Steps to finding a surgeon - ThinnerTimes - Gastric Bypass Forum, Lap Band Forum, and Vertical Sleeve Gastrectomy Forum

John · 05-22-2008, 05:52 PM

What steps did you go through to find the right bariatric surgeon?

Advice you would like to pass along to newbies?

I would like to build this into a sticky thread.

blisandt · 05-22-2008, 05:55 PM

I am going through this right now, so I will watch this thread...

My PCP is in favor of OPEN RNY - strongly in favor of it. And we have a great doc on board for it... but we wonder if Laparoscopically IS indeed the way to go (and for that we don't have a great doc on the line yet).

As I said, my Dad and I are still in the selection phase. The operation is for me.

If there are any past threads that debate this issue specifically, please point me toward them.

Thanks!

Godsblessedme · 05-22-2008, 07:58 PM

personally i would seriously question your PCP's knowledge of GBS at all and i would say thank God he's not doing the surgery. I think definatly an experienced surgeon with BOTH types of the RNY is required.

Being that i've worked in medical for a while i would always go on the board of med. examiners site and make sure they have no open or pending cases. and then goto the orientations and ask tons of ?'s are they a Center Of Excellence, What is the mortality rate? etc.. and let me say this, if a surgeon ever says "o i havent lost a patient yet"... run the other direction because that usually means either they dont have enough surgeries under the belt or there lying. Even the most capible surgeons will have patients expire on them not neccesarily the docs fault either. maybe see if they have other patients you could get some "reviews" from or word of mouth is always good too

O in my case i was reffered to a doctor (who a few here have had as a surgeon) but i knew this man had litterally too many patients being admitted to the hospital for "complications" and many deaths due to sepsis and stuff so i chose another doctor. Its always nice if you work in a hospital and are privy to that information

rappaport · 05-22-2008, 08:05 PM

I was referred by my PCP, but my only criteria was that the surgical center be rated a "Center of Excellence". I knew this meant that they had an excellent pre-op and post-op support, the surgeons were tops in the field, and that they worked with only the best anesthesiologists.

MiladyB · 05-22-2008, 09:34 PM

Working in the hospital where the bariatric program is was a plus for me. I already knew the reputation of all bariatric surgeons in the area. There are 2 different practices in the area and though both have the Center of Excellence rating I was able to quickly narrow it down to one practice. The other practice ONLY did the RNY open and I knew that I wanted it done lap.

In looking at which of the 3 surgeons I wanted from this one practice I looked at experience. Though all are very gifted surgeons and all have low complication rates I wanted the most experienced of the 3 surgeons.

I was a high BMI, had numerous co-morbidities and was almost 50 years old. Taking all of those into consideration my surgeon's experience was the main reason I picked him.

This is some information I have for members of my support group. I feel the points that are made in this article are some of the key things people should look at when picking a surgeon.

Quote:

It is extremely important to find a legitimate surgeon if you are considering having a bariatric procedure. Most surgeons in the United States are competent, but not unlike many other areas of medicine there are a few “quacks” out there that should be avoided. Even though all such surgeons are required to have certification, some surgeons have more training and/or experience than other surgeons. Reviewing a doctor’s credentials is an essential element in choosing the right bariatric surgeon.

It is a good idea to look for surgeons who offer the most modern gastric bypass techniques and/or utilize the latest advances in LAP-Band technology procedures. The bariatric surgeon or surgeons that you are considering should have an exceptional success rate with low incidence of serious complications. In general, bariatric procedures have a high success rate, but there are still risks involved as there are with any surgery. Choosing an exceptional surgeon will help to minimize these risks.

It is vitally important that you do not allow cost to be the determining factor when choosing a bariatric surgeon. In some cases, surgeons will charge less due to inexperience, lack of training, or both.

Bariatrics involves more than just surgery, so it is essential to find a surgeon and clinic that addresses all your individual needs and concerns. A bariatric treatment facility should have the following:

An office staff that is knowledgeable in regard to the specials needs of bariatric patients.
A staff that understands insurance problems and the issues that can arise with third party payers.

The clinic should have special facilities and equipment for obese patients.
It is also essential that hospitals that board bariatric patients to be supportive throughout the surgical process. The following are suggested questions for patients to address:

Are the anesthesiologists comfortable with morbidly obese patients?
Is the nursing staff knowledgeable in regards to the special needs of bariatric patients?
Are there special facilities available to larger patients?
Does the hospital openly promote its bariatric program?
Are intensive and critical care facilities sufficient and acceptable?
There aren’t any “written in stone” guarantees in any branch of surgical medicine.

Occasionally even simple procedures have unanticipated results. However, this risk can be minimized if a patient is willing to do his or her homework when choosing a surgeon.

Experience of a particular surgeon can be determined by several components:

Number of years in the bariatric branch of medicine
Number of surgeries performed by a particular surgeon
Variety of procedures that a surgeon has experience performing
Participation and/or leadership in a professional organization specifically dedicated to bariatrics

Current data suggests that complication rates, including mortality rates, have a direct correlation to the number of surgeries that an individual surgeon has performed and the number of procedures that have been performed at a given hospital or surgical clinic.

Certification by the American Board of Surgeons shows that a particular surgeon has done the following:

Completed a training program accredited by the American Board of Surgeons.
Passed both oral and written examinations given regularly by the Board to new surgeons upon completion of training
Recertification is required through another written exam every ten years in order for surgeons to maintain active certification status.

This certification is necessary for surgeons to obtain membership with most professional groups specific to their field.

The American Society of Bariatric Surgeons (ASBS) is the only professional society in the United States specific to the field of bariatrics. The ASBS has proposed requirements for certifying both hospitals and surgeons regarding the special needs of severely overweight individuals.

The ASBS also gives educational seminars and classes for its members and other interested individuals throughout the year. Many ASBS members believe that a competent bariatric surgeon should regularly attend ASBS meetings and maintain current knowledge and training in the latest treatment methods and technologies in the bariatric field.

To attain a regular membership in the ASBS a surgeon must be certified with the American Board of Surgeons and be in current good standing within his or her community. Affiliate members either lack experience in the bariatric field (have performed less than 25 procedures), are not Board certified, or both.

A legitimate and qualified surgeon should be able to clearly answer your questions-without causing any additional confusion-regarding the exact details of the procedure you are considering. Many surgeons require that you meet with a nutritionist and/or a psychologist. This is to help build a clear and solid understanding of the entire bariatric therapy process both before and after the surgical procedure and the changes in behavior that are necessary for the long-term success of the bariatric procedure.

Ultimately, it is up to you to make the final decision when choosing a bariatric surgeon. Upon gathering the necessary information and checking surgeons’ credentials, you must choose the surgeon with whom you are the most comfortable and who you believe will best accommodate your individual bariatric treatment wishes. However, you must keep in mind that ultimate success depends mostly on your own commitment to making lifelong lifestyle changes after the surgery.

bridgetgirl · 05-22-2008, 11:33 PM

You will want a Surgeon who has done over 200 cases. Dont accept anything less, you are not an expert unless you have done 200. Ask for his CV. It's like his resume, you can find out what medical school he went to, any additional training he may have received specializing in GBS. Ask why he specialized in prior to the surgery. Ask how many patients have died as a result of him performing GBS. Ask how or why they died. Then you can compare the amount of cases vs. the amount of deaths and see where he fits in the national average. There are alot of resources available that can help you on line. Gastric Bypass.com - Your Guide to Weight Loss Surgery may be of some help. Also try Obesity Help - Weight Loss Surgery, Obesity Support Groups, Obesity Forums, Surgical Procedures there you can info and different surgeons in your area.

blisandt · 05-23-2008, 05:33 AM

This is all great folks. Thanks...

My present "quirk" is: why is the "latest procedure" the one you want?

I am referring to the checklist in MiladyB's post which reads "It is a good idea to look for surgeons who offer the most modern gastric bypass techniques and/or utilize the latest advances in LAP-Band technology procedures."

I am not in any rush to return to work - this is too important a step for that to be a consideration.

I am pretty certain the possibly additional discomfort of open can be managed.

And the safety issues of and open and exposed operation site outweigh the risks of it (and do away with the risks of leakage (found or unfound in so many lap RNYs) almost completely)...

I am not trying to be argumentative here, folks.. just thinking it out for myself.

Thanks for all the time and care you put into your posts and responses.

veroniquetalk · 05-23-2008, 08:32 AM

I had been in therapy for eating disorder (binge eating) for two years. When I finally decided I was tired of the yo-yo losing and gaining cycle and decided on this surgery my therapist recommended my surgeon. He ROCKS - Dr. Howard Lederer.

Omaha Jim · 05-23-2008, 10:21 AM

Quote:

Originally Posted by bridgetgirl

You will want a Surgeon who has done over 200 cases. Dont accept anything less, you are not an expert unless you have done 200. Ask for his CV. It's like his resume, you can find out what medical school he went to, any additional training he may have received specializing in GBS. Ask why he specialized in prior to the surgery. Ask how many patients have died as a result of him performing GBS. Ask how or why they died. Then you can compare the amount of cases vs. the amount of deaths and see where he fits in the national average. There are alot of resources available that can help you on line. Gastric Bypass.com - Your Guide to Weight Loss Surgery may be of some help. Also try Obesity Help - Weight Loss Surgery, Obesity Support Groups, Obesity Forums, Surgical Procedures there you can info and different surgeons in your area.

I was a bit more stringent than the 200 surgeries number. I wanted a surgeon that had performed in excess of 500 as a starting point.

I first researched the Surgeons in my area, no matter what their speciality. Googled and Medical searched the ones I found. It is amazing what you can find on the internet. After narrowing down the number to the top three, I went to all of their seminars. Specifically asked about their stats. Number of surgeries, number of deaths, leakers, re-surgeries, etc.

The three I chose, one does the open DS, and two specialized in LapRNY. I asked the doctors, why they preferred one surgery over the other, I asked them to comment on other surgeons.

Then I prayed.

I prayed more, and made the correct decision.

You are dealing with your life here. Do not take this decision lightly.

snick1899 · 05-23-2008, 02:21 PM

My surgeon actually found me. I was in the hospital last year for what they thought was apendicitis (sp?). My bariatric surgeon was going to be the surgeon to take my apendix out if I had the operation. He spoke with me about the bariatric surgery, but my insurance company at the time didn't cover it. I kept his card and called him when I switched employers and got better insurance.

I did some research on him and he has done several hundred bariatric surgeries, not major complications or fatalities to date. I made my final decision when I met with him in his office the first time and he made my questions and concerns the most important thing on his agenda. That made me put my trust into him from that point on.