAYETTE TO DO SURGERIES TWICE A MONTH, HE HAS GREAT REVIEWS AND VERY GOOD BEDSIDE MANNOR.  EVERYTIME I'VE CALLED HIS OFFICE, HIS STAFF HAS BEEN AMAZING WITH ANSWERING WHATEVER QUESTIONS I HAVE!!  JUST A SUGGESTION.  HIS VSG IS WAY MORE THE DR. B.  AND HE'S LOCAL AS COMPARED TO GOING TO MEXICO.
CRYSTAL

i am self pay.  I did look at Dr H as well ( I think it would be about 4,000 more)  If I have to I can swing it to be honest but it would be tough.  I am just so mixed right now and need to know what questions to ask....

I WAS REALLY HEAD STUCK ON HARGRODER, I HAVE A FRIEND THAT WORKS IN THE OR AT SOUTHPARK HOSPITAL AND JUST RAVED ABOUT HIS SUCCESS WITH THE SLEEVE.  I FELT SHE GAVE ME THE MOST HONEST OPINION.  SHE DOESN'T RAVE ABOUT ALL THE SURGEONS, SO I FELT IT MEANT A LOT WHEN SHE DID COMPLIMENT DR. H. LIKE SHE HAS.  IF THE PRICE DIFFERENCE IS THE SELLER, I'D HAVE TO FEEL MUCH MORE COMFORTABLE WITH THE DR WHO HAS MORE EXPERIENCE WITH THE VSG.  I'M NOT TOO SURE WHAT EXACTLY TO ASK, I'M SURE THEY ARE ALL VERY WELL CERTIFIED IN THIS FIELD, I WOULD JUST BE CONCERNED ABOUT THEIR EXPERIENCE!!!  THERE IS ANOTHER DR AT LAFAYETTE GENERAL, HIS VSG IS LIKE 10,000ISH, IM NOT TOO DEFINATE.  I KNOW ASHLEY (ALLFORLIVING) IS USING HIM.  SHE SEEMS VERY CONFIDENT IN HER CHOICE FOR HER SURGEON.  I'M JUST THROWING A FEW OPTIONS OUT THERE, SO YOU CAN BE AS INFORMED AS POSSIBLE!!  I KNOW PERSONALLY I FELT MUCH SAFER BEING LOCAL.  HAVE YOU CHECKED OUT DR CHU AT SOUTHWEST?  I'M NOT SURE WHAT HER COST ARE, BUT SHE DOES THE VSG ALSO!!  WELL, THAT'S ABOUT ALL I HAVE FOR NOW.  TALK WITH YOU LATER!!!
CRYSTAL

I would find out what size bougie Doc B uses and what kind of training he has.

Personally, I think you're safer going to Mexico than with the inexperienced doc. If there is a more experienced one near you it might be worth considering, but for me, I wouldn't trust someone with so little.

My personal preference is someone with 250 sleeves and 250 bypass.  Bypass is a much harder staple line to do than a sleeve staple line.  If he doesn't have a lot of sleeves than 500 bypass would be totally acceptable.  If a doctor has a lot of experience with a difficult staple line, they can do an easier one.  The reason I say 500 staple lines is not that the staple line is that tough.  But a good doctor can recognize a complication and act accordingly.  That takes time and experience.  EVERY doctor has complications, since not all complications are under the control of the doctor the real test (IMHO) of a skilled physician is watching for complications and spotting them before they are out of hand.  Some doctors can do a sleeve staple line but not a bypass staple line.  Pesonally, if someone can't do a trickier staple line, they won't being doing ANY staple line on me.

I do think hospitalization is critical for a sleeve procedure.  Even the crappy doctors keep you at least one night.  Due to our weight we are at higher risk for surgical complications so I think hospitalization is very important after a sleeve, it is major surgery.

I would see if he oversews the staple line.  Some use glue but there are no studies whatsoever that demonstrate glue does anything to secure a staple line.  It does help bleeding, but not leaks.

What his leaks and various complications are (stats).

I don't believe that someone not following the post op diet is the fault of the doc, that death just isn't his fault.  The staple line is verrrry fragile especially the first week.  If she did exactly what he told her not to do that isn't his fault.

I would see what size bougie he uses.

Thank you so much for this very useful answer!  I will use your check list for sure.  This Dr has been doing Bypass surgery for years so he has been doing the more difficult surgery for some time.  i will ask what his stats are for that

HI,

I personally would have a problem with a surgeon that had one death and less than 40 surgeries under his belt. I am not saying that he had liability in the death if what he says is true but thats still a statiscally high number. And then you don't know how many of his patients had complications other than the death... Many surgeons if they do a lot of surgeries on high risk patients may have a fatality, so that shoudnt be the main reason to not select him, but for me that would be enough. Keep in mind that there should be little post op care with the sleeve. My surgeon is in NY and I live in GA. I chose him because he was one of the best and I was a tougher revision patient from band to sleeve. Trust and experience (not necessarily in this order!) ARE MY criteria.

Babs