Dudenal Switch

Hi As most of you know I have been given the ok to have this surgery. I just found out my Dr. is the only one in Indiana that has done this surgery. She has only done 10 of them. That does make me a little hesitant. What do you you think. Barb

If you are in Indiana, you are not that far from Ohio or Nebraska. I think you would be better off going over to Dr Maguire or Dr Anthone and having one of them do the surgery. The learning curve for the DS is 100 surgeries, and the mortality rate decreases dramatically when they reach that mark. Before 100 surgeries, the average mortality rate is 3-4%. After 100 surgeries, it drops to .3% That means in the first 100, a surgeon can expect to lose 3-4 patients. The next 3-4 deaths would occur over the next THOUSAND surgeries they do. You don't want to be in a doctor's learning curve - it increases your chances of dying from the operation by 10x. The added expense and hassle of traveling for surgery will be worth it.

Barbara I totally understand your reluctance. It gives me hope to know that more surgeons are learning and performing the DS. But like you and the others, I wouldn't want them learning on me. UNLESS, there was a qualified, long term, DS surgeon assisting. Have you thought about asking your surgeon if she regularly has another surgeon experienced in the DS procedure, assist? My surgeon teaches the DS to other surgeons at the Weill Cornell Medical Hospital in Manhattan. Though I know that he performed my DS, as it is being used as a teaching video, I would not have declined having another surgeon perform it, if he was assisting. 2 Surgeons have got to be better than one, any day! Lee Lap DS 3-16-05 w/ Dr. Gagner http://www.cornellweightlosssurgery.com/ 276/184/140 ...And it just keeps getting better! Her Grace, Countess of Tude (Attitude), Mor (Humor), Pathy (Empathy) and Tory (Victory). May God Bless every path you put your feet to

I'm with BT. This doesn't mean anything negative about your doctor, per se, and everyone has to begin somewhere -- but the stats are compelling. I'd travel for more experience. Alison * * * * Quest for DS officially began 2/28/05 Currently appealing insurance denials to CA's Dept. of Managed Health Care * * * * Insurance: Health Net HMO

Dr. Alverdy and Dr. Prachand do the DS at the University of Chicago. I had mine done by Dr. Alverdy in March 2004. They are excellent. If you have been approved for the DS, see if you are approved to go to the U of C. Morganna was also done by Dr. Alverdy in April. I know someone has to be the first few, and if the doctor is the one I am thinking about, she is very reputable and would probably do a great job. That said, the choice has to be yours. I would check into the U of C. Julia K

I would want a surgeon with some experience. Can you call some of the other surgeons and see what their wait times are, their requirements for aftercare and check-ups, staying in the area after surgery, etc. just so you know your options? That's what I did - made a list of doctors and of questions to ask, and then I just started calling. Note: Alverdy and Prachand (Chicago) are in the same office, even though their phone numbers are different. Jeanie

I'm more optimistic,than my co-respondents. She is a licensened bariatric surgeon, Is it significantly different to do a vertical cut then a horizontal cut, and poke a hole in the pouch, and attach a piece of intestine,is the sewing of intestines in a ds configuration different than sewing it in a rny, meaning ,sewing the intestine is still sewing the intestine. the routing is different, but that should be able to be handled. I am assuming she has done a few rny's, she is not developing her own methods , she is following a cookbook, and has the surgical skills already proven.

I take my vw to get fixed and it cost 75 dollars a hours, take a porcha to the same dealer and it cost 120.and hour to change a tire. Maybe if more doctors undertake doing the ds, it will be more available and the cost will be competative. Unless you have some particular needs perhaps such as a revision to ds from rny, or a wierd one like me , a ds under a nissan wrap. where the doctor is going to adlib his way thru it. you should be fine.

Walter, I have to respectfully disagree. Comparing the areas of intestine bypassed in the DS and RNY is comparing apples to oranges (or at the very least apples to pears) Stitching the duodenum is very tricky. Leaks are much more common with inexperienced surgeons. In addition, removing the greater curvature of the stomach can be a challenge as evidenced in a few of the recents posts we've had here on "strictures" in the newly reduced stomachs of DSers. I will ALWAYS vote for the hand of experience when it comes to the DS. It CANNOT be learned in a weekend seminar and I consider it foolish to risk your life with an inexperienced surgeon. This is why I flew halfway across the country to get one of the most highly regarded and experienced surgeons for my DS. Laurie in So Calif DS by Dr. Anthone in Omaha, NE

People have to learn somewhere. Our local group has three folks that were # one, two and three respecitvely. Turned out fine. Find out who she studied under, and maybe do some research into how many she has performed assisted.