Doctor Introduction; Self-Pay Program

DrPleatman · 07-19-2005, 02:00 PM

Hi all.

One of my patients suggested that I "formally" introduce myself here, as there are a number of comments about me, and it would make sense for me to answer the questions myself rather than have others answer them for me.

I have specialized in laparoscopic surgery since 1989, and have been doing bariatric surgery for the past 3 years. I do both Lap Band and Lap Roux-en-Y gastric bypass. I've done about 130 of each procedure. I've always tried to be cost-effective, minimizing the use of expensive disposable instruments. After doing a number of procedures, I approached the administration at one of my hospitals and asked them to review my cases and come up with a package price for patients without insurance coverage who would be willing to pay cash up-front. Fortunately my complication rate is very low, and patients often are discharged from the hospital within a short time of their surgery. We are currently offering a package price for Lap Band of $12500, and $11,000 for Lap RNY. This includes hospital, anesthesia, surgery, and 2 years of follow-up, including fills.

I also do fills for patients who have had there surgery done elsewhere, as well as take care of issues such as slippage, erosion, and port problems.

You may be asking, "What's the catch? Why is he so cheap?" Well, the fact is, my surgical fee is actually not cheap. I'm charging $5000 for the surgery and follow-up, which is actually somewhat more than most insurance companies pay. It is the hospital that is sacrificing their profit in exchange for increased surgical volume. Why am I willing to take care of patients of other surgeons? I just figure that it is good business. If you are happy with me, you will refer your friends or family.

Please visit my website if you have further questions. I've put together a Lap Band FAQ, and would welcome other questions so that I can make it more comprehensive.

Sorry if this is long-winded.

Mark Pleatman MD
Bloomfield Hills, Michigan
www.laparoscopy.com/pleatman
248-334-5444

the best me · 07-19-2005, 02:48 PM

Thank you Dr Pleatmen.

I have a question and since I'm not a medical person, I hope I can ask this well...it has to do with the band and stoma. I know the stomach is supposed to be tightly in place as it passes through the band, creating the stoma. It is not supposed to slip up and down inside the band, yes? So does the band, a non-eroded band, embed itself into the outside stomach wall? Or is there always a "loosness" between the band and the stomach? This may be better asked this way? Is the band suposed to adhere to the stomach as it heals? This would, it seems to me, help prevent slippage but increase the risk of erosion? Also, I think there are 2 types of erosion: from the outside in and from the inside out. Maybe that could be answered on your FAQ page?

The slip/erosion potential is always hanging over my head, as with many other banded patients. I suppose it helps to have an idea of what's going on inside. I want to keep my band for a very long time (forever!) but, frankly, I wonder if it will last. It doesn't seem possible for the band and stomach to "get along together" well enough to last a lifetime, but other implants last as long, so why not? But then, the stomach is soft tissue, not a hip bone. I dunno, just a question to ease my mind?

Sorry so long-winded...hope my ramblings give you an idea of my concerns. If it can improve your FAQ section, all the better. BTW, the FAQ section is great!

Again, thanks!

hagerteresa · 07-19-2005, 03:15 PM

Hi Dr. Pleatman,

It is very nice to meet you. I wish I lived in the Michigan area so I can take you up on the aftercare offer but alas... Oregon is a long ways from Michigan. My planned aftercare doctor recently lost his bariatric insurance and can no longer serve my needs. I am going to have to find a doctor elsewhere in the state or go up to Washington state. Anyway thanks a bunch for introducing yourself and hopefully you will make yourself available to answer the occassional questions. Best wishes, Teresa

DeLarla · 07-19-2005, 03:26 PM

Dr. Pleatman, how come you haven't accepted my offer of running a clinic out of my Vegas home? Please?

Okay, kidding, but thanks for the intro. I really wish someone like you would come to Vegas though.

I'llsucceed · 07-19-2005, 10:16 PM

WELCOME DR.P

Dr.Pleatman is the surgeon that performed my Lap Band surgery. I hope everyone will say hello. He is a great asset to those of us in need of a knowledgeable, reliable, afforable Doctor. I know that we will truely benefit from his expertise. He is so wonderful at answering questions but hopefully we all will take the time to do searches & view his site prior to asking. If you can't find an answer, I know he will do his best to answer your concerns quickly & honestly.

On a personal note he & his staff are extremly caring.

I respect them all.

Great question on erosion Kathy! I think we all worry about that one.

Parvathi · 07-20-2005, 12:12 AM

Welcome to the boards, Dr. Pleatman. There's always people around here looking for a good doctor, so you've come to the right place :)

Joyce in VA · 07-20-2005, 06:05 AM

Welcome Dr. Pleatman. I loved your web site especially the fact page.

**gordonfamily3** · 07-20-2005, 06:22 AM

Thanks so much for taking the time to post here. It is nice knowing there are Drs out there that really care about their patients and others. I look forward to hearing more from you.
(I was a lucky one my insurance paid 100% of it, it would be nice if the insurance companies would come around more for everyone.)

pati-o · 07-20-2005, 10:50 AM

Dr. Pleatman,
Thank you SO MUCH for posting this information!
I am so grateful to you for doing my fills and look forward to having you do any fills I will have in the future.
I work as an OPS R.N. in the Kazoo area, and most of the medical professionals that I've spoken with are completely unfamiliar with the Lap Band procedure. So, as time goes by and I tell new people about the procedure, I also tell them where to go to have it done- and I've given ALL of them your name.
Thanks for providing such great care, I really appreciate it!
Pati Smith

DrPleatman · 07-20-2005, 08:37 PM

Let me clarify some issues about band erosion. When the banding operation was first developed, few sutures were placed to hold the band in place. In a short time, it was recognized that this was a bad idea; there was a very high incidence of band slippage. To solve this problem, many sutures were placed from the stomach below the band to the stomach above the band. This anchors the band in a tunnel and maintains its position. If too many sutures are placed, or they are too tight near the buckle, there is a risk of the hard silicone rubber of the buckle to erode into the stomach. This potential problem was recognized fairly early after band erosions started to appear, and most surgeons now know not to place too many sutures in this area. Band erosion is very uncommon now. It's a matter of not too many and not too few.

The good news is that most band erosions (and slippages) generally occur within the first 3 years of the initial surgery. After that, the incidence of these problems drops off. In other words, if there is going to be a problem it will happen in the first 3 years.

I hope this answers your question.

Mark Pleatman MD
www.laparoscopy.com/pleatman

aaamom · 07-20-2005, 08:45 PM

just curious, but why would the Lap Band cost MORE than gastric bypass? You would think the gastric bypass is much more complicated

DrPleatman · 07-20-2005, 09:45 PM

The Lap Band itself costs $3000, but disposable instruments and staples for gastric bypass cost only about $1500. It does take more time to do the bypass, but for some reason the hospital doesn't worry about it. My surgical fee is the same for each procedure because I don't want patients picking based on cost. Also the Lap Band is a LOT more work to take care of because of all the fills, which are included in the fee. Bypass patients are very easy to take care of because they don't need anything!

Mark Pleatman MD

aaamom · 07-20-2005, 09:52 PM

Thanks for all the info. Welcome aboard. So nice to have you here !!

HarleyNana · 07-21-2005, 09:13 AM

How neat is this to have a Lap Band doctor among us! Welcome Dr. Pleatman, I look forward to your responses. Also, thanks for taking the time to chat/respond to us.

the best me · 07-21-2005, 09:26 AM

Quote:

Originally Posted by DrPleatman

To solve this problem, many sutures were placed from the stomach below the band to the stomach above the band. This anchors the band in a tunnel and maintains its position. If too many sutures are placed, or they are too tight near the buckle, there is a risk of the hard silicone rubber of the buckle to erode into the stomach. This potential problem was recognized fairly early after band erosions started to appear, and most surgeons now know not to place too many sutures in this area.
Mark Pleatman MD
www.laparoscopy.com/pleatman

Is this the "pars flacida" technique?

You are a dream Dr Pleatman! You are getting "up there" with Dr Billy in California! He has a great rep here at LBT...so that's a big compliment!! :)