Questions re Dr Marchesini

[nejy22]

Hi everyone,

I have received an initial reply email from Dr. Marchesini regarding my interest in having a DS revision (I had gastric bypass in 2009). I have gained back almost half of what I lost and cannot seem to lose anymore. I am confused by the info he has provided me with so far.

He recommends a biliopancreatic diversion without the switch. I have read a lot about people saying this is an old method and not very successful. As stated in his email "To convert to a biliopancreatic diversion with duodenal switch the stomach will need a reconstruction involving several suture lines that will offer higher risk of leakage and fistula...The difference between biliopancreatic diversion with and without duodenal switch is the way to cut the
stomach. In the first one the gastrectomy is distal and in the duodenal switch the gastrectomy is vertical (sleeve). The final results are the same"

Is there anyone that can help me understand his recommendation further? I have been doing quite a bit of research but hoped to hear from someone that the Dr has done a complete DS revision on them. I have read that he does do this revision so that is why I am confused.

Thanks for reading : )

[Deleted]

A lot of the overseas surgeons are hesitant to do a true RNY to DS revision for the reasons Dr.M stated. Dr. Baltasar is saying something similar, I have heard.

The RNY revisions have a high incidence of complications and they do not want to send you home and have you develop complications and they do not want you to end up being in a foreign country for weeks and weeks should you have complications. How long could you stay in Brazil should you have complications?

I understand their reasoning but I would not agree to the surgery he is suggesting.

I love Dr. M and know that he is a very skilled surgeon but I do not recommend RNY to DS revisions to him or any of the foreign surgeons anymore.

Have you looked at Dr Stewart in Texas?

[nejy22]

Thanks Shales. That is what I have found while reading through posts today. I guess I can stay in Brazil only until the money runs out LOL. But I have read of Canadians going to Brazil for this revision, I believe. So hopefully I will have a response from some of them??? Any idea what Dr. Stewart charges?

[Deleted]

Don't hold me to it but I *think* Dr. Stewart charges somewhere in the neighborhood of $25K. Call or email him.

Dr. M has done a LOT of RNY to DS revisions but if there is a complication you are stuck. Either in Brazil or the US.

Do you know if your pouch is stapled or completely transected?

[nejy22]

Nope no stapling

[Deleted]

RNY to DS revisions are the most complicated of all surgeries. Pouches that are completely transected (cut off from stomach) are even more complicated. That could be the reason for his answer. I know a few that ended up with the old BPD due to the complications. I know a few surgeons that won't touch them.

I am not trying to scare you but it is what it is. You could email Dr. M back and tell him that you only want the DS but his answer may stay the same.

Contact Dr Keshishian in California and see what he would charge you. He is a genius with revisions and if anyone can do it, he can!

Good luck!

[nejy22]

I just sent DR M an email asking again. He never asked about staples. I just told him I had rny in 2009 and now would like a ds due to weight regain. I do not want to go into debt so the usual $30,000 is not gonna happen. I have heard great things about Dr M so I am still holding out hope that he will do it.

[nejy22]

I received a reply from DR M regarding my need for rny to ds revision.


Dear Jennifer
Yes, I will accept doing a DS for you if you accept to have it started laparoscopically and converted to open if necessary for your safety.
As the surgical risk is greater doing this way (instead of BPD) you may need I.C.U. In this circumstance I won't be able to give a correct idea of expenses.
If you accept these conditions I will be glad to have you as my patient.
Hoping to hear from you
Regards
Dr. Marchesini

Is there anyone on here who has had DR M perform this surgery on them? What should I do???

[meta morphis]

Have you thought about dr. Gagner in montreal? If something goes wrong at least you would be covered in Canada through the health care system. He does bariatric surgery for self payers. I had my DS with him in aug. 2011.

[Deleted]

Gagner is no longer considered an acceptable option by many people here. Look up previous threads about his antics.