AboutJohn Pilcher, MD Expertise I can answer medically oriented questions about bariatric surgery including: patient
selection, preparation for surgery, differences between types of bariatric surgery, aftercare
following bariatric surgery. I can answer detailed questions about gastric bypass, Lap-Band, gastric sleeve, and revision bariatric surgery. I am only somewhat familiar with
Biliopancreatic diversion. I am not prepared to answer insurance or other financial
questions related to bariatric surgery.
Experience I have been a practicing bariatric surgeon since 1995. About 85% of my current practice consists of bariatric surgery, including all of the above procedures except biliopancreatic diversion. I am the senior surgeon of a 5-surgeon group. I am recognized among surgeons and other medical professionals as the most experienced bariatric surgeon in my region.
Organizations Fellow of American College of Surgeons
Member, American Society for Bariatric Surgery
Education/Credentials BA in Biochemistry - University of Virginia
Medical Degree - University of Virginia
Surgical Residency - University of Virginia
Expert: John Pilcher, MD Date: 7/11/2008 Subject: Bariatric Revision Surgery
Question Twenty-six years ago, I had a gastroplasty surgery. After losing 110 lbs., I had a complete obstruction (stomach pouched tipped over when solid food entered) even though I was following all the rules, & the gastroplasty was reversed. I'm now back to a BMI of 42, & I've been told recently that I am not a candidate for laprascopic surgery and would need to have a revision. What risks would I be facing, & would I even be considered as a revision candidate? If so, who is the best "revisionist" in my region (I live in Ashland, KY)? THANKS!
Answer Linda,
My opinion is that revision surgery would be fairly risky because of the old scar and the disruption of your gastric anatomy, BUT that it may well be worthwhile from a health standpoint because of your increasing weight. There are some surgeons who would aim to do a revision like this using laparoscopic techniques, but many other excellent surgeons who would only attempt this using an open approach.
I don't really have a handle on who is the best "revisionist" in KY but to be honest I would be cautious about promoting a certain surgeon in any case. I think you can't easily go wrong if you go to a surgeon & program who have been designated as a Center of Excellence. You can find such surgeons in your area using our national organization website at: www.asmbs.org
Given the complexity of your case, you may need to visit with more than one surgeon or program.
