First of all, not all surgeons believe the BCIR is the best procedure. Plus, surgeons tend to perform surgeries that know how to do. I would ask Dr. Dietz if he has made any improvements to the K-pouch since it was first done in the USA in the late 60's and early 70's. I had my K-pouch done in NYC in 1976. If I were to have a valve repair done now, I would ask Dr. Bauer if he has developed any improvements to the procedure over the years. I would explore the BCIR as well.