Question:
Does every cm bypassed count?

I am trying to choose between two surgeons. Both will perform the Lap RNY Proximal bypass (my bmi is 43). One typically bypasses 75cm (he is close to home) the other 100cm (I will have to travel). I am thinking about the longterm effects and wether or not 75cm is enough to bypass without weight regain (malabsorption being the benefit to some extent). I do plan to follow the program however, every cm counts...right?    — Teri F. (posted on January 29, 2004)

January 29, 2004
There are many post-ops with just 75cm bypassed that do very well losing weight and maintaining -others with much more bypassed that do not do as well. Its more how you stick to the post-op program. I had 110 bypassed and a good friend of mine had 75 bypassed. It took me 14 months to get to within 5 pounds of goal(-100)-it took her 9 months to get to her goal and at a year post-op she was under goal(-130+). And at 20 months, she is nicely maintaining. I think the less bypassed the better as the more bypassed, the less absorbtion of the good stuff, like vitamins and minerals essential for long term good health. There are no studies out there of long term post-ops with different lengths bypassed, we're all the guinea pigs of the future, so it makes more sense to me to have a better shot at long term health (if I do my part by taking vitamins etc) with less bypassed. Although there is some malabsorbtion of fats and calories initially, our systems eventually adjust to food and compensate somehow the further out we get though they never catch up with the vitamin and minerals. My opinion..hope I made some sense...
   — Cindy R.

January 29, 2004
There are many post-ops with just 75cm bypassed that do very well losing weight and maintaining -others with much more bypassed that do not do as well. Its more how you stick to the post-op program. I had 110 bypassed and a good friend of mine had 75 bypassed. It took me 14 months to get to within 5 pounds of goal(-100)-it took her 9 months to get to her goal and at a year post-op she was under goal(-130+). And at 20 months, she is nicely maintaining. I think the less bypassed the better as the more bypassed, the less absorbtion of the good stuff, like vitamins and minerals essential for long term good health. There are no studies out there of long term post-ops with different lengths bypassed, we're all the guinea pigs of the future, so it makes more sense to me to have a better shot at long term health (if I do my part by taking vitamins etc) with less bypassed. Although there is some malabsorbtion of fats and calories initially, our systems eventually adjust to food and compensate somehow the further out we get though they never catch up with the vitamin and minerals. My opinion..hope I made some sense...I think in choosing a surgeon I would look more to his surgical record, skills, and after care support program than the length bypassed. Have you asked each surgeon why they chose the length they bypass and not more or less?
   — Cindy R.

January 29, 2004
The intestine is an amazingly redundant organ-- the receptors contained in it that absorb nutrients and calories are repeated throughout it. Therefore, the amount needed to be bypassed to gain an appreciable malabsorption effect is significant and the differences between the 100 and 75 would be minor in this regard. The other issue is that, if you genuinely feel that you need the greater amount bypassed because of eating habits that you do not think you will be able to successfully overcome, consider the DS/BPD surgeries which have the greatest amount of intestine bypassed and the most significant long-term weight loss. All things considered, however, I wouldn't sweat the amount bypassed and would choose the surgeon who had the best, most integrated long-term care system for his/her patients. Good luck.
   — SteveColarossi