Hi all,
I am having three stage IPAA, and I already had the first stage done with Dr Alexander Greenstein at Mt Sinai in NYC. I am going to have the next stages soon, I need to decide on a surgeon/surgery technique for my j-pouch construction.
Dr Alexander Greenstein is the son of Dr Adrian Greenstein, who was a legend in j-pouch surgery. He was trained by his father, went to Cornell, and does a large number of j-pouch surgeries at Mt Sinai, as they have an IBD research center there. He is proficient in laparoscopic surgery for j-pouch construction.
Dr Remzi is an expert on pouch reconstructive surgery, and if you search his name on this website, you will see that he is a legend here on the forums among people with problematic pouches. His assistant says he does fifty-fifty pouch reconstruction and fresh j-pouches. He does the first and last step surgeries laparoscopically. However, he does the second step, the construction of the pouch, as an open surgery.
BTW, as a side note, he prefers three stage IPAA over two stage IPAA for all patients (not just weak patients), and recommends a six month wait between the first and the second stages (google mesenteric tension to understand why), and a three month wait between the second and the last stages. Dr Greenstein, on the other hand, recommends a five month and a two month wait respectively. The waiting time between surgeries is not a deciding factor for me, as I am quite happy with my ileostomy, to the point that I even considered not getting a j-pouch at all. Anyways, the surgery technique is the deciding factor for me.
Now, I have to make a decision between the two surgeons/surgery techniques. Dr Remzi/open surgery vs Dr Greenstein/laparoscopic surgery.
I am not concerned about the scar, because Remzi makes a small scar under the bikini line for women. I am more concerned about all the horror stories I read here on untreatable pain due to adhesions, and obstructions due to the adhesions, both problems that can surface many years after the surgery. Open surgery leaves more adhesions than laparoscopic surgery. I am not sure whether I should go with Dr Remzi, although he is called “Remzi the great” on the forums, due to my fear of adhesions.
Dr Remzi told me that Dr Greenstein is a very good surgeon, therefore he does not need to offer me to the surgery himself. Therefore, I think, since Dr Remzi also thinks Dr Greenstein is going to do a good job, and Dr Greenstein would do the j-pouch construction laparoscopically, why bother with open surgery, even if it would be “Remzi the great” doing it. What do you think?