Dr. Roslin brings DS to Saudi Arabia

[Larra]

http://www.medpagetoday.com/Endocrinology/GeneralEndocrinology/45323

Interesting story, though I wonder if the "modified" version of the DS he did was the loop DS. His comments on how obesity became a problem in these countries so fast and so badly are interesting.

 

[Elizabeth N.]

Um well.... I have similar concerns. I remember some years ago a woman from an obviously privileged caste in India who found WLS and paid cash to get butchered in mere hours with no clue. THEN she went online to learn what she'd done to herself. She did not like what I said to her on OH and stalked me big time and did not relent until I used my inlaws' ties to the embassy world to shut her ass up. THEN she stalked my cat image until I threatened a lawsuit in US court.

Not ONCE in all that traffic did she show the slightest interest in or comprehension of what she had done to herself. She was blown away that she could no longer snarf bread, beans and tea. She had zero clue and any effort to educate her resulted in the kind of blast that required me to call in embassy level favors.

This experience leads me to question what Dr. Roslin, with whom I have corresponded about research and whom I enormously respect, did before he went and did THIS. I would like to see his appropriate documentation of the whole trail.

 

[kirmy]

I didn't see any reference to a modified DS in the article...am I missing something?

 

[southernlady]

I didn't see any reference to a modified DS in the article...am I missing something?

Here it is:

The procedures I performed were a real mixture. Several patients were very large and sick and had waited for my arrival to have surgery. For these patients, I performed a modified version of a duodenal switch, which I believe is an operation far more successful than gastric bypass. Others had much milder obesity and went to private facilities to have weight-loss surgery for social reasons.

 

[Spiky Bugger]

So...mankind is doomed because it doesn't have enough, or...upon conquering that problem...it has too much.

Ahhh....finding the Perfect Spot. Reminds me of James Hilton's Lost Horizon, where everyone in Shangri-La practiced moderation in all things. And they didn't get all fanatic about it...they were even moderately moderate.

 

[Larra]

EN, I am not suggesting that anyone was butchered. I also have great respect for Dr. Roslin and hope and trust that he discussed the surgery and its ramifications with his international patients before performing it. There is certainly nothing in the article to suggest otherwise. The reasons I found it interesting were that a highly respected American DS surgeon is traveling across the world to a very different culture and doing surgery there (not just lecturing about it, for example), that morbid obesity is becoming such a terrible problem worldwide that it is prevalent everywhere that people aren't starving, and that he's doing some kind of "modified" DS over there for whatever reason.
There are certainly plenty of bariatric surgery patients right here in the good old USA who seem clueless about what they have gotten themselves into, never mind India or elsewhere. How many posts have we seen from people with lap band who still try to eat bread, people with gastric bypass who belatedly wonder what drugs they can take for their arthritis or migraines now that they can't take NSAIDs, etc etc. The whole field of bariatric surgery is loaded with poorly informed patients. Some docs do a great job educating their patients. Others - not so much.

 

[DianaCox]

Sigh. I'm afraid Roslin is using his access to patients who are not protected (I can't believe I'm even saying that) by insurance rules to practice the SADI procedure, which he has indicated he thinks is a good idea.
http://www.obesityhelp.com/forums/ds/4657128/Attention-to-Dr-Roslins-DS-patients/

There is an actual clinical trial going on in Spain, but the comparison is between people who FAILED the sleeve, and then had a second operation, either a proper switch or a SADI: http://clinicaltrials.gov/show/NCT01685177 And the results aren't going to be known for a long time.

I am uncomfortable with this. Very uncomfortable. One thing in particular - it doesn't say he's offering it as an OPTION - which means that he's NOT offering some of the Saudis (the sickest ones) a proper DS, and that suggests lack of fully informed consent - they can chose what he is offering, or get nothing (at least from him).

 

[kirmy]

So...mankind is doomed because it doesn't have enough, or...upon conquering that problem...it has too much.

Ahhh....finding the Perfect Spot. Reminds me of James Hilton's Lost Horizon, where everyone in Shangri-La practiced moderation in all things. And they didn't get all fanatic about it...they were even moderately moderate.

It will never catch on. You're a Communist.

 

[kirmy]

Here it is:

Oh yehhhhh...comprehension skills of the town idiot! Sorry.

 

[Munchkin]

Same thing happened to the Pacific Islanders. Once you get a taste of American junk food there is no going back. Then add to it the fact that in some of these countries almost everyone is OTT wealthy with free education and healthcare. They don't have to work and can afford to hire people to do everything for them. How can that not lead to boredom and overindulgence?

But I'd still like to experience that lifestyle....

 

[Joanne]

I just emailed him and asked him what he meant by "modified' version of the DS. Without knowing his response, I will note that I have heard him use the term "modified" before when talking about a standard DS, but meaning he uses a longer CC of 125-150CM. When I read the article that is what I assumed he meant, but I'll gladly post his reply here once I hear back from him.

 

[Larra]

Thanks, Joanne!
When I posted the article here, my intent was not to criticize Dr. Roslin in any way, but rather to inform about the obesity epidemic being worldwide, or at least anywhere with unlimited access to food, and to note the DS being advocated and done in a country very different from our own. I did assume that by "modified" he meant the loop DS, which may well be a mistaken assumption on my part, but even if this is the case, that doesn't mean that his patients were not well informed as to what they were getting and what they would need to do post-op to maintain good nutritional health. And I think it's interesting (and good) that one of our best known DS surgeons is bringing the DS to a country so far away and different from ours.

 

[Joanne]

No worries, Larra.I think it's a valid question. I interpreted it one way, because I've sat through so many of his seminars where I hear him refer to his DS as "modified", meaning not the standard 100cm CC. But that being said, we have talked before about his interest in the SADI so who knows...

I'm sure he'll get back to me soon and let me know what he was referring to and why.

 

[Elizabeth N.]

EN, I am not suggesting that anyone was butchered. I also have great respect for Dr. Roslin and hope and trust that he discussed the surgery and its ramifications with his international patients before performing it. There is certainly nothing in the article to suggest otherwise. The reasons I found it interesting were that a highly respected American DS surgeon is traveling across the world to a very different culture and doing surgery there (not just lecturing about it, for example), that morbid obesity is becoming such a terrible problem worldwide that it is prevalent everywhere that people aren't starving, and that he's doing some kind of "modified" DS over there for whatever reason.
There are certainly plenty of bariatric surgery patients right here in the good old USA who seem clueless about what they have gotten themselves into, never mind India or elsewhere. How many posts have we seen from people with lap band who still try to eat bread, people with gastric bypass who belatedly wonder what drugs they can take for their arthritis or migraines now that they can't take NSAIDs, etc etc. The whole field of bariatric surgery is loaded with poorly informed patients. Some docs do a great job educating their patients. Others - not so much.

No Larra, I'm the one who used the term butchered, and it was about the woman from India.

 

[Joanne]

I just hung up with him. He said he did a variety of procedures there- VSG, DS, and Loop DS. He said that he was brought in to teach the Saudi doctors, and that he didn't choose the patients or the procedures. His role was to be in the OR to teach his surgical techniques to the surgeons there, but the patients and surgical choices were done ahead of time between those surgeons and their patients, and was beyond his scope of being there.