Question:
Has anyone ever had additional sm. intestine bypassed.

I read on the AMOS site about a post-op patient who had stopped losing weight and her surgeon said that he would need to operate again and bypass more of her sm. intestine because she had a over-efficient sm. intestine. I was wondering if anyone knew what this was called and what the requirements are for this surgery?    — vmize (posted on December 6, 2003)

December 6, 2003
Hello, I just had surgery on November 24, 03 in Richmond, VA for a revision from a gastric bypass to a extended distal bypass. My original gastric bypass done in July of 2000 had not been too successful for me. It seemed I had no pouch function. I could always eat alot and complained to my surgeon each time I visited him. Over the years since this was the most frustrating and depressing period of my life. I had had 5 ft. of intestines bypassed with this operation and the malabsorption for this worked however because I had no pouch function and could eat amounts of food like I had before it was practically impossible to lose wieght. Contrary to what many people believe when they read all about the Al Rokers and the Carnie Wilson's, the gastric bypass while a wonderful surgery and tool does not work for everyone and there are stories of failure. Mine being one of them. My surgeon performed a surgery on me on Nov. 24, where in he went back in, another open surgery and moved the connection on my intestines extremely distal to within 3 ft. He also removed my appendix while he was in there. Anyway at this point, not quite two weeks post-op, I am doing well, I have lost about 5 pds and am just beginning to get out walking and feeling good again. I will be able to eat about anything I want however my smartest move will be to make intelligent food choices in choosing the highest protien foods. My body will not absorb hardly any calories or nutrients from the foods I eat so I need to concentrate on high protien foods and getting my supplements in. I also need to take my vitamins daily and will even have to add a couple to the slew of them I already take. I could suffer malnutrition if I am non-compliant to this. I have learned a lot. My struggle has not been easy. I am hopeing this will make the difference in my life. I would advise you to discuss this extended distal procedure with your surgeon or ask others in the site here to give you thier story. I am also intrested in hearing from others who have had to undergo this extreme procedure. [email protected]
   — Sarah B.

December 6, 2003
I live with an extreme distal, but it was my original issue type. (I had a revision due to staple line disruption, but the type of surgery didn't change). I have brought about a dozen people here (from all over the country) to have revisions with my surgeon. He will do distals if he is satisfied that you understand the consequences (good and bad). Some have been revised because their surgery was "broken" for one reason or another, but all have been revised more distally, as well. ALL of my revisions so far are down to normal body wts. Although they tend to lose more slowly, one who was 18 yrs out from a shorty proximal lost 147 lbs by 1 yr. She was pouting cuz she didn't make 150! She lost more than she had with her original surgery. 2 had bad pouches he could not repair, so they didn't have as much of a tool, and lost very slowly, but they both HAVE lost all their wt now and are maintaining with reasonable (not super human) effort. I have seen people start with a shorty proximal, then go just a bit longer toward distal and stop gaining, but also not lose more. There is a magic number in there somewhere, and I certainly don't know what it is. You really have to look around and ask, ask, ask before you jump on another table. It has to be distal enough to work, not so distal as to not be ABLE to be supplemented nutritionally.
   — vitalady

December 7, 2003
I have mainly heard of it being done when a revision is required for whatever reason. Like Michelle said it is critical that the person is committed to the post-op requirements of a very distal surgery, otherwise they will spend a lifetime with maybe worse medical problems than before WLS. I pray that my 150cm bypass keeps working well for me as I would not want to go to a common channel type surgery.
   — zoedogcbr