What is a good/experienced banding surgeon?

More important is what they are not... Just because a surgeon is extremely experienced and reknowned with the RNY, doesn't mean a darned thing when it comes to banding. Period. It would be like saying "Oh, this surgeon has done 5,000 appendectomies thus must be a good banding surgeon". Apples and oranges. Only banding experience counts. The aftercare for RNY and banding is completely different, so the fact that a surgeon has done 2,500 RNYs is pretty meaningless if he's only done 40 bands. All that RNY knowledge will not translate to knowing anything useful about how to make their bandsters be successful or how to give them practiced, good aftercare. If anything, surgeons new to banding have to really work to throw out all that RNY knowledge when it comes to their bandsters. The fact is that surgeons in the learning curve of banding (fewer than 100 bands placed and cared for) will have at least 25% higher complication rates (ranging from slips and erosions to patients throwing up constantly and everything in between) and significantly lower weight loss results. And of course, the numbers game is still only a starting point. There are banding surgeons out there who've done hundreds of bands, but then try to put their bandsters on crazy 2oz meals 3x a day "until all the weight is lost and then maybe you'll learn how to actually eat properly" and sure, a lot of patients fall for their sales pitch and promises of rapid loss, but what they don't hear about is the misery that surgeon's patients are in...and how many desperately call other banding practices to try to get saner aftercare and often cannot find someone else to take them on and so are basically stranded. The consultation is your opportunity to ask the surgeon about aftercare philosophy...if you've done adequate research, you'll know if those answers are within generally accepted practices or if they're extremist. Don't fall for sales pitches...they only work on those who haven't done their homework. So protect yourself...do your research, do multiple consults if you can. Don't treat the consult like the surgeon is interviewing you to see if you're worthy of WLS...you are interviewing them to see if they're the right person for you to hire to do this. Nancy

Word!

I was at my support meeting this past Saturday.  There was this woman there who hasn't been banded a year yet.  She was absolutely shocked at the fact that those of us who have been banded more than a minute actually EAT. Now regardless of your view of whether certain foods are good band foods or worthy of eating, you have said often the band is not about NOT eating.  Well, her surgeon is one of those folks that have patients on liquids for 4 weeks post-op (maybe a slight exageration, maybe not) and that they should only eat 1/2 cup of food 3 times a day. And of course, she's having problems.

What does football have to do with this post...a lot.  Our Boise Broncos went to Arizona and beat one of the best teams in Oklahoma that they had ever played...they were real underdogs.  Know what Oklahoma's take on this was....we are so good that they were ****y and underestimated the underdog who beat them.  The same can be said for a surgeon who has placed 1000's of bands and it becomes automatic and oops there is a mistake because they were so ****y..it happens.  Then there is the surgeon on his 100th band that is ultra-careful to do all the right things because he wants things to be perfect.  Who would I choose...give me the guy trying his hardest that has done 100 bands and wants to be perfect any day of the week. My dr. had done far, far more bands than this, but this is just an example that people think experience makes for perfection...it can also make for speed and error too...and missing little things that could turn out to be big. This is just my take on things...just because a surgeon has done 1000's of procedures doesn't make him any better than the hard working one that has done 100 meticulously.  That statistics show that some of these well known surgeons have patients with slippage and erosion....so no one is perfect.  I also might like the one who has done 100 lots more than the guy who has done 1000 and I have to follow up with him and have a patient/dr. relationship and that is important to me.  Those things will be my deciding factor in who I choose. My 2 cents for what it's worth. Dee

Dee... I see your point but I respectfully disagree.  No surgeon that has done 100 bands is going near me.  Placing a band is something that requires practice and skill.  The band can't be too high or too low.  It can't have sutures that are too tight or too loose.  It has to be the right size band.  This takes practice to perfect and it just doesn't happen with 100 procedures.  It takes 100 procedures just to discover your mistakes and take the patient back to OR to repair the damage. I was looking for a surgeon that had AT LEAST 750 bands.  I also wanted a surgeon that does the entire procedure himself.  Some docs have the asst. surgeon open the patient, the lap doc places the band, and the asst. surgeon closes the patient.  I wanted a doc that started from the beginning to the end. I wanted someone who has already made newbie mistakes and learned from those mistakes.  I don't want to be the one to be taken back to OR to fix an MD error.

750 is a bit of an overkill benchmark. Studies show that 80-100 bands placed is the learning curve area for PLACING the band. But again, it's not just a numbers game. The numbers are only a starting point. If the surgeon has placed 750 in a year, that would scare me a little...because that's production-line-style surgery and it's hard to give that many patients good aftercare of any sort. 750 placed in, oh, 5 years, that's ok...because it's not overwhelming per year so patients can still get enough time for aftercare. Also, we see some out of country surgeons with very high numbers and they can achieve those numbers because they're not having to do aftercare regularly on that many of them...most of those patients return home and have local aftercare. So numbers are a starting point...we have to figure out what they mean. Nancy

Oh, I never said anything about 750 a year!  My surgeon has done 1200 bands but he's been doing them for about 7-10 years.  Some surgeons limit their surgeries to 15 daily.  THAT is what you are referring to.  My surgeon limits himself to five surgeries daily (he is a general surgeon, he doesn't do just bands but other procedures as well).  I believe that is reasonable. I'd rather have someone with 750 bands under their belt than 100.  100 just simply isn't enough in my opinion.  Not when they are working on me. As for out of country surgeons, the complaints and comments from Anti-out of country people seem to be that they don't do aftercare.  They most certainly do because the same people complaining about out of country docs are the ones claiming there are no US docs (or very few of them) that will work on Mexico banded patients.  Those patients are getting care somewhere.  Many of them go back to their original surgeon.  I do because I prefer him over the US surgeons. Two of the busiest AZ surgeons are the ones doing 15 bands on "surgery day" and that is superior to my Mexico doc that maxes himself on 5 total surgeries daily?  Naw... the anti-out of country people need to make up their minds.  Either patients are getting aftercare in the US or they aren't.  If they aren't getting it in the US they are getting it somewhere and for me that somewhere is back to my original surgeon. I haven't even looked around to see who I could go to in Phoenix.  I didn't want them operating on me, I have little reason to go to them for aftercare.  Besides, many of the US surgeons were proctored by Mexico surgeons.

My belief is that all MX clients should have care available locally. THose that don't have a higher risk of big problems, and a much lower chance of doing well. If you have a big overfill, you can't be crawling onto a plane , sick and barfing, to get back to Mexico. The delay could (and has) cost people their bands. Some of the MX docs are very excellent, but not if you cannot easily get back to them!  After a few hundred bands, there is no difference in the doc's stats. After a couple hundred bands, the docs have seen most problems, most complications, and are thoroughly capable of handling them. I've looked carefully at the stats, and the docs who have done 5000-6000 bands have no lower a complication rate than the docs who have done 500-1000 bands.  There is much, much more to it than simply numbers. Sandy R

Sandy... I agree that there is much more to it than the numbers.  When I wrote that I was responding to a specific post that was suggesting a newbie doc might do a good job too.   I made research a full time job for quite some time before picking a surgeon.  I did my work, I did the leg work, I did a good job.  I picked the best surgeon for me. I also agree with you about having someone local available.  I do, I have someone I can go to for an emegency unfill, etc.  If complications arise I do have a person that has agreed to see me however, I still prefer to go to my doc for anything that isn't urgent. I also agree that someone who has done 500-1000 bands has no different complication rate than someone who has done 5000-6000 bands.  That was essentially my point early on.

If you had done your homework you would already know that one of the top lapbanding surgeons is right there in Phoenix.  If you are looking for experience go with Dr. Terry Simpson....you don't have far to travel to find one of the best.  No reputable US surgeon does 15 bands in a day...it's unhreard of and I wonder where the heck you get your info....I have, however, heard of having 50 lapbands being scheduled in a mo. which is about the norm for a good US surgeon that is in demand.... Dee