Question:
Can you choose surgery type?

Is the decision to have distal or proximal made by the surgeon or patient? Does the surgeon make the choice based on patients BMI,etc? Or, does the patient make it based on their wishes? If I can make the choice myself, then I'm really confused because my BMI is 43 so I don't need to lose a ton (just 100lbs) but Distals seem to have better results but more bad stuff to deal with. I don't have a problem with distal from a nutritional standpoint, but all this diarhea/gas stuff!! Geez, I can't even go number 2 at the office now, cuz I get embarassed! I digress! My main question is if it's the patients choice or the surgeons. Thanks!!    — [Anonymous] (posted on October 17, 1999)

October 17, 1999
Most surgeons have a favorite operation which they have a fair amount of experience with. It is probably a bad idea to try to talk them into doing a different operation which for whatever reason they are not used to doing. Every operation has its own problems and it is good to have someone who is familiar with the problems of the operation that you had. Therefore you can choose your surgery but it is best to do this by finding a surgeon who is familiar with the type of operation you want. I for example do proximal RNY gastric bypasses and am happy wiht them. My results are as good as any of the published series for that type or any other type of operation, so I would be reluctant to do a distal gastric RNY or a bilipancreatic bypass. Good luck.
   — Bruce B.

October 17, 1999
Hi--Most surgeons specialize in one type of WLS. If you are going through your insurance company, you might have to take the surgeon they offer within their network. If that is not a factor, you can research the subject and make your decision based upon which procedure you have selected, and then meet with the surgeons in your area that do it. I know, personally, that I really wanted a Lap RNY, but after talking to the surgeon (Dr. Shikora in Boston) and finding out that he does the open RNY in as small an incision as possible (usually no more than 5 or 6 inches, and often less), I was able to accept this, and that is what I am havig done in November 1999. So, be flexible, research the subject and take all the factors into account. Best of luck to you.
   — eve E.

October 17, 1999
I only had 120n to lose. It thought. I lost 150 and I'm oh-so-happy, I am distal and I'd do it again. But I agree, it isn't for everyone. And how distal is distal with your doctor? Our doc will do everything in between, too. You sort of pick your inches. Maybe your doctor will do something in between?
   — vitalady

July 20, 2001
In my first consultation with a surgeon, it was clear that he offered only one type of surgery, which he was quite ready to justify but not ready to modify. I gained a sense that choosing a surgeon may be tantamount to choosing a surgery!
   — Kerrin Leon W.

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