How much did you have bypassed?

I just found out I had 200 cm bypassed. Over 50ers--- read this and see what you think, 'k? How much did YOU have bypassed? ___________________________________________________

Document title

Effect of standard vs extended Roux limb length on weight loss outcomes after laparoscopic Roux-en-Y gastric bypass

Auteur(s) / Author(s)

FENG J. J. ⁽¹⁾ ; GAGNER M. ⁽¹⁾ ; POMP A. ⁽¹⁾ ; KORGAONKAR N. M. ⁽¹⁾ ; JACOB B. P. ⁽¹⁾ ; CHU C. A. ⁽¹⁾ ; VOELLINGER D. C. ⁽¹⁾ ; QUINN T. ⁽¹⁾ ; HERRON D. M. ⁽¹⁾ ; INABNET W. B. ⁽¹⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Minimally Invasive Surgery Center, Department of Surgery, Mount Sinai Medical Center, One Gustave L. Levy Place, Box 1103, 5 East 98th Street, New York, NY 10029-6574, ETATS-UNIS

Résumé / Abstract

Background: Increasing the length of the Roux limb in open Roux-en-Y gastric bypass (RYGB) effectively increases excess weight loss in superobese patients with a body mass index (BMI) >50 kg/m[2]. Extending the RYGB limb length for obese patients with a BMI < 50 could produce similar results. The purpose of this study was to compare the outcomes of superobese patients undergoing laparoscopic RYGB with standard (≤100-cm) with those undergoing the procedure with an extended (150-cm) Roux limb length over 1-year period of follow-up. Methods: Retrospective data over 2.5 years were reviewed to identify patients with a BMI < 50 who underwent primary laparoscopic RYGB with 1-year follow-up (n = 58). Forty-five patients (sRYGB group) received limb lengths ≤100 cm, including 45 cm (n = 1), 50 cm (n = 2), 60 cm (n = 6), 65 cm (n = 1), 70 cm (n = 1), 75 cm (n = 3), and 100 cm (n = 31). Thirteen patients (eRYGB group) received 150-cm limbs. Postoperative weight loss was compared at 3 weeks, 3 months, 6 months, and I year. Results: Comparing the sRYGB vs the eRYGB group (average ± SD), respectively: There were no significant differences in age (41.5 ± 11.0 vs 38.0 ± 11.9 years), preoperative weight (119.2 ± 11.9 vs 127.8 ± 12.5 kg), BMI (43.7 ± 3.0 vs 45.2 ± 3.5 kg/m[2]), operative time (167.1 ± 72.7 vs 156.5 ± 62.4 min), estimated blood loss (129.9 ± 101.1 vs 166.8 ± 127.3 cc), or length of stay (median, 3 vs 3 days; range, 2-18 vs 3-19). Body weight decreased over time in both groups, except in the sRYGB group between 3 and 6 months and 6 and 12 months after surgery and in the eRYGB group between 6 and 12 months. BMI also decreased over time, except in the eRYGB group between 6 and 12 months. Absolute weight loss leveled out between 6 and 12 months in both groups, with no increase after 6 months. Percent of excess weight loss did not increase in the eRYGB group after 6 months. An extended Roux limb did not significantly affect body weight, BMI, absolute weight loss, or precent of excess weight loss at any time point when the two groups were compared. A trend toward an increased proportion of patients with >50% excess weight loss (p = 0.07) was observed in the extended Roux limb group. Conclusions; In this series, no difference in weight loss outcome variables were observed up to 1 year after laparoscopic RYGB. Thus, extending Roux limb length from ≤100 cm to 150 cm did not significantly improve weight loss outcome in patients with a BMI <50 kg/m[2]. _____________________________________ Interesting points to ponder: 1) I purposely attempted to lower my post-operative risk by losing from a near 62 BMI to a BMI of 50 on my surgery day (ARE YOU LISTENIN', Lithia?) However-- my surgeon still elected to bypass the greater amount. I had been SMO (over 300 pounds) for no less than 18 years, so I can see what the guy was thinking. 2) According to this study-- while increasing the length of the roux limb in SMO (>50) patients may correlate with greater post-operative loss, no such correlation can be made in patients with a BMI of 50 or less. 3) So... basically what I am saying here is that I had a "bigger bypass" for what may be no good reason, since I was sitting right at the BMI of 50 on my surgery day. And this "bigger bypass" may account for many of my post operative problems, pain and dietary issues.                                                         OR Maybe it does somehow "help" and the guy did me a favor. What do you think?

I asked my surgeon while I was in the hospital, and he didn't give me a straight answer.  He said "it was about average, between 100-150, closer to 150.  Kind of vague, he probably didn't remember. 

I asked at my 3 month check up and doc said that it was not a short limb it was "normal" I will ask what length when I go again.  It should probably be discussed before surgery though.  Thanks for posting this for the preop ones  Estelle

Funny you should bring this up.  I was just looking at info about this.  I plan to ask my surgeon to do the same, the distal RYGB rather than the proximal rygb Apparently the distal one involves bypassing more length of intestine, while the proximal one is a bit shorter and they determine the length by the BMI.  From what I've read, over 50 BMIers do better long term with the distal bypass.  It sounds like your surgeon was going with this thought, that you have a better chance of losing all the weight and keeping it off.  At least that's how I see it.  I hope to lose 100% of my excess weight, not just some, but all.  I hope you enjoy success and hope to hear from you again soon.  Thanks for posting the research article with source. Now that I've read it I am seeing that it is not saying there is a better chance at weight loss.  This is disturbing so I will look into this some more. 

Hi. I am a DS'er and my common channel is probably on the shorter side of 100cm in total length.

The 200cm I referenced in my original post is the length of the roux limb, and not the common channel.