Best pouch size and bypass length for RNY?
I had my first surgical consult today -- thanks to this site, I had a bunch of questions! Two of the issues I was most curious about were how large my pouch will be and how much of my small intestine will be bypassed. My surgeon said that he bypasses 90cm for people my weight (BMI 42), 120cm for heavier folks, and 150cm for supers. He said he "wouldn't do 200cm on anybody." I asked him if he would consider 120cm for me, and he said okay. That it would increase my risk for nutritional deficiencies and diarrhea, but only slightly. He also told me that he usually makes his pouches 35 to 40cc. I asked him if mine could be smaller -- 15cc. He said that he believes pouches that small greatly increase a patient's food intolerances without significantly enhancing weight loss or sustainability. He didn't outright say no, but seemed pretty reluctant. Should I push this issue? How important is pouch size? I'm tempted to really lobby for the 15cc pouch and 150cm bypass -- I want to give myself the best chance possible for long-term success. I'd love to hear opinions from people who have read a lot about these issues and/or have opinions based on their personal experiences. Thanks!
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