Comments on: Adoption on condition of gastric bypass surgery http://www.kevinmd.com/blog/2007/08/adoption-on-condition-of-gastric-bypass.html Wed, 15 Feb 2012 00:05:00 +0000 hourly 1 By: Anonymoushttp://www.kevinmd.com/blog/2007/08/adoption-on-condition-of-gastric-bypass.html#comment-79556 Anonymous Sun, 26 Aug 2007 20:00:00 +0000 http://clients.emmense.com/kevinmd/2007/08/adoption-on-condition-of-gastric-bypass-surgery.html#comment-79556 To Anonymous 10:02:<br/><br/>GB is still the gold standard for long-term weight loss, especially at BMIs 35+. The band seems to do fine at lesser weights, and I've seen some fabulous results with people who can afford chefs and personal trainers, but most people abuse the band tremendously rather than using it as a tool -- the dumping syndrome the GB causes makes it more motivational.<br/><br/>To be honest, I don't know how the Europeans are getting their long-term results with the band. The successful surgeons here seem to go with the bulimic band theory: if you aren't throwing up when you eat a cup or two of food, it's time to come in and get an adjustment.<br/><br/>As for morbidity and mortality of the GB, if you're getting it laparascopically at a high-volume academic center and your BMI is under 65, you should see death rates of well under 1%. If you go to some guy who did a course last year and opened up a chop shop in the suburbs, they're playing Russian roulette. If your BMI is 65+, reasonable surgeons tell you to check into a weight loss program until you're safe for surgery. And anyone at 60+ ought to think about two-staging it anyway -- you may have the best surgeon in the world performing your surgery but do you really want to risk muscle ischemia? There's not enough padding in the world to prevent that if you're on the table seven hours while they're wading through your belly fat. To Anonymous 10:02:

GB is still the gold standard for long-term weight loss, especially at BMIs 35+. The band seems to do fine at lesser weights, and I’ve seen some fabulous results with people who can afford chefs and personal trainers, but most people abuse the band tremendously rather than using it as a tool — the dumping syndrome the GB causes makes it more motivational.

To be honest, I don’t know how the Europeans are getting their long-term results with the band. The successful surgeons here seem to go with the bulimic band theory: if you aren’t throwing up when you eat a cup or two of food, it’s time to come in and get an adjustment.

As for morbidity and mortality of the GB, if you’re getting it laparascopically at a high-volume academic center and your BMI is under 65, you should see death rates of well under 1%. If you go to some guy who did a course last year and opened up a chop shop in the suburbs, they’re playing Russian roulette. If your BMI is 65+, reasonable surgeons tell you to check into a weight loss program until you’re safe for surgery. And anyone at 60+ ought to think about two-staging it anyway — you may have the best surgeon in the world performing your surgery but do you really want to risk muscle ischemia? There’s not enough padding in the world to prevent that if you’re on the table seven hours while they’re wading through your belly fat.

]]> By: UroCanswerhttp://www.kevinmd.com/blog/2007/08/adoption-on-condition-of-gastric-bypass.html#comment-79549 UroCanswer Sun, 26 Aug 2007 07:03:00 +0000 http://clients.emmense.com/kevinmd/2007/08/adoption-on-condition-of-gastric-bypass-surgery.html#comment-79549 Gastric bypass, especially laparoscopic or robotic, has a very low morbidity/mortality now. As in most things, just make sure the surgeon is high-volume and well-trained at it. The lap band is somewhat newer. I think if I was 500+ lbs, and the gastric bypass surgery has gotten safer, I'd opt for that over the lap band. I do agree with the comment above. He seems motivated to do just about anything for his kid. Probably a great dad. Just my 2cents.<br/>-UC<br/><br/>===<br/>http://www.UroCanswer.com Gastric bypass, especially laparoscopic or robotic, has a very low morbidity/mortality now. As in most things, just make sure the surgeon is high-volume and well-trained at it. The lap band is somewhat newer. I think if I was 500+ lbs, and the gastric bypass surgery has gotten safer, I’d opt for that over the lap band. I do agree with the comment above. He seems motivated to do just about anything for his kid. Probably a great dad. Just my 2cents.
-UC

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http://www.UroCanswer.com

]]> By: Anonymoushttp://www.kevinmd.com/blog/2007/08/adoption-on-condition-of-gastric-bypass.html#comment-79546 Anonymous Sun, 26 Aug 2007 03:02:00 +0000 http://clients.emmense.com/kevinmd/2007/08/adoption-on-condition-of-gastric-bypass-surgery.html#comment-79546 The guy is really trying hard - he lost about 70 pounds before he even had his surgery. My one question is this: why is gastric bypass being done when some patients die, while lap band procedures are available and are much safer? The guy is really trying hard – he lost about 70 pounds before he even had his surgery. My one question is this: why is gastric bypass being done when some patients die, while lap band procedures are available and are much safer?

]]> By: Christine-Meganhttp://www.kevinmd.com/blog/2007/08/adoption-on-condition-of-gastric-bypass.html#comment-79545 Christine-Megan Sun, 26 Aug 2007 01:50:00 +0000 http://clients.emmense.com/kevinmd/2007/08/adoption-on-condition-of-gastric-bypass-surgery.html#comment-79545 If he was willing to do that, I have no doubt he'll be a great father. If he was willing to do that, I have no doubt he’ll be a great father.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2007/08/adoption-on-condition-of-gastric-bypass.html#comment-79534 Anonymous Sat, 25 Aug 2007 21:14:00 +0000 http://clients.emmense.com/kevinmd/2007/08/adoption-on-condition-of-gastric-bypass-surgery.html#comment-79534 Well you can't even discriminate against the fudge packers anymore, so who else are you going to go after? Well you can’t even discriminate against the fudge packers anymore, so who else are you going to go after?

]]> By: Toni Brayer MDhttp://www.kevinmd.com/blog/2007/08/adoption-on-condition-of-gastric-bypass.html#comment-79531 Toni Brayer MD Sat, 25 Aug 2007 17:55:00 +0000 http://clients.emmense.com/kevinmd/2007/08/adoption-on-condition-of-gastric-bypass-surgery.html#comment-79531 This takes "fat discrimination" to a new high. This takes “fat discrimination” to a new high.

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