Noob question - bilopancreatic limb length
5'9.5" | HW: 368 | SW: 353 | CW: 155 +/- 5 lbs | Angel to 
NoMore B.
on 12/1/10 7:52 am
on 12/1/10 7:52 am
Hi Dana
Welcome! Have you been to the DS Facts website?
www.dsfacts.com
The GENERAL rule of thumb is:
Longer common channel = less malabsorption, ie less weight loss, and less risk of nutritional complications.
Shorter common channel = more weight loss, higher potential for issues
But this is so subjective.
1. People have varying starting lengths of their intestines, which is why many surgeons favor the "Hess" method, which uses a percentage of total small bowel length to determine limb lengths. A 50CM common channel on someone whose normal bowel length is 500CM is different than someone who started at 800CM, for example.
2. The 50-150CM common channel, or even up to 200CM ,is the norm for most surgeons, with about 100CM being average. Considering the normal length of intestines can be 600CM+, the differential is not that big between common channel lengths as one would think. A 25CM difference is not a lot compared to the overall length of bypassed intestines.
3. Each surgeon measures differently. Dr K has a good explanation of this on his website, where he makes an analogy to a coiled up phone cord. Some pull more tightly to measure and others measure loosely.
4. The size of the common channel also works in conjunction with stomach size and other limb size to determine the "configuration" of your DS. Some people have longer common channels and smaller stomachs to offest it, for example.
5. There is a study out there that shows common channel length is more important in the super morbidy obese, and less so in the mobidly obese.
6. I said the above is a GENERAL rule because in the year or more I've been here I have seen more exceptions I think than the rule. Some people with long common channels do wonderfully, and some with short never make it to goal. What you eat, your level of activity, and also how your own individual body adapts to the malabsorption all plays a role.
Hope that helps some.
Another thing that may be confusing is that with the DS the lengths discussed with the common channel refer to the area where most absorption takes place. With the RNY the length most often discussed (ie 150CM) refers to the amount of small intestines bypassed - the opposite.
Welcome! Have you been to the DS Facts website?
www.dsfacts.com
The GENERAL rule of thumb is:
Longer common channel = less malabsorption, ie less weight loss, and less risk of nutritional complications.
Shorter common channel = more weight loss, higher potential for issues
But this is so subjective.
1. People have varying starting lengths of their intestines, which is why many surgeons favor the "Hess" method, which uses a percentage of total small bowel length to determine limb lengths. A 50CM common channel on someone whose normal bowel length is 500CM is different than someone who started at 800CM, for example.
2. The 50-150CM common channel, or even up to 200CM ,is the norm for most surgeons, with about 100CM being average. Considering the normal length of intestines can be 600CM+, the differential is not that big between common channel lengths as one would think. A 25CM difference is not a lot compared to the overall length of bypassed intestines.
3. Each surgeon measures differently. Dr K has a good explanation of this on his website, where he makes an analogy to a coiled up phone cord. Some pull more tightly to measure and others measure loosely.
4. The size of the common channel also works in conjunction with stomach size and other limb size to determine the "configuration" of your DS. Some people have longer common channels and smaller stomachs to offest it, for example.
5. There is a study out there that shows common channel length is more important in the super morbidy obese, and less so in the mobidly obese.
6. I said the above is a GENERAL rule because in the year or more I've been here I have seen more exceptions I think than the rule. Some people with long common channels do wonderfully, and some with short never make it to goal. What you eat, your level of activity, and also how your own individual body adapts to the malabsorption all plays a role.
Hope that helps some.
Another thing that may be confusing is that with the DS the lengths discussed with the common channel refer to the area where most absorption takes place. With the RNY the length most often discussed (ie 150CM) refers to the amount of small intestines bypassed - the opposite.
the length is really a determination your doctor will make based upon YOU,,,your need to loose, amount, and also what length you small intestine is to begin with,,,,each individual can have a different length .
my example,,,Im a light weight, my bowel was 535 cc long,(SOME ARE ONLY 200) SO Dr A bypassed 300 cc and gave me a 200 cc common channel, I also have a larger than most vsg. due to other surgical requirement.
I have already lost 50% of my goal. 20 days Joanna is right on the money,
my example,,,Im a light weight, my bowel was 535 cc long,(SOME ARE ONLY 200) SO Dr A bypassed 300 cc and gave me a 200 cc common channel, I also have a larger than most vsg. due to other surgical requirement.
I have already lost 50% of my goal. 20 days Joanna is right on the money,
Hi Dana,
Welcome to the DS board! You asked a great question and I wanted to ask your permission to add your post to a continuing thread for pre-ops. The link to this thread is in my sig line. Let me know if I can link this up to help others; it's very informative and explained in a simple way so it will be easier to understand. Thanks!
Welcome to the DS board! You asked a great question and I wanted to ask your permission to add your post to a continuing thread for pre-ops. The link to this thread is in my sig line. Let me know if I can link this up to help others; it's very informative and explained in a simple way so it will be easier to understand. Thanks!
The doctor I had uses the Hess method, but I asked him to be agressive with me since I was a revision from an ENRY and had metabolic weight loss resistance. My common channel is 50cm and I have a 2.5 ounce stomach. I did have a lot of post op complications and have been on enteral or IV nutrtion for a total of year. Most of my weight loss has occured during the periods where I have not been on IV nutriton (TPN). I am currently on TPN 3 days a week, and am slowly losing weight again. I have 35 more pounds to go to get to my surgeons goal weight and 25 pounds to go to get to my goal weight. My hope is by next August to be at one of those goal weights or even a little below it.
Warmly,
Maddie
HW (pre RNY) 430 / HW (pre DS) 302 / SW 288 /
Lowest weight 157 / CW 161 / GW 150
"I'm just one stomach flu away from my goal weight"
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