Correspondence with Dr. Pernaute

[star0210]

I wrote to him with a question about the malabsorption and this was his reply.

Hi Leigh,
Thank you for your confidence in my opinion. For your words I see you have read a lot about my surgical technique, as you have the very precise question we all have, i.e., why these different lengths in intestinal limbs (DS and SADI-S) behave the same. I have operated more than 180 patients, 50 of them with a 200 cm common channel and the rest with a 250 cm long one. In my experience, SADI-S 250 and standard DS with 150 + 100 behave similar; even more, I’m sure that SADI-S 250 is a bit more aggressive referring to weight loss. It has more advantages, as the operation is shorter, the mesentery is not opened so no hernia are expected to happen, and as the bile has a longer limb to run through, a lower amount of bile salts reach the cecum and so there is less irritative effect and lower number of bowel movements. What I cannot tell you is about SADI-S 300, as I have performed very few cases with this limb length.
If you are finally submitted to this operation, you have to take iron and calcium supplements since hospital discharge, and you have to warrant enough daily protein intake.
You can ask me any question you want about the operation.
Good luck,

 

[DianaCox]

"In my experience, SADI-S 250 and standard DS with 150 + 100 behave similar; even more, I’m sure that SADI-S 250 is a bit more aggressive referring to weight loss."

This makes no sense to me - I'd like to know what he bases this statement on, in particular whether he is comparing the same patient class in the SADI group vs DSers. Both procedures have the same length of intestine with food passing through it, but the SADI has digestion/absorption of all macronutrients (fat, protein and carbs) occurring in the entire length.

And - the initial weight loss with DS is from the sleeve - same would be true of the SADI. The switch affects long term weight loss maintenance, and there is insufficient data to know what that is going to be with the SADI, especially if they are given advice to eat just like a proper DSer.

 

[star0210]

@DianaCox I'm hoping Elizabeth posts Dr. Tugrul Mediral's response to her question on fb in a thread about the Sadi...(there's another girl who thought she was getting traditional DS and found out later he did the Sadi)

it's quite long and very interesting...it seems to me if I read it right that his theory is it's the amount that's bypassed that matters...moreso than the amount that's left.
Someone (Jean Dey - I don't know if she's a member here or not?) did post after and asked him specifically about the bile being in contact with food for the longer length of intestine. He hasn't yet responded. I hope he does.

 

[southernlady]

@DianaCox I'm hoping Elizabeth posts Dr. Tugrul Mediral's response to her question on fb in a thread about the Sadi...(there's another girl who thought she was getting traditional DS and found out later he did the Sadi)

it's quite long and very interesting...it seems to me if I read it right that his theory is it's the amount that's bypassed that matters...moreso than the amount that's left.
Someone (Jean Dey - I don't know if she's a member here or not?) did post after and asked him specifically about the bile being in contact with food for the longer length of intestine. He hasn't yet responded. I hope he does.

We've asked Dr. Tuğrul Demirel if we may share his comment here. We don't have an answer yet but if he gives us permission, we will be glad to share it.

 

[brooklyngirl]

@star0210 - just an FYI that I'll share with you since your post made me think of it....There was at least one person I can think of whose surgeon dismissed him as a patient for posting their correspondence on a forum. I'd hate to see that happen to you, maybe just paraphrase next time? Or ask if they mind the response being shared?

 

[star0210]

@star0210 - just an FYI that I'll share with you since your post made me think of it....There was at least one person I can think of whose surgeon dismissed him as a patient for posting their correspondence on a forum. I'd hate to see that happen to you, maybe just paraphrase next time? Or ask if they mind the response being shared?

Thanks...I felt comfortable posting it since he's given others permission to post his responses and has shared his email address publicly and posted himself on the pro boards site. He's not my surgeon at any rate.

 

[star0210]

We've asked Dr. Tuğrul Demirel if we may share his comment here. We don't have an answer yet but if he gives us permission, we will be glad to share it.

I saw that and I hope he responds and gives permission. His response made me view the whole subject from a different perspective.
My brain sees it the same way that @DianaCox sees it. So his take on it was quite interesting to me.

 

[Elizabeth N.]

I'd be surprised if he withheld permission to repost his remarks, but it's always better to wait and do it right .

 

[brooklyngirl]

Thanks...I felt comfortable posting it since he's given others permission to post his responses and has shared his email address publicly and posted himself on the pro boards site. He's not my surgeon at any rate.

Ok, good