It is interesting how you accuse me of not supplying patient follow up on one hand and then accuse me of seeing patients too much for the band in another- a logical fallacy. If a patient comes in for a post operative visit - whether it be for a DS or a lap band - you consider it business if we charge for one but not the other?

Then you cite a single paper - but not the multiple papers that are out there -- and use that as the sole basis for an argument- a paper that comes from a single source? Yet the whole of papers out there show that the lap-band is safer by a factor of ten- in all aspects?

Then you say I am likely getting kickbacks-- for which you accuse me of, but have no basis for?  And yet you fail to note or discuss the many staples that are used are also "medical devices" and something for which device companies are paid.  So if Ethicon or Covidian take a DS surgeon to dinner that is not bad, but if they take me to dinner that is bad? Did you know that the staple manufacturers get more for a DS than they do when they sell a band?  But because you think one is better it is ok - and not ther other?

Then you say an office visit is less renumerative for one than the other-- although they are coded out the same? So if patients use office visits to learn, to change lifestyle, to have good results because it takes time to learn about any procedure and what it does-- if they do it for one that is ok, but not the other?

Then when a procedure fails - and someone revises it to another - you say that is wrong- but you refuse or simply ignore other data? It is ok to revise from one procedure to another as long as you think it is good?

Thank you for the assumption that surgeons do one procedure for money and the other for love - when you don't know reimbursement rates, motives- but because you like the procedure you had it must be good.

Your arguments are not based on the whole of the data - and your conclusions are based on a flawed belief that if data/surgeons do not believe in your belief they are wrong.

This is not religion- this is medicine- this is surgey.

If you think it is better to reoperate on someone for multiple hernias from the malnutrition of a DS, or bowel obstructions, or leaks than it is to operate on someone to reposition the band- or to take a band out -- you are simply wrong.  You can be an evangelist for a procedure- but if you want to cite a small bit of literature and dismiss those of us who take the entire body of literature- admit it.

Here are the facts:

In all large studies across all literature-- the band is safer than other procedures.

The band does require education - as all procedures do- it does requre follow up visits-- as all procedures do-- and the band is adjustable - others are not without major intervention.

There is no trading malabsorption for obesity with the band.

Bad things can happen with any surgical procedure- and if you think a website is what I would use for informed consent then you are so wrong.

Glad you like your procedure- but to say it is better than a lap band is like saying a horse is better than a car because you don't need gasoline.

The band is not flawed, anymore than any weight loss operations are flawed. Patients have a problem of obesity- and this is the tool I seek to use. In our data-- outcomes (weight loss over three years or more) are equal -morbidity and mortality is less- and patient satisfaction is higher with the band than with DS.