While I don't have a longer common channel (mine is 85 cm), I would advise you to join Facebook DS support groups if you haven't already to get more anecdotal testimonies before proceeding. Can you succeed with a longer CC? Yes. Will it be better than a sleeve? Yes. However, based on what I've seen, I'd say the discrepancy between long term regain and maintenance with a longer CC (200 or longer) versus shorter CC (100 or less) is a bit more serious than what you seem to believe. From what ive seen, there are many more people struggling to lose all their excess weight and prevent regain than their are people struggling with malnutrition.

As far as protein is concerned, your bougie size will play a role in this as well.

If anything, standard DS (100 cm CC) has some regain due to that measurement not being short *enough*. Dr Keshishian, one of the leading DS surgeons in the world, wrote an article on the Hess method and how it's still the best option when customizing CC lengths. The majority of his patients (around 75% I believe) are given a 75 cm CC. Some even shorter!

Diligence would be required while monitoring your blood work regardless of CC length, and you'd likely have to fine-tune your vitamin regimen to your individual needs.

Granted, a 37 bmi is on the shorter end for obesity and DS surgery. At the end its your body, and you have to do what's best for you, but I figured I'd offer a perspective that swings more toward the other side of the spectrum.

Best of luck my friend.

Definitely DS. At that weight it's extremely unlikely he'll be able to sustain the weight loss with any other surgery. I also recommend that he gets a shorter CC, which will make weight loss and maintenance even easier. Where are you located? A couple of good surgeons I reccomend are Dr Keshishian in California or Dr Elariny in Virginia.

As far as drinking is concerned, yes, I reccomend that the issue is addressed before proceeding with the operation. The rapid weight loss is hard on people's livers, and the last thing someone needs is alcohol to stress out the liver even further.

How bad is the drinking issue?

Actually...the real horror stories are those with really short common channels. I've read about it here on this site.

Such as malnutrition, muscle wasting, bone lose etc.... Many people have had to have their common channel lengthened. You'll be thin...but ill and wasting away. Goal should be healthy. I had a lot of concerns about that, and possible regain. After much discussion with my Dr. I'm going with a common channel of 200Cm. Granted my starting BMI is 37.....but I don't want the nutritional deficiencies, and I don't want to be ****ting my pants 5 times a day and nasty gas...lol.

Before surgery you're adsorbing through about 600+CM of small intestine. Going to 200 is pretty good for my situation, considering my BMI and I was contemplating just VSG. Talk with your Dr. Best of luck!

Ahh, that would do it. I hear this procedure is not widely covered, yet. It was one of the questions I'd specifically asked my health insurance case manager since it wasn't listed as covered in our benefits. I called it modified switch and she said yes. Everything else has been through my surgery clinic and them, so guess I'm lucky there. My practice still calls it the DS and I'm always particular about calling it out, just in case.

If you weren't able to go with loop switch, I'd say a 200cm common channel is amazing for the traditional version as a compromise. If your surgeon is able to make that adjustment, good for you! You know yourself better than they do. I'd think that since the results of the loop switch are so similar to the DS with an even longer channel, that could be an indicator that you'll still get great results with the benefit of less potential issues.

Yes, I've read about some people who want the shortest channel possible and I know everyone's cir****tances are different but...too many possible side effects. Like you said, spending your life in the bathroom wouldn't be fun. And the protein, vitamin, and mineral deficiencies are so much more common the shorter you go. We're already playing on hard mode...personally wouldn't want to add that in.

And thanks! I'm super nervous but this is long overdue. Best of luck on your journey, and congratulations on finding a surgeon who will work with you! Cheers.

Hi there!

I'm still pre op but will be getting the SADI/SIPS/loop switch in a week. My pre op appointment is Monday, and I'll get to ask more questions there.

However, my manual says this clinic measures out 300cm, so I'm assuming that means I'll have a common channel of that length. Since half the point of the loop switch is a longer common channel to stave off the deficiencies that were much more common with the traditional DS, this makes sense to me.

I'm with you - super worried about the possibility of deficiencies across the board. That, and the fewer complications, are a couple of the reasons I opted for the loop switch over the traditional DS.

Guess I'll know more on Monday. Happy to talk about this, though! Cheers!