if you could aks the leading bariatric professionals ANYTHING...?

I'm not sure how it is in the Netherlands but I would want to  know the surgeon's credentials, how much experience do they have,  have they ever been fired from a hospital,  or have a malepractice suit against them?  What kind of follow up care do they provide?

I'll rattle them off in no special order...By the way,my local support group is really cool.  Both bariatric surgeons sometimes show up at our meetings.  We can ask really in depth questions.
1.  After an RNYer dies, what are they seeing in the old stomachs??  Anything interesting in the autopsy.
2.  Does the malabsorption issue affect people's teeth over the years?
3.  If dehydration is the # 1 reason for reenty into the hospital for all WLS...Why not give an IV solution at the 2 week check up??
4.  The VSG is very popular in Europe and is becoming more popular in the US.  Is age a consideration when determining whether to go with a VSG, DS, or RNY?? 
5.  Are any new procedures coming down the line to reduce the size of the pouch...Like the ROSE procedure?
6.  Got to go...Sports is on...

Hi there!

so far what I got:

Teethe issues: yes, he sees them but mainly in people who do not take enough calcium from the getgo and more so in DSers than in RNYers

Age is not a factor in deciding anything in his practice, just what type of eater the person is. UNLIKE many colleagues, if someone is a self proclaimed sugar addict or sweat eater, he does NOT give them a RNY because he believes they will not keep the no sugar ever rule up! he rather does a DS (two staged) on these folks.

Some light weight individuels can get by on just a sleeve but in his experience, the longer term sleevers who were morbidly obese, generally yield to few reult with just sleeve and come back for the second stage (switch)

He tried ROSE, stomaphyx etc but found them very ineffective, even proclaims Fobi and BOb dangerous. He reckons a lot of those patients out ate their original surgery and did so again after ROSE or whatever procedure. Intensive counseling might be an option. Or making a distal RNy allthough no fan of this. he also does some RNY to DS revisions but in 3 stages as it is a very tricky surgery. I think he prefers this to distal GBP

OK guys

My first interview with the bariatric surgeon was very insightfull.

This man does NOT do bands anymore for quite some time. I consider him kind of a visionair, because he was already in 2004 calling out to the bariatric world that bands are not a good option. Why? The disadvantages on the long run FAR outweigh any benefits it might (mistanely) claim to have! He has done hundreds of bands from the eighties till beginning 2000's and has found that:

almost 0 % keeps their band after say, 9 years. They almost always erode, infect, grow in, shift or cause other problems. In which case he never has places a new one but always had to resort to GBP/ DS after a failed band with LOTS of complications and damaged tissue from band. So as early as 2004 he was against it, being sued by tha band companies for saying so and being booed by his colleagues for not believing him. Also: band gives very limited results and demands quite HIGH self discipline from people and is easily cheatable.

Now, they are slowly but surely follwoing suit and more and more colleagues over here stop doing the band. My surgeon is one iof the few who still does them but with very careful patiente selection and very rigourous patient follow up.

There were more things he was early to call out, but later the scientific worl followed him, hence I call him a visionair.

example: he is the only one that strongly bevlieves in the Hypglycemia complication for the last few years, considering RNY. Now, slowly some colleagues are acknowledging the existence of this RNY complication. it is the REASON this man does not even DO a standard RNY anymore unless in redo patients. For virgin surgeries, he does some safer version of the mini bypass, which avoids some of the sugar/ hypoglycemia problems of the RNY

So again, he is visionairy in that one. He did a study this summer calling back hundreds of patients, RNY, he operated on 10 years ago. The findings were that 1 in 2 (!!!!!) get some kind of sugar problems, hypoglycemia or diabetes,and a lot of that is caused by or worsened by the use of sugar! Over here we do not have such strict rules as you guys do, genereally we are told to eat whatever in moderation, focus a bit on protein etc. So a

So a LOT of people still eat lots of carbs and also products with sugar in them. Yesterdays surgeon is the first over here to say NO added sugars EVER, not even ONE GRAIN if you can avoid it because it WILL lead to some kind of insulin problems down the road. He noticed that after 5 years, this develops in many people,sometimes sooner. His study will be publicized soon in some medical journal so he hopes other colleagues will -again- follow suit.

Rather STRONG opnion on the sugars and even does not do virgin RNY anymore because of it!!! Remarkable eh?

The problem being that RNY patients do not have any digestive juices in the limb directly after your pouch, generally 1,5 metres long. Also we do not have lots of digestation in the pouch itself, so sugar**** the intestine almost directly, undigested, in an unprotected part of the inesttine without acids and dig. fluids, so it is 100% absorbed and spikes CRAZY insulin reactions. The pancreas becomes crazy and the liver gets fatter, if you use more and more sugar. In the longer run, patients tend to develop Hypoglycemia, which can be VERY life numbing, always tired etc ect or even develop diabetes as an insulin result. Also, people who are VERY uncareful with sugars and alcohol, get fatty liver and even can get liver failure in the long long run. Alsp pancreas disease can occur. Also epilepsy as a result of severe hypoglycemia.

He points this out to his patients but every post op consult is a nightmare because they keep eating sugars, breads and fruit juice. He reckons only 5 % can REALLY for ever stick to the no sugar rule, that is why he just does not perform virgin RNY anymore. The mini bypass has a full loop up at the stomach where juices flow freely, so no 'dry limb' so to speak, which is a lot easier on the body if sugar comes into play. Still those people, like DS and sleevers alike, should avoid sugar for many reasons, but at least not like RNY where sugar can be VERY bad for your health

As you can imagine, I was quite shocked! I felt a bit bummed out with my surgery but hey, done is done and I can only just try my very best to keep this in mind and erase the few sugars I eat from my diet. of course, sidenote, this does not concern fruit sugars and milk sugars, but ADDED sugars.

well we talked about many more things. He perfoms a lot of mini bypass, after that sleeves with intention for a 2 staged DS. In his experience of many years and thousands of patients, stand alone sleeve does not yield enough result in many patients, like the band. Also procedures like ROSE, Plication and Stomaphyx have been tried and tested but found inadequate by him. So it's basically Mini GBP or two staged DS he offers. Unless it's a redo, a whole different story.

well I was quite inspired!

The next week I will interview a top psuchologist, after that a nutricionist and an endocinologist (who, I know, also is very much against sugars) and a plastic surgeon.

so any quetsion for them, let me know!

I also want to find more surgeons to get a more all around image of what's going on in the bariatric world.

I asked him about the differences and do the surgeons confer with eahc other

he said off course, he talks to a lot of surgeons in the US and in Europa. US surgeons share his opinion on many things, European not yet. He says that they simply do not believe him.

I think this might have to do with some kind of inherent sugreon's arrogance and know-it-all. Every surgeon thinks to know BEST and have a hard time believing otherwise or admitting something has been wrong.

This surgeon you've been speaking with- why does he do the DS in two stages? Especially knowing it's been proven less effective in the long run than a one-stage DS, and with the complication risks of a second, otherwise unnecessary surgery.

Hi Sarah

I remember him speaking of this but do not exactly remeber his answer, will have to listen back my interview to find that one. I think it had to do with insurances wanting it like that over here, if I remember correctly. Insurances over here want it like that because they find the surgery risks that way more acceptable.

I'll let you know once I hear back his answer but I think it was not his choice but and insurance requirement. no one does them in one stage over here anymore. He used to a lot though.