??vegas nerve and short vs long limb rny??(on main board, too)

Hello, I have never posted in this forum, only on the statewide forum. I hope that I can get a few more reponses this way. I just saw my surgeon yesterday and a date of December 8th is set for open rny. He said there are two types of rny - short limb and long limb - and that he will be doing a short limb rny. He said that since only a small portion of the intestine is re-routed, that it is really not a malabsorptive procedure. Isn't that what is necessary for long term maintainance? He said their center chose to do it that way because of complications (long term) with the long limb rny. Help - I don't want to do something that I will have to have redone or regret later in life. (I do plan on changing habits and following dietician's plans to the "t".) Also, any info on the vegas nerve? Another wls person that I talked to said his was preserved. The surgeon was vague about it. Is it something that should be preserved? Why? Any info is appreciated. Thanks in advance, Andrea

It's my understanding that on the long limb, up to 6 feet of small intestine can be bypassed- short limb, a lesser amount. Many surgeons don't like to do the long limb because of malabsorption problems. I had the long limb 5 months ago, and haven't had any problems as yet. I think you mean the vagal nerve. It has something to do with the stomach- I can't remeber any more than that. Good luck! Jeri H.

Hi Andrea! Glad to hear that your consult went well and you have a date! I'm also glad that you are really researching which option is the right one for you. None of us want to have to go through a revision in the future and I think you are right about really looking into things. I must admit that I didn't and I honestly have no idea what type of things were done to me in regards to short vs. long limb, etc. I found a couple of links for you to try. 1) This surgeon only does long-limb RNY's after his info is a list of obesityhelp members who had him as their surgeon maybe you could e-mail them? http://www.obesityhelp.com/morbidobesity/mdcomments.php?N=k37 2) Here is a link where they discuss alot of things about different surgeries including different opinions on long vs. short limb. You have to scroll down the page far enough to find the long limb RNY option where the short limb RNY is closer to the top http://www.obesitycare.com/Options.htm#rny (I just searched for long limb RNY in google to find these results) 3) The above poster is correct it is the vagal nerve and not the vegas nerve (which I thought it was the vegas nerve too) but I couldn't find much about it on the internet. Maybe you could search a little bit more? Hope this helps! Stephanie 3)

I had long limb and so far my blood tests have been good. Just have to keep up with the vitamins. The only thing I know about the vegal nerve stems from a surgical incident I had several years ago. I was having an operation to reconnect my fallopian tubes. They just got me opened up and I coded on the table. Of course they sewed me right back up, put me in ICU and did numerous tests to determine the cause but never did come up with an answer. The only clue they had was that the reaction occured after moving some of my organs around that also joggled the vegal nerve. Apparently it is a major nerve that runs down your trunk and is very sensitive when stimulated. I have had several other operations since then with no problems. I know of one woman who was opened up for RNY and they had to sew her back up before completing the operation because of the way her organs were arranged. At least that's the explanation she chose to give people- she was very depressed about it not working and would not talk about it so I don't know the whole story. I would suggest talking to your surgeon again or going to the library in your local hospital. They should have the answer.

I dont understand half of this lol.. but i thought I'd paste in what I have found while searching for the vagal nerve in gastric bypass. I think what they are saying is it is necessary for digestion..not sure. Here we go PASTING..........A vagal reaction can occur when a person has had prior stomach surgery, such as ulcer resection or gastric bypass. There are often foods that will trigger the following symptoms/chain of events, especially eating concentrated sweets: After eating, pt. will experience severe nausea, may vomit, will feel cold and sweaty/clammy, will become pale. This can cause irregular heartbeat, since vagal nerve runs thru entire body from esophagus to rectum. I myself experience it due to prior stomach surgeries. Some people can relieve the symptoms by vomiting, but not all. It can last from a few minutes to an hour or so. It usually (for stomach surgery people) culminates in diarrhea and then the worst of the symptoms subside. Vasovagal reactions occur for many reasons. Pale, sweating, nausea, vomiting, low pulse and drop in blood pressure. Fainting is a vasovagal reaction. The vagus nerve is one of the longest nerves in the body. It is the tenth cranial nerve that extends from the base of the brain to the abdomen. To help relive symptoms, the person should lie flat with legs elevated. ---------------------------------------------------------------------------- Abstracts 2002 Digestive Disease Week # 108460 Abstract ID: 108460 Vagal Nerve Division during Gastric Pouch Creation May Improve Outcome Sayeed Ikramuddin, Giselle Hamad, John M Glas**** George Eid, Philip Schauer, Minneapolis, MN; Pittsburgh, PA ========= While performing a laparoscopic Roux-en-Y gastric bypass, division of the nerves of Laterjet often occurs during formation of the gastric pouch. This can be avoided by performing the more technically challenging lesser curvature dissection. We attempt to compare the gastrointestinal sequelae of these two approaches. Charts of those patients undergoing a laparoscopic Roux-en-Y gastric bypass at the University of Pittsburgh Health System between June 1999 and February 2001 were reviewed . All patients had a GIA stapled anastomosis over a 30 - 34 French stent. The Roux limb was varied according to body mass index (BMI). Group A underwent pouch creation with lesser curvature dissection using the harmonic scalpel. Group B underwent pouch creation with direct entry into the lesser sac with incision of the gastrohepatic ligament. 175 Patients were identified, 91 patients in group A, 84 patients in Group B. BMI was slightly higher in Group B (44 versus 41). (P=

Thank you for all of your replies!!! Andrea