Question:
Anyone heard of taking all but 2 ft of small intestine for revision?

I had my surgery 7/23/02. I have lost 85 pounds and no more will come off. I have followed the program so that is not the problem. All of my labs show I have extremely efficient small intestine at absorbing calories and nutrients. My doctor made my limb at 100 cm with a BMI of 64.9. She did not see I had gained 47 pounds before my surgery due to CHF and sleep apnea. She based the 100cm limb on a BMI of 56. She told me yesterday she needs to go in and make the Roux limb much, much longer. She also wants to take my small intestines down to 2 feet. I am now at 12 feet. The small intestines limit of being able to sustain you is 2 feet. This will cause me to have diarrhea 3-6 times per day. Has anyone heard of only leaving a bariatric patient with 2 feet of small intestine? I will definitely lose the rest of my weight, but what kind of quality of life will I have? I could use any help &/or advice anyone can give me. Thanks!    — amytravis (posted on August 8, 2003)

August 8, 2003
Do you mean remove the intestine?? I would never consider that! A better choice for you might be revision to a DS. It would restore your stomach to normal function and lengthen the amount of intestine bypassed, allowing you to lose much more but eat and live like a normal person. You would need a DS surgeon who has experience doing revisions, and only he or she could determine whether it is possible in your case. You can go to http://duodenalswitch.com to get more info. Feel free to email me; since you have no profile I can't email you. I'm sorry your surgery hasn't worked out for you, but there may be hope!
   — Chris T.

August 8, 2003
I would think long and hard about allowing them to bypass all but 2 feet of intestine. Diarrhea isn't the only negative side effect. You will have severe problems with malnourishment. I have an enlarged stoma, and my surgeon told me the only thing he could suggest to help with losing more weight was to bypass more intestine (he had bypassed 150 cm) but he strongly did not recommend it. He told me there were severe risks to my health in doing that and that the clear majority of his revisions where to correct a situation where too much intestine had been bypassed. It is definately worth getting a second opinion from another bariatric surgeon on this. Bypassing more intestine may be the solution to your problem, but the real question has to be: how much is enough and is still safe?
   — Cyndie K.

August 8, 2003
Amy, This may not be what you want to hear but run as fast as you can as far away from this surgeon as possible. She does not know what she is doing. You are already bypassed way more than the 100cm she told you. The actual length the small intestine is proportional to your height but the average is 20'. The 100cm bypass she told you she did is equal to 3-1/3 ft. So based on her telling you that you still have 12' of small intestine that would mean you had 15' before surgery. This is not impossible but is quite a bit less than what is usually found. <p>Why does she feel the need to go so drastic? To cover her butt that it will work this time? Why can't she just length it to a total of 5' like most SMO have done? Or maybe even 6' total. which would still leave 9' of small intestine, assuming her numbers are right to begin with. You really must get a second opinion from another WLS surgeon, even if you must pay for it. Someone who can look at that surgery report and try and figure out what the whole truth is here. It just seems like she's not telling you something. You also had mentioned that she has never believed you that you are following the plan etc. I think she still feels that way and is going to go way overboard to "assure" you comply. But in the process she may end up making you very sick. Having an RNY with everything but 2' bypassed means you will live on multiple protein drinks the rest of your life - no question! You will NEVER be able to get in adequate protein and calories to support this huge bypass with your small pouch. I know of one other woman who has an RNY and is bypassed this much and she must drink 6 protein drinks a day in addition to what she can eat to stay nourished. What kind of like is that! You also do not have a normal functioning stomach like a DS has so you will have major malabsorption of vitamins etc. <p>This is just too drastic for someone who started at your weight. It should not take a DS type bypass to lose from the high 300's into the 100's. Something just does not make sense and I think it is something the surgeon did and isn't confessing too.
   — zoedogcbr