Mexican Surgery and Going it Alone

[jillc]

My 2 cents. I went to Greenbaum for a revision from a VBG to DS. I was very scared of open surgery because when I had my VBG 25+ years ago, it was open and very painful.
I could afford Greenbaum (barely - as I'm Canadian and the Canadian dollar was tanking and now it's in the toilet), so I decided to suck it up and have the open surgery. Plus it was a complicated revision and it being open made me feel more secure even though I was in fear of the pain after the surgery.
The pain was there, yes. But well controlled. Greenbaum is an excellent cutter. They put you in the ICU for a day or two after the surgery and then you go on the bariatric ward. Not traumatic at all.
Being without help? That would be a problem, IMO. I was lucky to have my mother come with me. You need assistance because you need to stick around in NJ for a week after you are discharged. (TMI, I couldn't wipe my bottom - my Mother had to do it for me - get a reaching thingy to help you).

 

[Elizabeth N.]

@jillc is someone you should listen to for many read: She had mega messed up guts. She traveled lots more than you will. She is an educated health care professional. Her mom, who came with her, is a retired health care professional. She had a rough early experience. But she's fine now.

 

[Clematis]

@Elizabeth N. Ungson is no longer doing bariatric surgery. He has gone to work for the government. And so who's the SECOND best Mexican DS surgeon?

 

[Jen-2]

@aprillperkins you posted on my profile page which isn't private so I started a conversation w you. The conversation will be private unless you add others to it.

 

[aprillperkins]

That's what we are all trying to figure out.
There are a couple of posts about Dr. Greenbaum in Jersey who does an open DS for roughly the same price as Dr. Ungson.

@Elizabeth N. Ungson is no longer doing bariatric surgery. He has gone to work for the government. And so who's the SECOND best Mexican DS surgeon?

 

[aprillperkins]

Thanks Jen-2
I pm'd you

@aprillperkins you posted on my profile page which isn't private so I started a conversation w you. The conversation will be private unless you add others to it.

 

[Clematis]

I know, April. I'm the one who started this thread on Mexican surgery.

(I'm not interested in Greenbaum or any open procedure.)

 

[aprillperkins]

Oh...lol
I'm with you on no open procedures

I know, April. I'm the one who started this thread on Mexican surgery.

(I'm not interested in Greenbaum or any open procedure.)

 

[hilary1617]

Not trying to sway you as I respect the choice you've made but want to share my experience for others who may be comparison shopping as it were.

I've had five abdominal surgeries; four of which were open (two c-sections, one panniculectomy / abdominoplasty, and one massive cancer surgery). Only one surgery was performed laparoscopically (DS).

Ironically, though the lap scars were the smallest, one incision from the lap procedure hurt the most of any surgical cut I've ever had, I think because they had to wrestle fairly big chunks of my stomach out through a small hole. Were I to go back in time and do it over knowing what I know today, I probably would have gone for open.

I've had multiple surgeries on other body parts as well, but they were scattered from an anatomy perspective (e.g. tonsils, legs, nose) I don't think those would provide a fair basis for comparison.

That said, I think both lap and open are fine choices.

To me the choice of procedure is far more important than whether it is open or lap. For bariatric surgery I would only consider VSG or DS because I think pylorus preservation is critical (so that rules out Roux-en-Y) plus inserting foreign bodies into people has proven to generate significant and frequent complications (rules out lapband).

Also, I have learned three very important things about surgery:

(1) Get to the best possible surgeon - they aren't all created equal. Also keep in mind that the medical profession isn't so different from others and that a Toyota dealer will not sell you a yellow Corvette, even if that's what you want/need.

(2) Get copies of all medical records (my hospital failed to notify me about a tumor on my pancreas found during a CT scan. I only learned about it when reading my own records six months down the line.); and

(3) Advocate for yourself - Who has your best interest at heart more than you?

Best wishes!

 

[DSRIGGS]

Oh...lol
I'm with you on no open procedures

@hilary1617

What an excellent post. I am so sorry for what you have been through but you are so positive and provide wonderful insight.

I don't want to belittle or diminish anyone's fears, but the open vs Lap part should not matter if you are doing this for the right reasons. I am going to be brutally honest here ladies. Go look at Spikey's post with the pictures of the lady after major weight loss. Unfortunately many are left with a lot of excess skin so if you are worried about the scar because of cosmetic reasons, the DS will do its job but it will leave you with excess skin that you will probably not like. That cosmetic/appearance issue is unfortunately one that many have to worry about and the scar from the open surgery will pale in comparison...if that is your concern.

Here is an interesting comment from a surgeon talking about open vs lap abdominal surgery. It basically says that for lap this guys restricts patients lifting and excess straining to 2 weeks, and for Open it is 4 weeks. Is two weeks really worth not getting the best procedure and settling for a VSG that has significant potential of large weight regain?

http://www.swedish.org/blog/2013/02/activity-after-open-or-laparoscopic-abdominal-surgery


Another interesting study that says:

CONCLUSION: The short and long-term outcomes of laparoscopic and open abdominal wall hernia repairs are equivalent; both techniques are safe and credible and the outcomes are very comparable.

http://www.ncbi.nlm.nih.gov/pubmed/26074289

Another NIH study that concludes:

CONCLUSIONS:
Laparoscopic surgery has demonstrably better quality-of-life outcomes than open surgery for cholecystectomy, splenectomy, and esophageal surgery. However, open hernioplasty has at least as good, if not better, health status outcomes than laparoscopic repair.

Hernioplasty is much more akin to a DS procedure than taking out a gall bladder or spleen so I believe the bolded section is relevant when discussing DS surgical technique (open v Lap)

http://www.ncbi.nlm.nih.gov/pubmed/10653229

 

[aprillperkins]

@DSRIGGS

The reason I prefer lap over open has nothing to do with cosmetics. It is a genuine fear of mine and reading about the down time for an open surgery is just too long as well. It doesn't mean I'm doing it for the wrong reasons it means I'm being realistic about my situation. Everyone's situation and support is different and I wouldn't voluntarily put myself in that situation knowing I don't have the support it would take to go through it. If I had the support and open was my only option, as fearful as I would be, I'd do it in a heartbeat.
I believe the VSG is an excellent alternative for me. I'm looking at it as the first step and I'm going to do whatever it takes to make my tool work. If it fails me I can move on to the next step, DS. Lots of people with my bmi have great success with the VSG and hopefully I will too.

 

[robs477]

@Elizabeth N. Ungson is no longer doing bariatric surgery. He has gone to work for the government. And so who's the SECOND best Mexican DS surgeon?

WTF??? Thats not good news! Going to work for the "Mexican Government"??? I double re-iterate....WTF???????

 

[DSRIGGS]

@ DSRIGGS

The reason I prefer lap over open has nothing to do with cosmetics. It is a genuine fear of mine and reading about the down time for an open surgery is just too long as well. It doesn't mean I'm doing it for the wrong reasons it means I'm being realistic about my situation. Everyone's situation and support is different and I wouldn't voluntarily put myself in that situation knowing I don't have the support it would take to go through it. If I had the support and open was my only option, as fearful as I would be, I'd do it in a heartbeat.
I believe the VSG is an excellent alternative for me. I'm looking at it as the first step and I'm going to do whatever it takes to make my tool work. If it fails me I can move on to the next step, DS. Lots of people with my bmi have great success with the VSG and hopefully I will too.

@aprillperkins
I understand your fear of the open surgery and time to recuperate. You have to do what you feel is right. I am simply trying to make sure you have as much information as possible to make your decision. Good luck

 

[Clematis]

WTF??? Thats not good news! Going to work for the "Mexican Government"??? I double re-iterate....WTF???????

Yeah, seems weird to me that a guy becomes THE expert in DS and walks away from it to do who-knows-what for the federales. It's being called a promotion by the surgery center.

I haven't found a single review for Ungson's replacement, Antonio Esquerra.

Too bad there isn't a BLIS complications insurance program for Mexican surgery that could be used for care back home in US. (I'm not sure BLIS even applies to DS performed in the US.)

 

[Elizabeth N.]

WTF??? Thats not good news! Going to work for the "Mexican Government"??? I double re-iterate....WTF???????

Show me the evidence. Don't believe everything you read.