VBG to DS Revision ?'s (Surgeon Decisions)

[jillc]

Hello there,

So, I think I've narrowed my surgeon choices down to either Marchesini or Lutrzykowski. Some people say stay away from Dr L, but I can't find any first hand experiences that are damning.

So here it is. Marchesini:

1. Is one of the top bariatric surgeons.
2. His prices are affordable.
3. But he's in Brazil. And I think I would be alone in Brazil for surgery.
4. He does either open or lap. But here's the thing - I've watched tons of videos and I think it was Rabkin and Keshishian both advise against lap revisions. Is Marchesini skilled enough, or has lap surgery become better?

Lutrzykowski:

1. I'm Canadian and he was a primary provider for OHIP (Ontario Health Insurance Plan). I'm not from Ontario, but for one of our provinces to approve of a surgeon, he's vetted. I'm from Alberta, which doesn't even have DS as an option and it's a 5-7 year waiting list. It won't fund out of province WLS surgeries either. Although I am going to appeal, and I can claim it on my taxes.
2. Also affordable. I won't go to a surgeon just because of his price, though.
3. I got sent his pre-op diet which I found confusing in its rationale. It's low carb, but not low carb as I know it (also uploaded, in case I'm off base).
4. I haven't spoken to him yet, I have to get an upper GI, a bone scan, an EKG and a chest Xray plus a panel of tests. I'm attaching the panel of tests to see what ppl think.

Any input from DS revision patients of either surgeon? Or input from anyone who has an opinion would be greatly appreciated.

 

[Spiky Bugger]

No solid BAD info from me that I recall, except that I have been on these boards for about 12 years and, given the opportunity, I would go to Marchesini.

There used to be online diaries of the wonderful experiences people had there. Damn, I wish I were up for that kind of travel!!!

Maybe you can find someone else who will be going at the same time.


NOW, that said, the flight home from Monterrey, Mexico after the band and the drive home from the DS were NOT good experiences. I guess I'm just not a good post-op traveler.

 

[jillc]

Spiky,

My gut tells me to go with Marchesini. But I'm getting familial pressure to go to Detroit. My mom's a retired RN, but she's also 75 and I told her that I wouldn't want her to travel to Brazil, and I don't think she's keen on it.

But she would come to Detroit with me.

How long after your surgery did you travel? I think Marchesini requires you to stay 2 weeks.

Thanks for your input I really appreciate it!

 

[Charris]

I would darn there take the DS Gods , Rabkin and Keshishian, words as the gospel about lap revisions. I know Dr K only does open revisions is what he said because he doesn't know what he will find once her gets in their.

 

[jillc]

Charris,

Open is an option with Marchesini. And I think although I would love to have a lap surgery, I think I agree. Less chances of complications with open.

I have visceral memories of my open surgery in 1988. I hope the pain management is better now (and hope the incisions are shorter)!

Thanks,
Jill

 

[Spiky Bugger]

Spiky,

My gut tells me to go with Marchesini. But I'm getting familial pressure to go to Detroit. My mom's a retired RN, but she's also 75 and I told her that I wouldn't want her to travel to Brazil, and I don't think she's keen on it.

But she would come to Detroit with me.

How long after your surgery did you travel? I think Marchesini requires you to stay 2 weeks.

Thanks for your input I really appreciate it!

I stayed in town...I think... a week after the DS. And it was only about a 3.5 hour drive home. I think I'd have done much better at two weeks.

In retrospect, I think that L's skill set is alleged to be just fine, but that he suffers from the same superiority complex so many US doctors are plagued with. I don't know why I think that...nothing specific comes to mind...but my gut level would be Marchesini as well.

I recall one diary wherein we were treated to the great nursing care provided by a male nurse who was, at best, a tad fey...and who just mother-henned the patient to bits. She wasn't quite sure about what to do with this guy flitting about her hotel room...helping her tidy herself up...his English wasn't great (Dr. M is fluent) and she spoke no Portuguese. But it was fun reading.

Here's what I think. Make friends with @Larra . She's an experienced world traveler and I think she really needs to go to Brazil! You could go a week early, see some sites and she could promise not to leave until you were well on your way to recovery.

Problem solved!

 

[jillc]

I like it

 

[SHales]

I have seen a LOT of complications from postops that used Dr. Lutrzykowski. Enough of them that I don't even recommend him for a virgin DS. Call Dr. Marchesini and speak with him about lap vs open and your concerns. I know that it is not recommended to have lap with an RNY to DS revision and the surgery your are having is different. I went to Brazil alone, while it is not optimal, it is doable and there are usually other US patients at the hotel. Also the hotel is next door to Dr. M's office and you will have all of his phone numbers, including his private cell and home phone. I l9oved the man and would have married him but 1. he was already married and 2. he didn't ask. His postop eating plan sucks so just smile and nod. Oh, and the medical care I received in Brazil was far, far better than anything I have ever had in the US. (I have had a lot of surgeries, lol)

 

[Mary_J]

I'm with SHales . . . . many years on forums and Dr L seems to have come up too often in the negative category. The VBG to DS revision isn't a simple revision (none are of course). From reading your post, I'm guessing 1988 was the year of your VBG. Do you have your surgical report? The band material they used in mine in 1985 is known to promote massive amounts of adhesions. I can never remember the name, but it starts with an 'm' I think. Dr M will want to know that for sure!

 

[jillc]

Thank you SHales. Everyone has nothing but good things to say about Dr. Marchesini. Great info about Lutrzykowski, too, I've heard whispers but nothing concrete.
Good to know about going it alone. If I go to Marchesini, do you mind if I pick your brain about Curibita and ask advice? Too bad he was married and he didn't ask

Mary_J, like me you probably have a mesh band. Yep it was in 1988 when hair was back-combed and I loved Duran Duran. We're the old type before they changed to a silicone ring. There's a great video on Youtube that shows the removal the the silicone ring and it' easy peasy. Not so much for us. They have to re-section our stomachs.

I am lucky enough to have my surgical report. I chased it down and the hospital I had the surgery in still had it 26 years later. I have sent it to Marchesini and Lutrzykowski.

Thanks for the advice. I want to go to Marchesini and I think I will, I just have to nudge my family so I don't go feeling the weight of their guilt on top of the weight on my body.

 

[SHales]

I will help all I can, It has been 9 years since I have been there. We can probably find more recent patients, though.

 

[Mary_J]

I actually still have my intact VBG. I contacted three prominent surgeons (at the time), and because I had already had a revision (repaired open staple line), they were all hesitant to touch my stomach because it was likely very as fragile as wet tissue paper. I was no way in hell going to wake up with an ERnY! So, I chose to have just the intestinal portion done.

 

[jillc]

Thanks SHales!

Mary_J - I can see that being an option, but personally, if I can stop the blockages and emesis by getting rid of it, I will. Are you coping with it? How has your weight loss been?

I don't think I have any staple line disruption, but the upper GI will tell me that. I will be very specific. It's DS or nothing. They can close me back up without cutting me before I will accept another surgery. It is worrying though about what they will do to you while you are under the knife.

I am keeping my pylorus. It's proving to be very integral to successful bariatric outcomes from what I've seen.

 

[Mary_J]

I lost from 325 to 125 (for a New York minute, after both my plastic surgeries). I hung around 135 for several years, then life changes (change of jobs, medications, and quit smoking)! I'm now at about 150 at 6.5 years post op. Take the intestinal bypass alone, if they can't do the complete take down and full surgery . . . it works better than the VBG alone!

 

[jillc]

Mary_J Is the 325 from the VBG or was that the weight you were when you had the intestinal portion done?