These might be dumb questions...

But i'm going to ask them anyway since dumb questions seem to be my forte`.
I have been reading everything I can find about how the DS is performed and all of the literature indicates that they ALWAYS removed the gall bladder and appendix simply (so it seems to me anyway) to make room while the surgeon is in there rearranging things. Have any DS'rs kept one or both of these organs? Is the removal of one or both simply for the purpose of making room from the surgeon? Is this removal done just during open DS surgery or also during lap surgery? I'm just wondering because when I had my hysterectomy (laparoscopic) they did not mention anything about needing to remove organs in order to make room for the surgical instruments. Is it because the DS is so much more of an involved surgery? Are there risks of complications if the organs are left intact?

I hope these make sense. I am also going to ask my surgeon about it as well because seriously, if they don't absolutely have to remove them for health reasons or because they will no longer be being used by my body after the DS then I would really rather they leave them alone.

It depends on the surgeon.  Some feel that by removing these organs, it eliminates future problems.  Futrue abdominal pain can't be attributed to the gallbladder or appendix if they are removed, thus two possible sources of abdominal pain are no longer relevant.  My surgeon doesn't believe that it's worth it since it is so easy to go back in to take out an appendix or gallbladder.  I had my gallbladder taken out 8 years before my WLS, yet i still have an appendix.  They aren't that big so it's not a matter of more room, it's just surgeon preference.

Many surgeons take out the gallbladder because a lot of people suffer gallbladder problems as a result of their rapid weightloss. Some people keep their gallbladders and take Actigall to try to avoid problems, but I've even read of that not working.

Taking out the appendix is just to save time in the event of future problems. Blockages, which can be deadly if not treated promptly, are more quickly treated when other common sources of abdominal pain can be ruled out immediately.

Taking out either has nothing to do with "making more room."

I have highlighted those things that may be relevant to your situation.  I guessed at one of them.  With successful WLS, you will be adding one more risk factor to at least three or four existing risk factors.  In fact, NutriSystem got sued because people lost weight quickly and had gallbladder attacks.  (A March 1, 1996 document of the U.S. Court of Appeals, Ninth Circuit, provided by FindLaw, notes several lawsuits filed against Nutrisystem alleging gallbladder problems connected with the weight-loss programs. Related congressional hearings included testimony on the health risks of these programs, including the development of gallstones due to rapid weight loss.)

What causes gallstones?

Scientists believe cholesterol stones form when bile contains too much cholesterol, too much bilirubin, or not enough bile salts, or when the gallbladder does not empty completely or often enough. The reason these imbalances occur is not known.

The cause of pigment stones is not fully understood. The stones tend to develop in people who have liver cirrhosis, biliary tract infections, or hereditary blood disorders—such as sickle cell anemia—in which the liver makes too much bilirubin.

The mere presence of gallstones may cause more gallstones to develop. Other factors that contribute to the formation of gallstones, particularly cholesterol stones, include

• Sex. Women are twice as likely as men to develop gallstones. Excess estrogen from pregnancy, hormone replacement therapy, and birth control pills appears to increase cholesterol levels in bile and decrease gallbladder movement, which can lead to gallstones.

• Family history. Gallstones often run in families, pointing to a possible genetic link.

• Weight. A large clinical study showed that being even moderately overweight increases the risk for developing gallstones. The most likely reason is that the amount of bile salts in bile is reduced, resulting in more cholesterol. Increased cholesterol reduces gallbladder emptying. Obesity is a major risk factor for gallstones, especially in women.

• Diet. Diets high in fat and cholesterol and low in fiber increase the risk of gallstones due to increased cholesterol in the bile and reduced gallbladder emptying.

• Rapid weight loss. As the body metabolizes fat during prolonged fasting and rapid weight loss—such as “crash diets"—the liver secretes extra cholesterol into bile, which can cause gallstones. In addition, the gallbladder does not empty properly.

• Age. People older than age 60 are more likely to develop gallstones than younger people. As people age, the body tends to secrete more cholesterol into bile.

• Ethnicity. American Indians have a genetic predisposition to secrete high levels of cholesterol in bile. In fact, they have the highest rate of gallstones in the United States. The majority of American Indian men have gallstones by age 60. Among the Pima Indians of Arizona, 70 percent of women have gallstones by age 30. Mexican American men and women of all ages also have high rates of gallstones.

• Cholesterol-lowering drugs. Drugs that lower cholesterol levels in the blood actually increase the amount of cholesterol secreted into bile. In turn, the risk of gallstones increases.

• Diabetes. People with diabetes generally have high levels of fatty acids called triglycerides. These fatty acids may increase the risk of gallstones.

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digestive.niddk.nih.gov/ddiseases/pubs/gallstones/#2

always is not always, as i am one of those that didn't have them removed, and I am not the only one on the board.  it really is a surgeon preference.  I think more will remove jsut the gallbladder and leave the appendix,but again surgeon preference. 

My surgeon removes them lap.  Not to make room to do the surgery, obviously, because other surgeon's leave them.  His POV is that if they are gone it helps with diagnosis if there are future symptoms.

I was thrilled that he took them.  I'll never have to have surgery to remove them now because they are GONE.  I also didn't have to take medication for my gallbladder post op.  A lot of folks wind up having a second surgery to remove the gallbladder which I was glad was prevented.

~Becky

Many surgeons remove the appendix if they are "in the neighborhood" for other reasons.  They do it for a good reason - we don't need our appendix, and when it goes septic it can be an acute emergency, especially if you happen to be somewhere that you can't get immediate medical care.  If they are in there anyway, may as well remove it and avoid another surgery.  Bariatric surgeons in particular generally want the appendix out, because is simplifies the differential diagnosis if the patient later develops abdominal pain.

I had two prior abdominal surgeries (in addition to my C-section), and both times, my surgeons remarked to me afterwards that they had gone looking for my appendix to take it out while they were in there, but couldn't find it.  In fact, the second time, I had TWO surgeons (one general, one gyno because I had an ovarian cyst) tell me they had seen the scar from my prior appendectomy.  (I also had an ultrasound-diagnosed appendicitis in between the two surgeries, which resolved on its own.)  Well, I knew that wasn't true, and a while later, I had a barium enema (an experience I'd prefer not to repeat), and lo and behold, my appendix got a dose of barium and was outed - high up on my cecum under my liver!  I took the xrays of my appendix to my DS surgery so Rabkin could find it and remove it - it took him an extra hour and a couple of extra lap ports to get it out, but he finally did!

As for the gall bladder, it no longer has a function after the DS - gall bladders store bile made by the liver in order to give a big blast of it timed to mix with food from a big fatty meal as it is released by the pylorus.  Since our food doesn't meet up with bile until further down the line, it doesn't need to be released in a bolus with our meals.  Dribbling down the biliopancreatic limb works just fine. 

And of course, our style of eating small frequent meals doesn't require a big bolus of bile either - what that WAS good for is how we used to eat in our evolutionary past - long periods of time with NO food, and then a big fatty meal when our hunters killed a mastodon - having a bunch of bile stored to help efficiently digest an infrequent but large fatty meal was critical to absorbing the most calories from such a meal.

So, another useless organ sitting around doing nothing necessary, waiting to become septic, full of stones or a place where cancer could start.  No thanks.

Anyway, both appendix and gall bladder are better out than in, as far as I'm concerned.

Dr.Selwyn took my appendix at the same time as my DS because he said it is a useless organ and by taking it then it would rule out appendix as the problem if something came up in the future and it could save time and get to the proper diagnosis faster. He also fixed an umbilical hernia I didn't even know I had.

I had my gallbladder taken out as an emergency surgery in 2008 3 months after my first daughter was born (once again Dr. Selwyn did the surgery).

I had my gallbladder removed when I had my RNY. It was to avoid the gallbladder problems that develop when a person loses weight rapidly.

Edit: Can't spell gallbladder correctly. Sorry 'bout that.

Thanks everyone! I appreciate the answers very much and they make more sense to me than what I have been reading. I will have to double check the sites I was reading on but at least 2 for sure showed the gallbladder and appendix as removed during the surgery (http://www.dssurgery.com/procedures/duodenal-switch.php and http://www.lourdesnet.org/services/duodenal.php) stated that removal was "usual" which is where my questions arose from.
Seeing as it is to prevent further issues with either one or both organs later on down the line I can see why most surgeons would prefer to remove them.
Diana, your answer about evolutionary use really made it clearer for me. Why have it if we aren't using it? I get it now! Thank you!
Ms Cal Culator... holy geez I have all but 3 of those risk factors. Guess I will be making sure they remove my gallbladder while they are in there.